Bioidentical Hormone Replacement Therapy vs. Synthetic Hormones

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It is the utmost importance for women to understand that they have alternatives to Premarin and Provera that are scientifically shown to be safer and healthier. Below are the facts to support this statement on the benefits of bioidentical hormone replacement therapy.

Fact #1: Cardiovascular Health

Natural hormone therapy maintains and augments the cardioprotective effects of estrogen and decreases the risk of heart attack and stroke. A number of medical studies have shown that coronary artery spasm, which increases the risk of heart attack and stroke, can be reduced with estrogen and progesterone. On the other hand, the addition of Medroxyprogesterone acetate (MPA), a synthetic variant of the steroid hormone progesterone and marketed as Provera, to estrogen has the opposite effect and results in vasoconstriction, increasing the risk of heart attack and stroke in postmenopausal women.

In addition, MPA increases the amount of collagen in vascular plaques, which promotes thrombus (blood clot) formation. MPA also increases the progression of coronary artery arteriosclerosis, accelerates low-density lipoprotein uptake in plaque and promotes insulin resistance and its consequent hyperglycemia.

Studies have shown that the estrogen and progesterone combination resulted in a 50% reduction in athrosclerotic plaque in the coronary arteries. This effect was independent of changes in lipid concentrations.

Fact #2: Cholesterol

In the large PEPI trial, 875 postmenopausal women were randomized to receive either placebo, Premarin, Premarin and Provera, or Premarin and natural Progesterone. This study demonstrates the superior effect of natural progesterone over Provera. HDL cholesterol was increased by 9% when estrogen and natural progesterone were used versus just a 3-4% increase with estrogen and Provera.

Based on the results from the PEPI Trial and other studies the President of the American Heart Association stated that, just based on this difference in the effects on HDL, a woman who changes her medication from MPA to natural progesterone would significantly lower her risk for heart disease.

Fact #3: Insulin Resistance

MPA and synthetic progestins are also shown to significantly increase, even double the amount of insulin resistance and Type II diabetes when compared to estrogen alone or estrogen and progesterone. Treatment with combined estrogen and progestin medication impairs glucose tolerance in some patients.

Fact #4: Breast Cancer

The Nurses Health Study followed 58,000 postmenopausal women for 16 years (725,000 person-years). The study found that, compared with women who never used hormones, use of unopposed postmenopausal estrogen from ages 50 to 60 years increased the risk of breast cancer to age 70 by 23%. The addition of a progestin to the estrogen replacement resulted in a tripling of the risk of breast cancer. Again, natural progesterone is documented to reduce the risk of breast cancer.

Premarin is made from pregnant horses’ urine, hence its name Pre (pregnant)-mar (horse)- in (urine). It consists of a combination of conjugated equine (horse) estrogens that are more potent and more carcinogenic than other natural estrogens such as estradiol and especially estriol. 4-hydroxyequilenin, a component of Premarin, is especially potent, 100 times the potency of natural estrogen, and carcinogenic, through the formation of variety of DNA lesions in vivo.

Natural estrogens have no such carcinogenic metabolites. The natural estrogen, estriol, is shown to cause much less breast cell proliferation and is felt to be a much safer form of estrogen than even estradiol and especially Premarin. The levels of estriol in women are inversely correlated with the risk of breast cancer, with low levels being associated with cancer, while high levels are protective.

There has been considerable research in estrogen metabolism and its relation to breast cancer. Estradiol can be metabolized to either a potent carcinogenic compound, 16- hydroxyestrone, or to a noncarcinogenic compound, 2-hydroxyestrone. Women who metabolize estradiol to 16-hydroxyestrone have a significantly increased risk for breast cancer, and it is being realized that these metabolites likely play a major role in the incidence of breast cancer.

A study conducted at Johns Hopkins demonstrated the profound anti-breast cancer action and protective role of natural progesterone. In this study, 1083 women who had been evaluated and treated for infertility were followed for 13 to 33 years. The results showed that the risk of breast cancer was 5.4 times higher in subjects who had a low progesterone level when compared to those with a normal level. Additionally, women in the low progesterone group experienced 10 times more deaths from neoplasm (cancer) when compared to those with normal progesterone.

Fact #5: Side Effects

The overall side effects are definitely not to be ignored in the case of synthetic hormonal therapy! The use of progesterone-like hormones (progestins) is associated with a number of potential adverse reactions, including bleeding, amenorrhea, and at higher doses, somnolence. They may also attenuate the beneficial lipid and cardioprotective effects of concomitantly administered estrogen. Because of the potential adverse reactions, careful medical oversight is required if the synthetic progestins are to be used during the first trimester of pregnancy or by patients with diabetes, hyperlipidemia, or hypertension.

Premarin, being an oral estrogen, will increase clotting factors, inflammatory proteins, the risk of thromboembolism, stroke and heart attack. This does not occur with transdermal estrogens. When oral Premarin is taken with Provera the risk of thromboembolism, stroke and heart attack increase in a synergistic manner.

Fact #6: Safety

Bioidentical hormones are a safe alternative to Premarin and Provera. The natural bio-identical hormones are very different from their synthetic versions, often having completely opposite physical and cellular effects. The word “bioidentical” means that a substance is biologically identical to one made by your body. For example, the molecules that make up bioidentical progesterone are shaped exactly like your own progesterone.

Studies revealed that bioidentical progesterone does not have a negative effect on blood lipids or vasculature as do many synthetic progestins, and may carry less risk with respect to breast cancer incidence. Studies of both bioidentical estrogens and progesterone revealed a reduced risk of blood clots compared to non-bioidentical preparations.

Fact #7: Efficiency

Bioidentical hormone preparations have demonstrated effectiveness in addressing menopausal symptoms and other hormonal imbalances.

Medical studies confirm that women report improved satisfaction when they are changed from MPA to progesterone and have an improved quality of life. The medical studies also show that therapy with bio-identical hormones is safer and far superior to Premarin and Provera with better outcomes and fewer risks and side effects. These are very important considerations when choosing the best hormonal therapy for a better health and life.