Journal / Hormone Replacement Therapy

What are Bioidentical Hormones?

Medically reviewed by Nancy L. Belcher Ph.D, MPA

Written by Winona Editorial Team

Last updated October 14, 2021

Bioidentical Hormones

When women, and even health experts, google ‘hormone therapy’ they will still see the antiquated results of the Women’s Health Initiative (WHI) study. The WHI was a unique effort to look at women’s health as they age, however, the misinformed results of the WHI from 2002 (started in the 1990s) stated that hormone users may have a slightly elevated risk of breast cancer, heart disease, stroke, and blood clots. The research was wrong. 

Though the WHI study results have been corrected (and reversed), many women and their clinicians concluded that they had to stop using hormone therapy.1 

Sadly, most of those women’s hot flashes, insomnia, night sweats, weight gain, bone loss, anxiety, and other menopausal symptoms returned with a vengeance.1 Additionally, the inaccurate WHI conclusions scared two generations of women away from using safe, effective, and regulated medications to prevent suffering and long-term health issues. They are suffering unnecessarily. 

Hormone therapy is still considered the most effective treatment for symptoms of menopause, but women are still frightened off and not rushing to try hormone replacement therapy (HRT).1 A major concern for health experts is that women are turning to ‘natural’ alternatives like herbs and tinctures that they think are safer — but may not be. They may actually be quite harmful.1 The term ‘natural’ for some companies that are selling herbal products is a euphemism for ‘unregulated.’ The term “natural” is open to interpretation.

What Does it Mean to Be Natural?

A great sales and marketing option is to use the word ‘natural,’ but what does it mean to be natural? Any product that has an animal, plant, or mineral source is technically ‘natural.’ 

White snakeroot is a beautiful herb with small white flowers. It is so lethal that it not only can kill you by eating it but if you are like poor Nancy Hanks, you could be poisoned by simply drinking the milk of a cow who had grazed on the plant. Nancy was Abraham Lincoln’s mother.

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What is a natural hormone?

It doesn’t matter whether the substance is ground, put into capsules, sold over the counter,  combined with other ingredients in a laboratory, manufactured by a pharmaceutical company, or made available by prescription, it can be called ‘natural’ if it comes from animal, plant or mineral. But is it regulated? Is it safe? Many are not. Ours are. 

For example, most people would say a yam is ‘natural.’ We make estrogen treatments for women to ease menopausal symptoms from yams. Products have undergone extensive testing and quality control. The open hormone marketplace is mixed with well-tested bioidentical hormones (like ours) and ones where the risks of use are known (black cohosh can cause liver damage), and those that have unknown risks.

Another example, other companies make supplements from soy and sell them over the counter (without a prescription). Soy is natural but these supplements aren’t regulated and haven’t been rigorously tested in humans, so we don’t know whether they’re safe or even effective. If anything, they are not likely as safe as people hope. There is well-documented evidence that certain soy components may actually stimulate breast tumor growth. So “natural” doesn’t necessarily equal “safe” — and may mean “unregulated.”

Every day we at Winona hear from women who are looking for something to relieve hot flashes, night sweats, anxiety, weight gain, and vaginal dryness. They hesitate to take hormones because they heard about the WHI study,  or others don’t want to take medications for symptoms because they think it might imply that menopause is a disease rather than simply a process of aging.

Winona doesn’t treat peri- and menopause as a disease, but we do want to treat the symptoms of menopause effectively, safely, and efficiently so women can get back to living their best lives.

In Search of “Natural” aka “Bioidentical” Hormones

The interest in finding a more ‘natural approach to provide hormone replacement therapy  (HRT) shifted researchers’ attention to bioidentical hormones. Bioidentical hormones are identical in molecular structure to the hormones women make in their bodies, unlike the hormones used in the WHI study so many decades ago. 

Bioidentical hormones are made from a plant chemical extracted from yams. These hormones then go through another process in the lab called micronization. ‘Micronized’ means that they are just finely ground in the laboratory for better absorption in the body, and less medication can be used. 

Bioidentical hormone therapy is often called “natural hormone therapy” because bioidentical hormones act in the body just like the hormones we produce. Technically, the body can’t distinguish between bioidentical hormones from the ones your ovaries produce. The hormones used in the WHI (Premarin) can’t even be measured in standard laboratory tests. Winona never prescribes Premarin or anything like it.

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How Do I Find Bioidentical Hormones?

Bioidentical, micronized estrogens, and progesterone are offered in easy-to-use Winona products and are available with a prescription by our physicians. For your convenience, bioidentical hormones come in several forms, including pill, patch, cream, and vaginal preparations. 

Some women might like cream or patch better than a pill. Creams, gels, and lotions applied to the legs or arms deliver bioidentical estradiol directly to the bloodstream, and you can use lower doses when taking it this way. If you are taking bioidentical estrogen and still have a uterus you must still take micronized progesterone. 

In comparison, the so-called ‘natural,’ plant-derived progesterone creams sold over the counter (not prescribed by doctors) will contain too little of the hormones or won’t be properly absorbed and leave a white ‘powder’ on your skin. The treatments you choose need to be effective, not just gimmicks, by using them instead of truly effective, thoroughly vetted products, you can put your health in jeopardy. 

Bottom Line

Many factors are important in delivering safe, effective hormone replacement, the source of the original product (a yam for example), how they are made from the product, and the care in which they are prescribed. We are grateful that science has gotten us to a place where our physicians can prescribe safe, effective, efficient medication to help with your menopause symptoms that are not only bothersome but if untreated can lead to long-lasting medical conditions like osteoporosis and heart disease. Treatment from Winona can restore the natural hormones your younger self had, but that has decreased as we age. Visit Winona today to meet with our physicians who specialize in women’s health.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”

References

  1. https://www.health.harvard.edu/newsweek/What-are-bioidentical-hormones.htm

  2. https://www.medicalnewstoday.com/articles/319465#how-are-bioidentical-hormones-used

  3. https://www.britannica.com/list/7-of-the-worlds-deadliest-plants#:~:text=Castor%20bean%20(Ricinus%20communis)%20with,seeds%20and%20(right)%20fruit.&text=Widely%20grown%20as%20an%20ornamental,are%20deadly%20in%20small%20amounts.