Bioidentical Hormone Replacement Therapy

hI’m a huge proponent of the medicine that I practice, which involves healing the body and mind using the gifts of nature.  This can be as simple as a whole foods diet, clean water, regular body movement, healthy sleep habits, solid stress management techniques, and herbs.

However, for some, this just isn’t enough.  Hormone imbalance can be a tricky thing to deal with as hormones are susceptible to the smallest of changes in our environment, they fluctuate readily, and are tightly interwoven in a delicate balance – so that an issue with one hormone gland (adrenals, thyroid or ovaries) tends to throw the other hormone glands off kilter too.

The conventional solution is to prescribe HRT –Hormone Replacement Therapy; made from synthetic chemicals that are close in structure to what our own bodies make, but not identical.

Welcome BHRT – Bioidentical Hormone Replacement Therapy!  They are derived from completely natural sources, are identical to our body’s natural hormones, and therefore cannot be patented. Because of this, there is limited profit in manufacturing and selling BHRT and even less reason to perform clinical trials that compare the effectiveness of these natural sources of hormones to conventional HRT.  However, the studies that have been done show the effectiveness and safety profile of BHRT.

A common pattern I see in clinical practice is estrogen dominance.  Due to an overwhelming amount of exogenous estrogen intake (pesticides, herbicides, birth control pill, plastics with BPA, HRT, non-organic meat and dairy, etc.) estrogen becomes the dominant hormone and causes a rift in the healthy ratio of estrogen to progesterone.

Estrogen dominance typically appears with symptoms of high estrogen and low progesterone: PMS, fibrocystic breasts and breast cancer, endometriosis, uterine fibroids, ovarian cysts, irregular periods, heavy menstrual bleeding, spotting between periods, menstrual cramping, abdominal weight gain, and hypothyroid symptoms.

Generally I diagnose and treat estrogen dominance by collaborating salivary hormone testing with reported symptoms.  Testing the saliva for hormones differs from testing the blood – it has a higher rate of accuracy as it’s testing the hormones that are actually acting on the cells, whereas blood hormone testing measures active and inactive hormones that are free floating and bound to proteins in the blood rather than those that have bound to and acted on the cells.

I prefer to treat using nutrition as medicine, lifestyle changes, herbs and supplements, but in certain circumstances I will also add bioidentical hormones to help the body normalize hormones levels quicker.  In the case of estrogen dominance, the most typical bioidentical protocol would be to prescribe progesterone cream, in the lowest dose necessary, while aiding the liver to detoxify estrogens properly into their healthy metabolites.

For further information on bioidentical hormone replacement therapy and salivary hormone testing drop me a line!


Further reading:

Bioidentical Hormone Replacement; Guiding Principles for Practice by Tracy Marsden, BScPharm

Educator Lori Steiner Talks about Aging and Bioidentical Hormones an interview by Barbara Minton


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