The grip that pharmaceutical companies have on the HRT industry is slowly loosening. Increasing numbers of physicians and their patients are choosing bioidentical hormones over synthetic or animal-derived versions. The reason for the new wave of bioidentical hormone users can likely be attributed to more widespread awareness of the risks and side effects of synthetic hormone substitutes, combined with a public that increasingly demands “natural” products of all kinds.
Research Evidence on the Safety of Bioidentical Hormones
Synthetic hormones are not the same as human hormones. They do not have the same molecular structure, receptor affinity, absorption capabilities or other functional traits. For many years, research has continued to associate these chemical mismatches with increased incidence of breast, endometrium and prostate cancer in addition to a greater risk for cardiovascular disease, blood clots and other maladies.1
Bioidentical hormones, on the other hand, are identical to those made in your body. They work in synchronicity with one another—which is why BHRT must address multiple hormones, not just one, and strive to achieve hormonal balance. When you restore hormone equilibrium using bioidenticals, you are actually physiologically replacing what is missing. These hormones will communicate perfectly with receptor cells, metabolize properly and perform the tasks the body needs. In a seminal review of research literature published in 2008, Schwartz & Holtorf examined 267 scientific articles regarding hormone replacement using bioidentical hormones versus synthetic and animal-derived hormone substitutes.2 In their summary, they stated, “we believe the well-informed use of hormones in wellness and disease prevention will result in symptomatic improvement and should be considered an integral part in the armamentarium of options we offer our patients.”
Research Evidence on the Effectiveness of Bioidentical Hormones
Despite efforts to discredit bioidentical hormones, scientific research continues to accrue in support of the use of these hormones. Bioidentical hormones have been successfully used around the world since the 1930s. They still enjoy widespread popularity in Europe, Australia and, now, in the United States.
So, what does the research say? In a review of scientific literature published in 2006, 138 articles were evaluated for disparities in safety and efficacy between synthetic and bioidentical estrogens, as well as progestins and progesterone.3 Special attention was paid to clinical outcomes in the breast, endometrium, bone, cardiovascular system, and brain. The studies suggested 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 suggest a reduced risk of blood clots compared to non-bioidentical preparations. Bioidentical hormone preparations have demonstrated effectiveness in addressing menopausal symptoms. The author advocates for continued research on bioidentical hormones and concludes there is currently sufficient evidence to support their preferred use over that of their synthetic cousins.”
Likewise, in another important scientific review published in 2008, Schwartz and Holtorf assessed the evidence in 267 studies and came to these same conclusions. “A thorough review of the medical literature clearly supports the claim that bioidentical hormones have some distinctly different, often opposite, physiological effects to those of their synthetic [non-bioidentical counterpart] hormones. With respect to the risk for breast cancer, heart disease, heart attack, and stroke, substantial scientific and medical evidence demonstrates that bioidentical hormones are safer and more efficacious forms of HRT than commonly used synthetic versions.”
The question is why would you choose a synthetic hormone replacement therapy that puts you at serious risk for health problems? Data and clinical outcomes associate bioidentical hormones with lower risks of breast and prostate cancer, cardiovascular disease, as well as a reduced risk of blood clots and osteoporosis. In fact, bioidentical hormones have been shown to have positive effects on overall health and well-being.
When it’s time to consider hormone replacement, chose a physician who is expert in the use of bioidenticals and understands the need for balanced, youthful levels of hormones; one who will offer you individualized treatment based on your unique biochemistry; whose method is grounded in science, not guesswork.
1 Rossouw JE, Anderson GL, Prentice RL, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 2002;288:321-333.
2 Schwartz ET1, Holtorf K. Hormones in wellness and disease prevention: common practices, current state of the evidence, and questions for the future. Prim Care. 2008 Dec;35(4):669-705. doi: 10.1016/j.pop.2008.07.015.
3 Moskowitz D. A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks. Altern Med Rev. 2006 Sep;11(3):208-23.