Bio-identical Hormone Therapy vs. Synthetic: Which one is better?
When you discover your symptoms are from perimenopause, you have a few options to help soothe your symptoms.
Synthetic Hormones
Bioidentical Hormones
Herbal and Homeopathic Remedies
Filling your nutrient gaps and addressing your thyroid, sugar, cortisol, and gut health.
As perimenopause is an 8-10-year experience, you’ll probably float between all four experiences.
In this post, I’ll share the synthetic and bioidentical hormones and why we may want to choose one over the other.
Let’s dive in.
What are synthetic hormones?
Synthetic hormones are lab-created compounds meant to mimic our hormones estrogen and progesterone for contraception or hormone replacement therapy, also known as HRT; sometimes called bioidentical hormone replacement therapy, or bHRT.
Some examples of progestins, synthetic hormones, include: norethisterone, levonorgestrel, and drospirenone.
The progestins (synthetic hormones), not progesterone (bioidentical hormones), act more like testosterone than progesterone in the body, causing hair loss and weight gain. [source}
For synthetic estrogen, you’ll see
The patch: Ethinylestradiol (EE)
The ring: Ethinylestradiol (EE)
The pill: Ethinylestradiol (EE), Mestranol, Estradiol Valerate [source]
These synthetic hormones carry a greater risk for cancer [source], blood clots [source], and nutrient depletion, namely B6, B12, Folate, Ca, Mg, Vitamin C, and E. [source]
What is Bioidentical Hormone Replacement Therapy (bHRT}?
BHRT refers to bioidentical hormone replacement therapy.
These are hormones, more body-identical, or more easily absorbed and utilized by the body. Typically, made from a cream, sometimes a pill or a patch, and they carry a lower risk of disease and nutrient depletion.
“There is strong evidence that micronized progesterone has no effect on clotting factors, and resistance to activated protein C in users of transdermal oestrogen.” [source]
Examples of bioidentical progesterone include: Prometrium, Utrogestan, Teva, and Famenita.
Examples of bioidentical estrogen include: estradiol, estrone, or estriol, which mirror human hormones.
Patches: Vivelle-Dot, Alora, Minivelle.
Gels/Sprays: Divigel, EstroGel.
Pills: Estrace.
Vaginal Inserts: Estring, Vagifem [source]
Testosterone can also be included as a bioidentical hormone and tends to decline with age.
What is the difference between bHRT and Synthetic Hormone Replacement Therapy (HRT}?
Dr. Lara Briden, author of “Hormone Repair Manual”, suggests bioidentical hormones are safer and carry a lower risk to your health compared to synthetic hormones.
Dr. Briden states, “progesterone, not progestin, probably reduces the risk of breast cancer”.
Bioidentical Progesterone
Natural progesterone, or bioidentical hormone replacement therapy progesterone, is available as
Bioidentical progesterone cream, or oil, is sold over the counter, like a company called Bezwecken
Or prescribed by your doctor
As a compounded progesterone capsule, or cream
or products such as Prometrium, Utrogestan, Famenita, or Teva
What about Wild Yam?
Wild Yam (Dioscorea villosa) is a time-honored anti-inflammatory digestive remedy and may have a mild estrogenic effect when taken on its own.
When sold as a “natural progesterone”, it has been doctored in the laboratory with added hormones, usually from affordable “raw material”, from pregnant mare’s urine - the natural ingredient in Premarin.
This “Progesterone” cream, applied topically, goes directly into the bloodstream and can be beneficial for a short period of time to support a woman with the transition of perimenopause.
It’s usually suggested to apply this cream from Day 14-28 in a cycling woman to mimic your body’s natural rhythm.
When you’re struggling in perimenopause, the first thing to go is your sleep. By adding bioidentical progesterone from Day 14-28, it mimics your natural sleep rhythm and can support you for a few years.
As you get closer to menopause (no bleeding for one year), low estrogen contributes to your insomnia, rather than progesterone, and you may notice progesterone doesn’t work for you anymore.
“Furthermore, estrogen may act on the thermosensory pathway and the thermoregulatory nuclei in the hypothalamus, in order to modulate body temperature, helping to maintain deep sleep phases”. [source]
Where to get bioidentical hormones?
You can now purchase some bioidentical hormones from Fullscript, an online dispensary. Bezwecken is great!
I also love Joi and Bloke and had a great experience with them.
Transition without hrt
Can you transition without hormone replacement therapy and use herbal medicine? Yes, of course.
But we have to address your lifestyle, your stress, sleep and nutrient depletion. Many busy moms are finding it hard to figure it out themselves, so hormones are a quicker fix and can provide great relief in this busy lifestyle we’re living in.
Your hormones thrive in these three areas.
Getting your blood drawn and checking for
Thyroid {ask for a full thyroid panel}
Blood Sugar
Cortisol {noticing your stress and how you metabolize hormones}
Is key to having a smooth perimenopause transition with or without hormones.
And, having someone read your labs from a functional medicine point of view - not conventional, is key to healing.
As an herbalist, I read your blood work and help you create a customized health protocol for this season of your life.
We look at…
Your diet - are you eating enough protein
Your supplements - are you consuming the right ones
Exercise
Are you doing too much? Can you exercise less and focus on calming your nervous system?
Stress and Cortisol
How do you metabolize your cortisol, or are you exhausted at 3 pm?
Your cycle
Herbs to lengthen your cycle and reduce cramping, blood clots, and insomnia
Gut health
Reduce bloating, constipation, and heal digestion
Mold
Are you living in mold?
Thyroid
TSH, reverse T4 and reserve T3 to see what supplements you need to support your thyroid
And more!
Conclusion
Your hormones thrive in three areas of your body: your cortisol (or stress levels), your thyroid, and your blood sugar. If any of these three markers are off, you will struggle with your perimenopause health. Bioidentical hormones can be a great relief for symptoms when used correctly. These hormones can be used alongside herbal medicine to help bring you great relief during the perimenopausal years. Keep in mind, herbal medicine will never replace hormones, so if you were struggling with extreme symptoms, the first step is to get your blood work taken and look at the three areas we discussed above.
Then we want to address those three areas from a functional medicine perspective. What that means is conventional medicine usually looks at your blood markers and only flags them when you need medication, not when you need nutrients.
When we provide the body with the nutrients it needs, such as iodine and selenium for the thyroid. Some of your symptoms may quiet down without choosing hormones. Then, adding in the hormones to a body that is ready to receive them will reduce your risk of creating gallstones and needing emergency gallbladder removal.
As perimenopause is an 8 to 10-year experience, you may find yourself using herbs and bioidentical hormones at the same time. Additionally, your hormones should change over the perimenopausal years depending on your unique living situation, your body, and your body's ability to detoxify them. I believe your body can heal, and herbal medicine can be a great support during this time. But when you're living in an extremely stressful situation or have had trauma, the body does need more support. Bio-identical hormones can be an amazing relief when used in the correct way.
Getting your blood work taken every 3 to 6 months is key to learning what's going on in your body and choosing the right nutrients to support you during this great transition.
xo
Tara
P.S. Have you tried hormones? What was your experience?
Source
