Hormone Replacement Therapy

On March 2, the National Institutes of Health (NIH) instructed 11,000 women enrolled in the estrogen-alone group of the Women's Health Initiative (WHI) to stop taking study medications and to begin the follow-up phase of the study. After a review of data from approximately seven years of follow-up, the NIH concluded that in that time frame, estrogen alone does not affect heart disease or breast cancer risk, while increasing stroke risk and decreasing hip fracture risk. These results would not be likely to change even if the estrogen trial continued to its planned completion in 2005, according to the NIH.

The increased risk of stroke with estrogen alone was similar to that for estrogen plus progestin, which prompted investigators to stop that part of the trial in July 2002. The WHI was split as to whether the estrogen-alone study medications should be stopped or whether they should be continued, provided that a letter was sent to the subjects clearly informing them of the stroke risks and other findings. On Feb. 2, the NIH decided to stop the estrogen-alone part of the trial.

In July 2002, we learned from the Journal of the American Medical Association that the clinical trial being performed by the Women’s Health Initiative comparing the risks and benefits of combined estrogen and progesterone treatment on women was halted due to the large increase in breast cancer, coronary heart disease, stroke, and pulmonary embolism cases within these women participants. The study concluded that the risks far outweighed the benefits of combined estrogen and progesterone treatment.

Since then, hormone replacement therapy (HRT) is the subject of much controversy. Many women have questions about the safety and efficacy of conventional hormone treatment for menopause and osteoporosis. Conventional hormone heplacement therapy was used in the clinical trial performed by the Women’s Health Initiative. Lets discuss the difference between natural hormone replacement therapy and conventional hormone replacement therapy.

Natural Hormone Replacement Therapy

Natural hormone replacement therapy may be termed natural because the hormones that are produced are biochemically and molecularly identical to the human hormones in the body and are derived from plant sources. The two plant sources for the hormones are soy beans and wild yam. Plant-derived hormones can be made from either plant and are bioidentical to hormones produced in our ovaries and adrenal glands, therefore these hormones carry out bioidentical processes in the body.

Conventional Hormone Replacement Therapy

Conventional hormone replacement therapy refers to hormones that are made from the urine of a pregnant female horse which are not bioidentical to our own hormones. They are not exactly the same hormones that our body is used to metabolizing. It is possible that women may not react to and metabolize these hormones in a similar manner than their own natural hormones. These hormones may be converted into a more toxic or harmful substance once metabolized by the body. If conventional hormones are poorly metabolized by the body, it is possible that their affects may last longer due to the slowing of their breakdown. Prolonged estrogen in the system could be a potential risk factor for breast cancer.

Are hormones right for you?

Natural hormones offer a safer, more comfortable alternative for women who are concerned about the long term side-effects of conventional hormone replacement therapy. Many women today are taking HRT. As women, it is our job to become informed about the different options for the treatment of menopausal symptoms and osteoporosis prevention. Some women are better canidates for HRT than others. For example, women who have a higher risk for osteoporosis would be better candidates for HRT.

Each woman's requirement for hormone balancing is unique. This is why I take a thorough history, do a physical exam, and order hormone testing on each patient. All of these assessments are used to offer treatment options specifically suited for you.

HRT may not be the treatment for all women. Many women will be able to successfully treat menopausal symptoms in addition to preventing osteoporosis and heart disease without the use of hormones. Lifestyle modifications, a balanced diet with proper supplementation, and botanical treatments will often do the job for some women.

Over-the-counter Progesterone

Progesterone can be obtained over-the-counter and self-prescribed. It is important to seek the guidance of a qualified professional when choosing and dosing hormones, even if they are sold over-the-counter. A naturopathic doctor is trained in hormone testing, botanical medicine, lifestyle modifications, nutritional supplements, natural and conventional hormone replacement therapy, and many more treatments successful in the treatment of menopause and prevention of heart disease and osteoporosis.

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