I am very excited to announce that I will be integrating bio-identical hormone replacement therapy (BHRT) into my Ottawa practice very soon! I am getting additional training at the end of February at a bio-identical prescribing conference in Toronto, where I will learn clinical pearls from leading integrative medical doctors and naturopathic doctors.
So, what is all the fuss about bio-identical hormone therapy? Let me clarify a few things for you.
What is bio-identical hormone replacement therapy?
BHRT is the use of biologically and structurally identical hormones to those naturally found in the human body for the purposes of replacing hormones that are found to be lacking. BHRT is most commonly used in women to help with the symptoms of peri-menopause and menopause. However, imbalances in estrogen and progesterone are found in younger women as well, and these women can also benefit from bio-identical hormone replacement therapy carefully timed to their menstrual cycle.
Who can benefit from BHRT?
Women with the following symptoms and hormonal imbalances may benefit from BHRT:
-Sleep disturbances that are hormone-related
-Polycystic Ovarian Syndrome (PCOS)
-Depression, anxiety, and mood swings
I heard that hormone replacement therapy is dangerous. How would bio-identical hormone replacement be any better?
The well-known Women’s Health Initiative study (WHIS), which was published over 10 years ago, highlighted the dangers of conventional replacement therapy, with increased risks of heart disease, stroke, blood clots, and dementia in those taking a combination of Premarin® (conjugated equine estrogens) and Provera® (synthetic progestins). This study looked at the use of non-bio-identical hormones that resemble but are not identical to our human estrogen or progesterone. That is key. Premarin® is a mix of conjugated horse estrogens (extracted from the urine of pregnant mares), only 50% of which are identical to human estrogen. The other 50% are not well recognized by our body. Provera® is a synthetic progestin, which is structurally different from progesterone. The lowest risk in the WHIS study was in those who were treated with Premarin only. This may be because Premarin contains 50% bio-identical estrogens.
But, we can do better! We can use 100% bio-identical hormones. We can also have the exact amount you need compounded for you based on your levels, which makes it a very individualized process. Furthermore, we now know that giving estrogen as a cream (transdermally) is much safer than giving it orally. Because bio-identical hormones cannot be patented, funding for large studies is harder to find. While there are no very large trials of bio-identical hormone replacement yet, we are seeing more studies with hundreds of participants confirming that BHRT appears to be effective and substantially safer than conventional hormone replacement.
How do you determine what’s going on with my hormones?
Before starting bio-identical hormone replacement therapy, I will do a full naturopathic assessment, and look at the roles that your diet, lifestyle, adrenal glands, thyroid, and liver play in keeping your hormones in balance. If these underlying aspects are not addressed, you may not see as big of an improvement as one would expect from bio-identical hormone replacement therapy.
We will also need to do a baseline assessment of your hormones, usually using salivary hormone testing. I will then work with a compounding pharmacist to prepare an individualized bio-identical topical cream or vaginal suppository, based on your needs. Once we start treatment, we will monitor your hormones periodically and make changes as needed.
BHRT is only one part of the puzzle
Don’t forget that health is multi-faceted. Replacing one or two deficient hormones can be extremely helpful, but supporting the health of your entire body is vital for enduring health. As I mentioned earlier, addressing underlying causes and supporting the function of the liver, adrenal glands, and the thyroid are extremely important for lasting hormone balance.
If you are interested in pursuing BHRT to help with your hormone imbalance symptoms, I invite you to make an appointment with me starting March 1st, 2016. Just call either of my locations (Nepean 613-225-3339 or Orleans 613-837-8885), and we’ll get you set up!
Gillson, G., & Marsden, T. (2004). You’ve Hit Menopause: Now What? Calgary, AB: Rocky Mountain Analytical Corp.
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Dr. Tamar Ferreira is a Naturopathic Doctor in Brampton, Ontario. Her areas of focus include digestive health, hormone balance, and skin conditions.