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Menopause
and Natural Hormone Replacement Therapy
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| NHRT
-What are Natural Hormones or Bio-Identical Hormones? |
Natural
hormones are derived from chemical precursors found in plants. Soybeans
and wild yams are the most common sources of these chemicals. For
a soy or yam precursor to be converted into a hormone, it must be
done in a laboratory. Therefore, natural hormones, like their synthetic
and animal-derived counterparts, can be pharmaceutical compounds.
The major difference being Natural hormones
are identical in molecular structure to the hormones the body makes,
thus they are called bio-identical.
When a bio-identical hormone circulates through your system and
binds with a receptor, the fit is the same as if your body had produced
that hormone.
Animal-derived and synthetic hormones are similar to human hormones,
but they do not have the same molecular structure. When one of these
binds with its receptor, the fit is not exact, sometimes resulting
in side effects. These side effects include weight gain; increased
blood pressure; swollen, tender breasts; bloating; and feelings
of anger, irritability, or depression. When women have their prescriptions
changed to bio-identical hormones, they get almost immediate relief.
Bio-identical hormones fit with your hormone receptors like they
are supposed to."1 This "fit" can be compared to
the difference between a "master" key and a "duplicate"
key - a master key (bio-identical hormone) fits into the lock (receptor)
perfectly and provides smooth operation, while sometimes a duplicate
key (animal/synthetic hormones) doesn't fit quite right and requires
some finessing in order to work the lock.
Not only do bio-identical hormones provide a perfect "fit"
with hormone receptors, they also provide advantages when metabolized.
Metabolization is performed by enzymes whose work it is to break
down (metabolize) hormones -- these enzymes can be quite picky in
that they won't metabolize hormones that they don't recognize, which
can cause non-bio-identical hormones to sit on the hormone receptors
longer than they should, which in turn can cause over-stimulation
of the receptors and possible side effects, such as prevention of
a women's own biologically produced hormones binding with the receptors
and over-stimulation of hormone-sensitive tissues.
Natural hormones have been growing in popularity because they are
very effective and often without the same degree of side effects
that can come with the use of synthetic or animal-derived hormones.
It is important to note that while natural hormone replacement may
offer significant advantages over "traditional" hormone
replacement, years of clinical studies and research have been performed
by the medical and pharmaceutical communities that strongly suggest
that women taking conventional HRT reap significant health benefits.
Clinical research regarding bio-identical hormone replacement therapy
is sparse in comparison but growing. The most comprehensive and
significant study on bio-identical hormones is the Postmenopausal
Estrogen and Progestin Interventions (PEPI
Study), which suggests that bio-identical progesterone with
estrogen offers more cardiovascular benefits than synthetic progestin,
in additional to providing protection against endometrial cancer.
This is reviewed in detail in the natural progesterone section below.
In
addition, some women simply are more comfortable committing to HRT
when they know that the hormones they are taking are identical (NHRT)
to those their bodies produce which to me is just plain common sense.
The
following table lists some of the natural estrogen preparations
that are currently available from pharmaceutical companies and from
compounding pharmacies, along with some of the synthetic (non-bio-identical)
hormones that are commonly prescribed in "traditional"
HRT.
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ESTROGEN
ONLY
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| Product
Name |
Bio-Identical |
Description |
| Alora
Proctor & Gamble |
Yes |
skin patch |
| BiEst
Compounding Pharmacies |
Yes |
Combination of estradiol (20%) and estriol (80%). Ratios can
be modified to address individual patient response. This combination
is advocated by some health professionals for women who would
be pre-menopausal under normal circumstances (under 52 yrs.
old) |
| Climara
Berlex Labs |
Yes |
Estradiol
- skin patch |
| E2
III Cygnus |
Yes |
17b
estradiol - skin patch |
| Estrace
Bristol-Myers Squibb |
Yes |
Estradiol
|
| Estradiol
or Estriol Gel (Natural) |
Yes |
Available
through compounding pharmacies in any dosage prescribed by your
physician |
| Estraderm
Novartis |
Yes |
Estradiol - skin patch |
| Estratab |
No |
Plant-based,
75%-85% sodium estrone sulfate and 6-15% equilin sulfate |
| Estinyl
|
No |
Ethinyl
estradiol |
| Ogen |
No |
Not
Available |
| Ortho-Est
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No |
Not
Available |
| Premarin
Wyteth-Ayerst |
No |
Conjugated
equine (horse) estrogens |
| TriEst |
Yes |
Combination
of estradiol (10%), estrone (10%), and estriol (80%). Ratios
can be modified to address individual patient response. This
combination is advocated by some health professionals for women
who would be post-menopausal under normal circumstances (over
52 yrs. old) |
| Vivelle
Novartis |
Yes |
Estradiol
- skin patch |
| ESTRASORB |
Yes |
Estradiol lotion using a patented micellar nanoparticle technology
for the systemic application , currently in phase 3 clinical
trials |
|
ESTROGEN
AND PROGESTERONE
|
| BiEst
+ Natural Progesterone Compounding Pharmacies |
Yes |
Combination
of estradiol (20%) and estriol (80%) plus progesterone. Ratios
can be modified to address individual patient response. This
combination is advocated by some health professionals for women
who would be pre-menopausal under normal circumstances (under
52 yrs. old) |
| Combi
Patch Rhone-Poulenc |
Yes
- Estrogen
No- Progestin |
Estradiol
plus norethindrone - skin patch |
| Estradiol
or Estriol (Natural) with natural progesterone |
Yes |
Available
through compounding pharmacies in any dosage prescribed by your
physician. |
| FemHRT
Parke Davis |
No |
Combination of ethinyl estradiol, and a progestin hormone, norethindrone
acetate. |
| Premphase
Wyeth-Ayerst |
No |
Combination
of conjugated estrogen (Premarin) and medroxyprogesterone acetate.
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| Activella
|
Yes
estrogen No progestin |
Estradiol plus norethindrone oral tablets |
| TriEst
+ Natural Progesterone |
Yes |
Combination
of estradiol (10%), estrone (10%), and estriol (80%) plus natural
progesterone. Ratios can be modified to address individual patient
response. This combination is advocated by some health professionals
for women who would be post-menopausal under normal circumstances
(over 52 yrs. old) |
|
PROGESTERONE-ONLY
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| Aygestin
ESI Lederle |
No |
Norethindrone
acetate |
| Cycrin
ESI Lederle |
No |
Medroxyprogesterone
acetate |
| Micronor
Ortho-McNeil |
No |
Norethindrone
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| Natural
micronized progesterone Compounding pharmacies |
Yes |
Available
in custom dosages Yes Available in custom dosages |
| Nor-QD
Watson No Norethindrone |
No |
Norethindrone |
| Prometrium
Solvay |
Yes |
Natural
micronized progesterone in peanut oil |
| Provera/Upjohn |
No |
medroxyprogesterone
acetate |
| Natural
Hormone Replacement - The Estrogens |
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Disclaimer:
The information contained on this website
has not been evaluated by the FDA. This information is not intended
to treat, diagnose, cure or prevent any disease. All material provided
in the Dr. Brizel's web site is provided for educational purposes
only. Always seek the advice of your physician or other qualified
health care provider with any questions you have regarding a medical
condition, and before undertaking any diet, exercise or other health
program
©2002, All Rights Reserved, Center For Clinical Age Management,
Inc.
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