Bio-identical Hormones
A Better Solution
Many women experience significant changes in their health before, during and after menopause. Many of these health problems are associated with hormone imbalances that can be overcome with natural therapies or HRT (hormone replacement therapy) – whether it be using traditional or bio-identical hormones. Hormones are powerful chemical messengers that circulate throughout the bloodstream to specific target cells where they generate biological responses. Women have traditionally used “synthetic” estrogens and progestins (traditional HRT) to protect against osteoporosis and heart disease. These “synthetic” hormones offer some protection against heart disease and osteoporosis but have many unwanted side effects. Because of these side effects many women abandon traditional HRT very soon after starting. This has led to a strong interest in the use of bio-identical hormone replacement therapy (BHRT).
What are Bio-Identical Hormones?
Bio-identical (BHRT) hormones are derived from natural plant sources to produce molecules which are physiologically identical to hormones made in the human body. Bio-identical hormones are chemically processed from precursors found in yams or soy plants, yet they are identical to the hormones produced by the human body. Hence the term “bio-identical plant-derived hormone.” These hormones are able to follow normal metabolic pathways so that essential active metabolites are formed in response to hormone replacement therapy. Synthetic hormones are chemically altered and are not identical in structure or activity to the naturally occurring hormones in the body. No two women are alike, of course, and the value of bio-identical hormone replacement therapy is that it can be adapted to fit your individual body and hormone levels. In fact, hormones can be made in a variety of strengths and dosage forms including capsules, topical creams and gels, suppositories and sublingual troches or lozenges. With the help of your doctor and a compounding pharmacist, a woman can start and maintain a bio-identical hormone replacement regimen that closely mimics what her body has been doing naturally for years.
Benefits of BHRT include:
- fewer side effects compared with traditional HRT
- protection against heart disease
- reduced risk of breast cancer , and
- improved lipid profile.
Goals of Natural HRT
- Alleviate the symptoms caused by the natural decrease in production of hormones by the body.
- Give the protective benefits which were originally provided by naturally occurring hormones.
- Re-establish a hormonal balance.
Where do I go for help?
Your doctor will assess your current hormone status by either a blood , saliva test, or a questionnaire. If your doctor is not familiar with this treatment, ask them to call us for further information. After determining the level of hormonal imbalance, the doctor can prescribe natural hormones
• in various combinations, e.g., progesterone cream, triest & progesterone troches,
• in various dosage forms, e.g., cream, troche/lozenge, capsule, pessary, gel or oil.
Where more than one hormone is deficient, they can be incorporated into one dosage form, e.g., DHEA & testosterone troche. In effect, the doctor prescribes a complete NHRT supplement tailored for the individual patient in a dosage form suitable for that patient.
Which dosage form do I use?
Your doctor will prescribe the most appropriate dosage form for you. The types of dosage forms available include:
Transdermal Cream
Hormones are compounded in a cream or gel to be applied to hormone sensitive areas on the skin for absorption via adipose tissue. The areas for application are breasts, tummy, inner part of the arms or legs. This allows the hormone to reach the target tissue (similar to hormone patches) avoiding rapid breakdown by the liver allowing a much lower strength to be used.
It is a good idea to apply the cream on various areas of the skin, or rotate daily to avoid overload of the receptor sites. Please ensure that the hands are washed before and after application.
Troches
Troches are sublingual lozenges made to dissolve in the mouth and absorbed by the salivary mucus, avoiding first pass liver metabolism. Troches are probably the most favorable dosage form particularly if more than one hormone is deficient. Place your recommended dosage (a whole or half troche) between gum & cheek or under the tongue to allow for slow absorption via the saliva so that the active hormone will be absorbed straight into the blood stream. Avoid sucking the troche quickly as you would want maximum absorption into your body.
Capsules
Capsules are a convenient method of administration. Natural hormones are micronised and can be compounded with slow release ingredients to prevent rapid liver metabolism.
Pessaries
Pessaries are useful where high doses of hormone are required intra-vaginally for a short duration e.g. triest pessaries for dry vagina. Take the pessary or suppository (for rectal use) out of the wrapping before insertion with your finger. The best time to use a pessary or supposi-tory is whilst lying down. As every woman is unique, our approach is for the patient, pharmacist, and doctor to work together to customise hormone replacement therapy.
What is compounding?
Compounding is the preparation of medicine by a pharmacist for an individual patient according to a doctor’s prescription. The practice predates the manufacture by mass production of drugs. In every field of medicine, there are some patients who don’t respond to traditional methods of treatment. Sometimes they need medicine at strengths that are not manufactured by drug companies. Sometimes they simply need a different method of ingesting a medication.
Are all compounding chemists the same?
No. There are many small compounding pharmacies popping up over Australia however due to lack of regulation it is important to chose a pharmacy that is well established and has appropriate quality control measures and equipment. Ensure to ask your pharmacy what measures they take for quality control and what equipment they use to ensure your product is of the highest potency and quality. It
is not safe to be compounding hormones without a powder extraction hood, otherwise you may be receiving the hormones from the previous script in your item. You might find that you get better results from the pharmacy that is a little bit more expensive.
