Suzanne Somers brought bio-identical
hormones onto center stage. In her books, Ageless and
The Sexy Years, and in media appearances to promote them, she
described how bio-identical hormones relieved her menopause
symptoms. She also makes it clear that she intends to stay on them
for the rest of her life. She continues to be a wonderfully positive
spokesperson for lifestyle change and wellness.
Oprah also stepped forward in the past to educate women about the importance of first educating
themselves about the body's changes in the peri-menopausal and
menopausal years and then secondly making a decision to improve
their lives by managing any symptoms they may be having. She has
also become a proponent for bio-identical hormone replacement!
The basic question women ask is, “Are they for me?” Let’s explore
what we’ve learned about bioidentical hormone replacement therapy (BHRT)
in the years we’ve used it in our clinical practice, and help you
answer that basic question for yourself.
Just what are “bio-identical hormones”?
Bio-identical hormones start as extracts from soy or yams and are
then manufactured in the lab to have the same molecular structure as
the hormones made by your own body. In contrast, pharmaceutical
companies can’t patent a bio-identical structure, so they invent
synthetic hormones like Premarin, Prempro and Provera, the most
widely used examples. These synthetic hormones are manufactured to
be intentionally different in their molecular structure so they are
"unique" and can be patented - and make money - LOTS of money!
Unfortunately, synthetic hormones have several problems - first,
they generally come in fixed doses that are "one size fits all", and
we all know that each of our body's are unique! Second, and the
with changing the molecular structure of a hormone and making a
synthetic chemical is that they frequently
cause unwanted, and often dangerous, changes in the body - proven in
the Women's Health Initiative Study - increases in cancer,
dementia, and other
bad side effects!
Although bioidentical hormones have been around for years, most
practitioners are unfamiliar with them.
In our practice, we have had the greatest success with an
We practice scientific medicine
and never guess where your levels might be by clinical symptoms as
this is as useless as trying to guess your cholesterol level or your
blood pressure!! We begin with laboratory tests of hormone levels,
adrenal function, thyroid levels, and vitamin D. We frequently do testing
for adrenal and hormone levels through Saliva. This is a more sensitive
method of testing and actually
measures the unbound or active hormones in the central part of your
body rather than the bound or inactive hormone levels circulating in
your blood. When warranted by test results, we then prescribe a
precise dosage of bio-identical progesterone, estrogen, testosterone
or DHEA that we feel are necessary and sufficient to balance your
levels. Sometimes these are combined into one cream that is made
specifically for each individual at a compounding pharmacy.
Each patient is then monitored carefully through regular
follow-up hormone levels to ensure we get symptom relief at the
lowest possible dosage to maintain long-term safety. In the initial
stages, we will do a hormone panel every three months. Once balance
is restored, we may only do one panel a year at an annual visit.
Are bioidentical hormones
better than synthetic hormones?
We long ago concluded that the answer to this question is yes.
But that doesn’t mean bioidentical hormones are perfect, or
necessarily safer if not monitored regularly!
The great appeal of bioidentical hormones is that they are
natural, and our bodies can metabolize them as it was designed to,
minimizing side effects. Synthetic hormones are quite strong and
often produce intolerable side effects. Moreover, the compounded
bio-identical hormones can be matched individually to each woman’s
needs — something that’s just impossible with mass-produced
Are bioidentical hormones
safer than synthetics?
scientific monitoring the answer is yes!
European medical studies suggest the same - bio-identical hormones
are safer than synthetic versions. This makes perfect sense.
Why would a human want to use hormones derived from horses whose
hormone composition is completely different? Unfortunately there are
also patients who try to manage this on their own
by buying hormone creams on the internet and get into trouble with
side effects, and long term who knows what may be the adverse
outcomes - even Suzanne Somers developed breast cancer! Did this
need to happen? I can't say, but I do think careful monitoring is
critical to long term safety. The first tenet of my Hippocratic oath
is "First Do No Harm" and I hold that tenet as sacred!
Further, there are physicians who prescribe bioidentical hormones
just as they did synthetic ones - without measuring values, and this
can lead to problems as well! I have seen women who have come to me
from other physicians with levels of estrogen that were sky high -
similar to synthetic hormones - and this puts them at the same risk
for cancer and other bad outcomes!
No physician would prescribe male hormone replacement without
measuring levels before and during therapy, much less prescribe
insulin or cholesterol lowering medication - without first measuring
levels!! It makes absolutely no sense to me to try to prescribe and
manage female or stress hormones without measuring and following appropriate
levels - you are just guessing!!
What do I recommend?
The great majority of women can rebalance their hormones without
the use of drugs. We have found that about 85% can find relief
through an approach that combines medical-grade nutritional
supplements, gentle bioidentical hormone support, preferably in a
compounded form personalized to their needs by an experienced
practitioner, and dietary and lifestyle changes. We recommend that
every woman start with this combination approach as a foundation of
What about bio-identical
hormones for breast cancer patients?
The pendulum has swung so far that today, very few doctors will
prescribe any type of HRT — synthetic or bio-identical — for women
who have had breast cancer or even a family history of breast
cancer. In fact, many such women are given anti-estrogen drugs.
I feel that we just do not have enough data to rule out HRT in
every case, and I prefer to look at each woman’s particular
situation, history, pathology and blood work. Often when hormones
are measured these women have markedly
elevated natural estrogen levels - either from over
production, or from poor estrogen metabolism. This places them at a
very high risk for a recurrence in the second breast!
A guided approach to improve diet, exercise to encourage weight
loss, and the addition of nutritional supplements to improve
estrogen metabolism and liver excretion to normal levels while
balancing estrogen and progesterone levels often relieves symptoms
as well as lowering the risks of the elevated hormone levels long
I feel another vital element in breast cancer survivors is to
evaluate for stored environmental toxins that are the root cause of
all cancers - these include heavy metals like Lead and Mercury, BPA
from plastic beverage bottles, pesticides from residue in foods or
spraying our lawns for dandelions or our houses for bugs, and even
household toxins like flouride from drinking water and chlorine in
tap water and household cleaners.
Some breast cancer patients, like Suzanne Somers, continue to use
low-dose bio-identical hormones by choice. These women have
researched the issues, discussed them with their doctor, and made a
well-informed decision for themselves. Bio-identical progesterone use
in breast cancer can actually be preventive!
Janet was a 54-year-old woman who came to us with severe
menopausal symptoms. We changed her diet to increase her protein and
vegetables and reduce carbohydrates, added pharmaceutical-grade
nutritional supplements, and did a complete hormone evaluation.
At her first follow-up visit six weeks later, Janet definitely
felt better, but she still suffered too many hot flashes and
sleepless nights. Our next step was to add bio-identical hormone replacement therapy.
After reviewing her hormone panel we placed Janet on a
combination of bio-identical estriol (the weakest one of the three
forms of estrogen), DHEA and progesterone, all in cream form. Six
weeks later Janet came back for another follow-up. “I feel
fabulous,” she said, explaining she hadn’t felt this good since her
A year later Janet still feels great. She’s carefully compliant
with her diet and exercise regime, and takes her bio-identical
hormones faithfully. Her latest hormone panel shows she’s still in
balance and there is no need to adjust her dosages.
Not every patient is as easy to help as Janet. Sometimes we have
to adjust the formulas three to five times to get it balanced, but it’s
a very effective solution.
So — are bio-identical hormones for
At Renew, our goal is to help inform you about your options so
that you can make the choice that’s best for yourself. Hormonal
balance is a dynamic equilibrium that shifts from day to day, week
to week, and through the years, influenced by multiple life events. When you
give your body the support it needs it can heal itself - because
it’s equipped and programmed for balance and wellness. So we
recommend beginning with the gentlest form of support possible to
allay your discomfort and tweaking it as you go. We’ll support you
in any way we can, each step of the way. The good news is that you
can feel incredibly well through menopause and beyond.
I plan to be in great shape and feeling well in my 90's as many
of my patients now do - I invite you to join us!!
If you have questions, don't hesitate to call us:
We're here to listen and help.
We’re always happy to welcome new patients to our office in