Even after nearly 40 years of use, hormone replacement remains a source of confusion for women and the doctors who treat them. During the early development stages of hormone replacement, it was thought that synthetic hormones could safely alleviate the symptoms of menopause. Now that pendulum has swung swiftly in the opposite direction, with the consensus urging women to avoid all forms of this treatment. Many patients are now choosing bioidentical hormones as a safer alternative for menopause-related discomfort.
Hormone replacement therapy was developed in the early 1940s for several reasons, including the treatment of menopause symptoms like hot flashes, night sweats, headaches, joint pain, mood swings, vaginal dryness and fatigue.
Hormones act like little messengers throughout the body, turning on or off certain signals. The messengers stimulate, strengthen and maintain the vitality and integrity of many tissues in the body. As certain hormone levels decline, the organs that they effect will also change in their function. For example, as estrogen decreases, vaginal lubrication declines. Estrogen is also thought to play a role in mental function. Many women complain of brain fog related to the declining levels of estrogen associated with menopause.
Doctors began “replacing” deficient estrogen and progesterone with adequate amounts of synthetic versions. These versions (brands like Premarin and PremPro), used for years, did alleviate discomfort for many patients. Initial debates over the safety of these hormones subisided with the prevailing belief that hormone replacement helped decrease the risk of chronic diseases like heart disease.
Finally, a detailed study by the Women's Health Initiative examining the benefit of synthetic hormone replacement for chronic disease uncovered the opposite; that hormone replacement actually increased the risk for heart disease and cancer [Source: Rossouw]. The verdict was in. After the widespread press release of the results, women and doctors began to rapidly abandon the method.
Today, treatment decisions in relation to hormone replacement depend on the extent of the patient’s symptoms. Many women experience declining hormones in their mid-30s, while for others, menopause symptoms take hold after age 50. Some women will experience very few, if any, symptoms, while others battle extreme discomfort. Weighing the benefits of relief from against the risks that conventional hormone therapy can bring is a challenging task for patients.
For nearly 25 years, many doctors and women have been using a form of hormone replacement called bioidentical hormone replacement therapy (BHRT). This treatment only uses versions of hormones that are identical to the form of hormones that the body makes. For example, traditional hormone replacement used progestin to mimic the body’s own hormone, progesterone. Though the structure of the progestin may look similar to the body’s natural product, it's not an exact match.
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