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What is bioidentical hormone replacement therapy (BHRT)?

First, we will ask the question: what is hormone replacement therapy? Hormone replacement therapy is the use of sex hormones (estrogen, progesterone, testosterone) to address the variety of symptoms and risk factors that can become more prevalent with aging. For women, the prominent hormonal shift that triggers a significant decrease in sex hormones is called menopause. Menopause is 12 months of the cessation of menses. For men, the counterpart is andropause. Andropause is a gradual decline in testosterone that occurs starting around age 30- 40 years old.

Hormone replacement therapy is aimed at replenishing hormone levels and the two distinct approaches involve bioidentical hormones versus synthetic hormones. We urge patients to opt for bioidentical hormones, which are often a controversial topic to conventional medical providers as many forms of BHRT lack FDA approval. Research consistently points to increased risk of disease with synthetic HRT with synthetic progesterone increasing risk of breast cancer and synthetic progesterone and estrogen increasing risk of blood clots.

Does HRT cause cancer?

The study that emerged and created much fear in the medical community around HRT and breast cancer was the Women’s Health Initiative. The WHI published findings of increase breast cancer prevalence in women undergoing therapy with synthetic estrogen and progesterone. The risk equated to less than 1 additional case of breast cancer per 1000 women annually. This level of risk is less than the level of risk linked to breast cancer in women who consume alcohol regularly, have low activity levels, or are obese. Additionally, this breast cancer risk from hormone replacement therapy is only present in women with prior HRT exposure, not women who are hormone naïve.

There are many different forms of BHRT in terms of ways to administer it. Pellets, transdermal patches, oral tablets, sublingual troches, and transdermal creams are various BHRT forms. The decision on what form of BHRT to take is a nuanced conversation with your integrative or naturopathic provider that depends on your individual wants, needs, and budget. Different forms of BHRT may be dosed daily, weekly, every few months and therefore a conversation with your provider will help identify what you are most likely to adhere to!

Is BHRT for everyone?

Because estrogen replacement can worsen estrogen sensitive breast cancers, women with a history of breast cancer are not ideal candidates. Fortunately, there are botanical options that can be effective against menopausal symptoms for these women. The beauty of naturopathic medicine is we have many tools in our toolbox beyond prescriptions.

BHRT combats many aspects of aging, including: bone loss, heart disease, cognitive decline, muscle loss and fat accumulation, fatigue, arthritis, skin thinning and laxity, slowing metabolism, and loss of libido. These symptoms are universal to men and women with the aging process but are not inevitable with restoring hormones to their vital and youthful levels!

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