Should i take bioidentical progesterone

You look it up on Google and the information is conflicting. Hormones are The Fountain of Youth! Hormones cause breast cancer and strokes! This is part one of a series on perimenopause and menopause that helps you sift through the good, the bad, and the ugly so you can make an informed decision.

At Hearthside Medicine, we want you to be aware of the risks and benefits of all treatments and empower you to make an informed decision. While we lean towards bioidentical hormones over synthetic hormones, it's important to note that hormones are not safe for everyone.

They are often touted as being "safe and all natural" and "derived from plants. Here are some common questions we field at Hearthside Medicine:. Why might I benefit from hormones? Do hormones cause breast cancer and strokes? Is bioidentical really all natural? Can I just use those over the counter menopause supplements? Are hormones regulated by the FDA to ensure they contain what they say they contain and meet safety standards?

Is one route safer than other routes? Who should NOT take them? What side effects do I need to be aware of? When can I or should I start them and for how long? What is the difference between a compounded hormone and what I can get at a regular pharmacy? What can I try instead of hormones for my perimenopause symptoms? At Hearthside Medicine, we are all about supporting our patients with the safest and most natural options available, so let's run through these questions together!

First, why consider hormones? Others will look first for holistic options and supplements to treat their symptoms we have an entire blog for that! Signs of perimenopause may include some or all of the following:. Perimenopause can start as early as 10 years before menopause, and the average age of menopause is meaning, if you are headed into your 40 or already there, the above symptoms may already be happening. How can taking hormones help me?

Hormone therapy HT is a good way to relieve many unwanted symptoms but, as with all medical treatments, it has some risks. The safety of HT depends largely on the age of the patient and any underlying medical conditions they may have smoking, personal or family history of breast cancer, history of blood clots, etc. Some menopause experts believe non-oral routes of estrogen are also safer as they bypass the liver and thus are associated with fewer blood clots.

For most, the risks are few and the potential benefits are many. Hormone therapy can benefit you in many aspects of your life. Some research even suggests a decline in production of hormones can increase your vulnerability to cardiovascular disease and osteoporosis. What are the risks and benefits of HRT? In a thorough review of past and current studies, it is painfully apparent that a general lack of consensus persists among providers regarding benefit vs risk of HRT due largely in part to the WHI study of elaborated above.

According to the North American Menopause Society , contraindications for HT include unexplained vaginal bleeding, severe active liver disease, prior estrogen-sensitive breast or endometrial cancer, coronary heart disease CHD , stroke, dementia, personal history or inherited high risk of blood clotting disease, porphyria cutanea tarda, or hypertriglyceridemia, with concern that endometriosis might reactivate, migraine headaches may worsen, or leiomyomas may grow. More common adverse effects include nausea, bloating, weight gain, fluid retention, mood swings progestogen-related , breakthrough bleeding, headaches, and breast tenderness.

Potential risks of HT initiated in women aged younger than 60 years or who are within 10 years of menopause onset include the possible risk of breast cancer with combined EPT, endometrial hyperplasia and cancer if estrogen is unopposed or inadequately opposed, venous thromboembolism VTE , and biliary issues.

Additional risks across ages include myocardial infarction MI , stroke, and dementia. Benefits of hormone replacement therapy are believed by many providers to include the following:. Increased elasticity of the blood vessels, allowing them to dilate widen and let the blood flow more freely throughout the body.

Improved short-term symptoms of menopause such as hot flashes and mood swings, as well as vaginal dryness, dry skin, sleeplessness and irritable bladder symptoms. Decreased risk of osteoporosis and fractures broken bones. The health risks of HRT include:.

Increased risk of endometrial cancer only when estrogen is taken without progestin For those who have had a hysterectomy removal of the uterus , this is not a problem. Increased risk of breast cancer with long-term use or depending on age. Possible Increased risk of cardiovascular disease including heart attack with long-term use. Increase in inflammatory markers such as C-reactive protein. Increased risk of blood clots and stroke in susceptible patient obese patients, those who smoke, those with history of clots.

All those taking hormone replacement therapy should have regular gynecological exams including a PAP smear. The American Cancer Society also recommends that those over age 50 should:. Have a breast physical examination by health care provider once a year we are happy to do that for you as part of your annual wellness exam.

Heart attacks — The risk of having a heart attack related to use of hormone therapy appears to depend on your age. According to the landmark WHI study, there is no increased risk of heart attacks related to hormone therapy in women who:. Other studies since the WHI also report that hormone therapy does not increase heart attack risk in younger women; some suggest it might even lower the risk slightly. In the WHI, women who become menopausal more than 10 years ago or over age 60 years were at increased risk of having a heart attack related to hormone therapy.

Breast cancer — In the aforementioned WHI study using synthetic hormones primarily in those over 60, there was a small increased risk of breast cancer in those who took combined estrogen-progestin therapy but not in women who took estrogen alone.

Those with a uterus must take progesterone with estrogen to prevent endometrial cancer. Those without a uterus can safely take estrogen alone. Again, this breast cancer data is based on the WHI study which primarily examined those older than 60 using synthetic, oral hormones. Now, we are encouraging patients to start younger, stop sooner, consider using bio-identical hormones, and consider using non-oral routes.

Osteoporotic fracture —. The risk of breaking a bone at the hip or spine because of osteoporosis is lower in women who take estrogen-progestin or estrogen alone.

However, currently hormone therapy is not recommended by menopause experts to prevent or treat osteoporosis, because there are bone medicines called bisphosphonates that are very effective and have fewer serious risks. That being said, being on HRT will certainly help preserve bone strength. Other ways to minimize risk of osteoporosis includes weight lifting, taking calcium citrate mg with magnesium and vit D, running, maintaining a healthy weight, not smoking.

Dementia — Among the older women studied in the WHI, there was no improvement in memory or thinking with either estrogen alone or with combined estrogen-progestin but there was an increase in the risk of developing dementia.

It may also be used to improve symptoms of cancer treatment or to treat conditions such as:. Bioidentical hormones are manmade hormones derived from plant estrogens that are chemically identical to those the human body produces.

Estrogen, progesterone, and testosterone are among those most commonly replicated and used in treatment. Bioidentical hormones come in various forms, including:. Some bioidentical hormones are made by drug companies. This process is known as compounding. Compounding typically involves ingredients being combined or altered to meet the needs of an individual. The U.

Food and Drug Administration FDA has approved some forms of manufactured bioidentical hormones, including bioidentical estriol a weak form of estrogen and progesterone. Most bioidentical hormones are manufactured and sold without controls for safety, quality, or purity. Many medical organizations have taken a stand against the marketing and use of unapproved bioidentical hormones. Compounded bioidentical hormones are often touted as being safer and more effective than synthetic hormones.

The hormones used in traditional HRT are made from the urine of pregnant horses and other synthetic hormones. Compounded bioidentical hormones may carry even more risks. BHRT is typically used as people age and hormone levels drop, particularly for women who are in perimenopause or menopause.

In addition to helping with symptoms, hormone replacement therapy may also reduce your risk for diabetes, tooth loss, and cataracts. For those with cancer who have undergone treatments that affect their estrogen levels, BHRT has been shown to be effective in improving their general well-being and quality of life.

In one study , people with cancer who underwent BHRT found relief from treatment-related symptoms such as migraines, incontinence, low libido, and insomnia. The study also found their recurrence rate of breast cancer was no higher than average.

But these claims have not been confirmed by large-scale, reputable studies. The FDA urges caution when using compounded products. Research has shown that hormone replacement therapy in general may increase the risk for certain conditions and diseases including:.

There may also be side effects that accompany BHRT, particularly in the beginning as your body adjusts to the hormones. Common side effects of BHRT may include:.

Many people cannot take BHRT or any form of hormone replacement. Some women may benefit from nonstandard doses and forms of hormones in compounded bioidentical hormone preparations, but there's currently no scientific support for an advantage of these compounds over common commercially produced preparations.

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See more conditions. Request Appointment. Bioidentical hormones: Are they safer? Products and services. Are bioidentical or natural hormones safer and more effective than hormones used in traditional hormone therapy for menopause symptoms?