Sent to you by Jane Kennedy NP, MPH

Hormones
Hormones Hormones

Jane Kennedy NP, MPH
Gordon Medical Associates

Greetings!

Too often, I hear opponents of bio-identical hormones claim that "there really isn't any research to back them up." This simply is not true, but unfortunately statements like this continue to perpetuate confusion.

In this newsletter, I want to share with you the results of multiple studies demonstrating that bio-identical hormones are associated with reduced health risks and are more efficacious than their synthetic counterparts. I have prepared a synopsis of a current article that reviews the published bio-identical hormone literature. The article was written by Kent Holtorf, MD and was published in January 2009 issue of Postgraduate Medicine.

As more studies are done in the future, I believe we will continue to see that bio-identical hormones, when prescribed to replicate normal ranges in our bodies, can make positive contributions to our health and well being.

Be well,

Jane Kennedy
Nurse Practitioner

Gordon Medical Associates

A complete copy of the article " The Bioidentical Hormone Debate: Are Bioidentical Hormones (Estradiol, Estriol, and Progesterone) Safer or More Efficacious than Commonly Used Synthetic Versions in Hormone Replacement Therapy?" by Kent Holtorf, MD can be found by clicking here.

This article represents the most comprehensive review to date on the use of bio-identical hormones and their comparison with synthetic hormones. Dr. Holtorf reviewed and evaluated over 200 physiologic and clinical studies that demonstrated bio-identical hormones are more effective and have lower health risks than synthetic hormones.

Much misunderstanding in this area results from the inaccurate use of terms. The most important distinction to keep in mind is the following. Bio-identical hormone replacement therapy (BHRT) refers to the use of hormones that are exact molecular copies of the hormones of estriol, estradiol, and progesterone are made by the human body. This is in contrast to synthetic hormone replacement therapy (HRT), which uses pharmaceutical products (derived from mare's urine) with chemical structures that are foreign to the human body. These synthetics include conjugated equine estrogens (CEE), medroxy-progesterone acetate (MPA), and other progestins. So, remember that progestin is synthetic while progesterone is bio-identical.

Some of the main points reported in the article are:

Symptomatic Effectiveness

Several studies found that women experienced greater satisfaction, fewer side effects, and improved quality of life when switched from progestin to progesterone. Some studies found the following specific improvements when participants used progesterone rather than progestins:

30% reduction in sleep problems
50% reduction in anxiety
60% reduction in depression
30% reduction in somatic symptoms
25% reduction in menstrual bleeding
40% reduction in cognitive difficulties
30% improvement in sexual function

Overall, 65% of women felt that progesterone (and estrogen) therapy was better than progestin (and estrogen) therapy.

Physiological Effects and Cancer Risks

Several studies demonstrate that progestin and progesterone have different effects on breast tissue. Progesterone (bio-identical) has anti-carcinogenic properties (reduced risk for breast cancer) while progestin (synthetic) has been clearly associated with increased risk for breast cancer.

Although there have been no randomized controlled trials that directly compare the risks for breast cancer between progesterone and progestin, studies have consistently shown a decreased risk for breast cancer with use of progesterone. Several of these studies included thousands of women.

In addition, bio-identical estriol, one of the three estrogens made by our bodies, has unique physiologic properties associated with a reduction of breast cancer risk. Whether prescribed by itself or in combination with estradiol, it would be expected to decrease the overall risk of breast cancer.

Cardiovascular Disease Risk

The Women's Health Initiative study demonstrated that synthetic hormones MPA and Premarin (a CEE) resulted in a substantial increase in the risk of heart attack and stroke. Multiple additional studies have demonstrated that progestins create negative cardiovascular effects and wipe out the positive effects of estrogen on the cardiovascular system. This includes significant reductions in HDL (the protective "good" cholesterol), increased risk for blood clots, and increases in insulin resistance.

A number of studies have also shown that coronary artery spasm, which increases the risk of stoke and heart attacks, is reduced with use of transdermal bio-identical estrogen and/or progesterone. Furthermore, progesterone by itself or with transdermal bio-identical estrogen has been shown to prevent atherosclerotic plaque formation, a main culprit in heart disease.

Conclusion

Multiple studies support the use of bio-identical hormones in patients needing replacement therapy. These studies provide evidence that bio-identical hormones carry the greatest health benefit and lowest risk of hormone replacements for our patients. Additional clarification and refinement of these issues will hopefully result from future appropriately designed randomized controlled trials.

This Saturday March 7th is the first of my monthly Salon series for my patients at GMA. It is free of charge! Come casual and bring your coffee/tea while we talk and listen to each other about menopause, mid-life, and more. For those who are interested, we'll test out a yoga practice for a few minutes with a local yoga teacher at the break. See you Saturday at 9 AM-11 AM!

GMA meeting room at 3450 Regional Parkway, Santa Rosa. Just come - no RSVP needed.

Jane Kennedy is a Board Certified Family Nurse Practitioner with a Master's Degree in Nursing from UCLA as well as a Master's in Public Health from Loma Linda University. Jane comes to Gordon Medical Associates after relocating from Southern California, where she practiced in menopausal and preventive health.

With 25 years of clinical experience in family medicine and women's health, combined with her own personal experience, Jane has created a unique approach for women to achieve balance during the changes of mid-life. Her approach is grounded in the fundamental belief that each patient is unique and their individual health and well-being depends on the integral relationship of body, mind, and spirit.

www.GordonMedical.com

707.575.5180