Certainly everyone reading this article knows about synthetic hormone replacement therapy (HRT) and maybe even BHRT (bioidentical hormone replacement therapy). But perhaps you’re not sure what the difference is, or why you are not told more about these differences. You are not alone by a long shot. For example, pharmaceutical companies and most medical doctors, in order to promote HRT, have successfully made women believe that hot flashes are the worst thing a woman can experience during her life. Of course hot flashes are uncomfortable and can be embarrassing; however, I believe it’s important to understand that a woman can get through hot flashes and that hot flashes are certainly not something that women die from. However, many of the long-term side effects of synthetic HRT can actually cause very troublesome health concerns. Unfortunately, most women are not made aware of what they may be sacrificing health-wise in the name of relieving hot flashes.
History of HRT (Hormone Replacement Therapy)
Let’s look at a brief history of hormone replacement therapy.
In 1938, Charles Dobbs discovered diethylstilbestrol (DES), supposedly the first synthetic estrogen. Dobbs thought DES would solve the problems of menopause but the AMA immediately began to make extravagant predictions that it would prevent miscarriages and solve all problems of pregnancy as well. It was prescribed as a “safe pregnancy” drug to prevent miscarriages. But by 1960, the number of DES daughters having sex organ issues was up around 60 to 90% of all infertility problems, miscarriages, and cervical cancer. Breast cancer in the mothers had increased by 40%.
Next there was Robert Wilson’s “Feminine Forever” thesis that menopause was an estrogen deficient disease. Insufficient estrogen was proposed as the cause of all menopause symptoms. The drug industry immediately donated $1.3 million to set up the Wilson Foundation for the sole purpose of developing and promoting estrogen drugs based upon pregnant horse’s urine. Resulting drug company funded studies were cited as inconclusive, or skewed results were reported. Negatives were swept under the carpet as irrelevant.
In 1975 the New England Journal of Medicine published findings after studying endometrial cancer. Women who took estrogen had increased their risk of endometrial cancer by five times, even up to 14 times if they had used the drugs for seven years. However it was found that if synthetic progesterone (called progestin) was added to the estrogens the risk of this cancer would be reduced. This new product was promoted by changing the name from Estrogen Replacement Therapy (ERT) to HRT. In the same year, the American Cancer Society of 240,000 found a close relationship between HRT and cancer. However, this study was generally ignored.
As the HRT industry gained strength, unsupported claims that it prevented osteoporosis and heart disease arose. But side effects of HRT were beginning to become a bigger problem than the menopause symptoms they were to solve. Side effects now occurring were migraines, increased clotting, high stroke risk, mood swings, disrupted copper/zinc ratios in the brain, fibroids, endometriosis, and sluggish blood circulation.
As the complex menopausal myths occurred, the natural health movement was gaining strength as the Baby Boomers became educated, and many took a more proactive approach to their health care needs. The natural medicine community followed the estrogen myth developments and warned women of the consequences of HRT. The position was taken that the body is not made for substances that are foreign. How much more foreign can you get than a pregnant horse’s urine?
The traditional method of health care in the United States provides the pharmaceutical industry highly lucrative markets. The potential market for patentable progestins is vast–birth control, irregular menses, osteoporosis–literally every woman through the age of puberty on, is a target for a sale.
Ample medical research regarding progesterone was carried on from the 1940’s through the 1960’s, and was well reported in mainline, recognized medical literature. Since the early 1970’s, however, medical research became much more expensive and the grants subsidizing progesterone research, or any unpatentable medicine and treatment technique, dried up. Funds supported synthetic drugs, particularly progestins, because they were patentable and because they brought in huge amounts of money.
If a pharmaceutical company is selling a product, the final product cannot be a natural substance or they cannot patent it. This means that naturally occurring substances cannot be patented. This is also why pharmaceutical companies were not interested in natural progesterone, nor would they sponsor any research to help further prove its effectiveness. Presently, the FDA has actually approved 14 different bioidentical progesterone products manufactured by pharmaceutical companies – without those “gold standard” clinical trials. Obviously they know BHRT works, they just want to corner the market and, in fact, have asked the FDA several times over the last 10 years to make bioidentical hormones prescription-only. So far, the FDA has declined their request and most likely the reason has been the inundation of women’s comments requesting that over-the-counter bioidentical hormones continue to be available.
Integrative practitioners and doctors understand that estrogen is not usually the hormone to replace. They are becoming increasingly aware that it is progesterone that is desperately needed. As previously mentioned, synthetic estrogen products are formulated to include synthetic progestins to offset some of the bad side effects of estrogen dominance. This vicious cycle is now understood with the advent of natural progesterone.
Products use terms for estrogen and progestin, such as “similar to natural hormones.” Many drug companies do derive these natural hormones from plants, but then in order to patent it, they have to change a molecule, so that it is not a naturally occurring substance. This change makes it foreign to our bodies, creating the bad side effects. Be very cautious. Physicians unfamiliar with natural health practices and standards will sometimes call pharmaceutical products natural when prescribing them or they will use the term progesterone when they actually mean synthetic progestin.
Be aware that when doctors request serum lab tests for hormone levels, they typically find that women are low in estrogen. However, the hormones are even lower in progesterone, which many doctors do not even test for. Dr. John Lee found that raising just the progesterone levels could balance out the estrogen levels naturally in the body.
We are now more aware of how the health system works in this country. Over-the-counter BHRT will most likely never get full acknowledgement from the allopathic (traditional medicine) community. There is just not enough money to be made by using things as simple as healthy diet, exercise, stress management and hormones that are bioidentical.
Many women taking synthetic estrogen, or synthetic estrogen combined with progestin, are able to satisfactorily discontinue synthetic HRT and make the move to BHRT. I suggest finding a knowledgeable practitioner for guidance and help. As a side note, it is not wise to use estrogen without the balance of progesterone, yet many practitioners continue to recommend estrogen-only. It is also possible, that if progesterone levels are balanced, the body can also balance estrogen levels without using an outside source for estrogen. I highly suggest performing a hormone saliva test before using any type of hormone therapy – natural or synthetic. This will give you a baseline in which to compare future testing.
Hormone levels can be tested with a simple and inexpensive hormone saliva test in the privacy of your home. With these results, you and your healthcare practitioner can determine if there is a need for natural hormone replacement therapy.