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Bio-Identical
Hormone Replacement Therapy for Women : Confusing Research
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| The findings of numerous studies
on hormone replacement therapy (HRT) conflict and,
as a result, have raised serious questions regarding
the appropriateness of HRT. Hormone replacement
is an approved therapy for relief from moderate
to severe hot flashes and symptoms of vulvar and
vaginal atrophy. Numerous studies have confirmed
that estrogen replacement decreases the risk of
colon cancer, estrogen and progesterone decrease
fracture risk, and various hormones increase energy
levels and enhance libido. Reputable sources offer
conflicting reports regarding issues such as memory,
Alzheimer’s disease, and stroke. |
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| With the exception of the Postmenopausal
Estrogen/Progestin Intervention (PEPI) study, major
studies have either failed to distinguish among
types and dosages of HRT used in the study, or examined
only the use of synthetic HRT preparations (as in
the case of the Women’s Health Initiative).
The Women’s Health Initiative (WHI) study
was designed to identify the potential risks and
benefits of HRT. The estrogen-progestin portion
of the clinical trial was stopped in 2002 after
results showed that a synthetic hormone combination
containing conjugated equine estrogens (CEE) plus
medroxyprogesterone acetate (MPA) increased the
women’s risks of developing invasive breast
cancer, heart disease, stroke, and pulmonary embolism.
The data and safety monitoring board concluded that
the risks outweighed the evidence of benefit for
fractures and colon cancer. Utilizing data from
the WHI, researchers later concluded that synthetic
CEE plus MPA does not improve mental functioning
and may increase the risk of dementia in women over
age 65. They suggest these hormones increase the
risk of stroke, which is known to increase the risk
of dementia. With regard to the risk of dementia,
typical HRT users are in their 50s and the WHI study
focused on women aged 65 and over, who have a higher
risk for dementia. The “estrogen-only”
portion of the WHI study was halted in March 2004
after analysis of data suggested that synthetic
CEE alone had no impact either way on heart disease
(the main focus of the study), but may increase
the risk of stroke. |
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| Many patients and medical professionals
are unaware of the availability of bio-identical
alternatives. In reality, women's experiences and
clinical outcomes of HRT differ vastly depending
on the dose, dosage form, and route of administration,
and most importantly, whether the hormones are synthetic
or bio-identical. As a result of concerns and doubts
generated by studies that use synthetic hormones,
many women who could substantially benefit from
bio-identical hormone replacement may never have
the opportunity. |
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| Published research delineating
the differences between natural bio-identical and
synthetic HRT is now more abundant, but studies
of bio-identical HRT will probably never be as plentiful
as those dealing with patented synthetic hormones.
Our pharmacy welcomes your questions. |
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Compounding content © 2005, Storey Marketing. All rights reserved. |
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