During a discussion of the pros and cons of the use of bio-identical hormones in an initial visit with a new patient, she proceeded to share with me that despite all the bad press hormones have had over time she couldn’t see why something that was needed to balance our body’s health in the first half of our lives could just make a u-turn and allegedly be bad for us in the second half. “Don’t they still play a role in providing balance for the body?” she asked.
Absolutely, they do!!! Great ideas and questions from this woman seeking to understand hormones and bio-identical therapy in order to make the best choices for herself to give her peace of mind and optimal health. These are questions that we all should consider.
Usually, I recommend that we first look at the diseases that are in your family background.
Even though you are not necessarily destined to develop these diseases, they can represent areas of genetic vulnerability or weakness that need your attention. Fortunately, there are almost always some form of life style practices you can adopt to prevent these vulnerabilities from turning into active disease or at least limit the risk.
Take cancer for instance. Multiple studies show that we can reduce our chances of developing cancer by doing daily exercise, eating healthfully, limiting alcohol consumption, taking supportive vitamins and minerals (especially vitamin D), managing stress more effectively, avoiding chemicals that are endocrine disruptors, etc…. You can choose which lifestyle factors you are willing to put in place and then rest in the confidence that you are actually doing something to reduce your cancer risk.
Headlines of recent articles, including “Estrogen After Menopause Lowers Breast Cancer Risk for Some Women” have cast more light upon this subject. These articles were reporting on a follow-up analysis of the landmark Women’s Health Initiative that was begun in 1993 and partially stopped in 2002 and 2004. This follow-up study, published in the journal Lancet Oncology, provides the strongest evidence yet that estrogen by itself not only lowers breast cancer risk over a sustained period for some women, but also curbs the chances of dying from the disease if you are at average risk for the disease. Women who took estrogen therapy for 5 years had a 23% reduced risk of breast cancer compared with those who took a placebo. In those who had a high risk profile for breast cancer, however, it did not reduce risks.
Be mindful, however, that these studies looked at the use of synthetic estrogens taken orally, which we know to increase other risks such as blood clot formation. This is believed to be due to the fact that the liver changes the estrogen molecule when it is processed through digestion, creating a different molecule that is more likely to cause these side effects.
Since bio-identical hormones are not taken orally, we avoid these side effects.
Recently, a new study (Jour of Gen Pract, 2013) looked at the use of bio-identical hormones in menopausal women for a 4 year period using a protocol like the one I follow. It found no adverse health incidents so far in their patient population of 460. In a statistical comparison with the Woman’s Health Initiative study which used synthetic oral hormones, the bio-identical study would have resulted in 33 women with negative health incidents (breast cancer, blood clot formation, heart attack, stroke),but they have none so far.
When we look at creating balance in the body by using physiologic levels of bio-identical hormones in a way that is similar to the manner and quantity as released by our ovaries (as opposed to oral routes for estrogen and testosterone), we see that they offer the potential to optimize health and well-being. With studies showing the decreased risks of heart disease, osteoporosis, high cholesterol, dementia and Alzheimer’s through the use of bio-identical hormones in physiologic ranges, I and many of my patients see hormones as our friends! I hope you do too.
Yes, we have to be responsible in our use of hormones, but they can give us a health benefit that is unique.
Here’s to you in creating optimal health and well-being!
Jane Kennedy, CFNP, MN, MPH