During menopause, a decrease in the amount of eggs within your ovaries leads to a reduction of your sex hormones progesterone and oestrogen.  These lower than before hormone levels contribute to the common menopause symptoms - hot flushes, vaginal dryness and mood changes.  Medical doctors have been telling women for years that taking HRT would lower their risk of heart disease - this has no scientific basis.


HRT v's bHRT

Conventional hormone replacement therapy (HRT) is no longer a favourite treatment for many women due to the raft of side effects (some annoying, others deadly) that come with this line of therapy.  The drugs used in HRT are synthetically produced, even though some of them are marketed as being "plant-based" and "natural".  "Natural" does not always mean healthy, in the world of pharmaceutical drugs.  The HRT drug Premarin, for example, is made using pregnant mare urine - a natural substance - but then further synthesized in a lab to create the drug.  Some conventional HRT therapies are derived from plant sources though and it appears not to be where the hormones are derived from that is the key, but how they are manipulated in the laboratory. 

When you isolate the active ingredient of a herb you are taking it away from the other components that are naturally occurring in the whole of the herb therefore leaving it open to causing side-effects. There are now medical doctors starting to treat menopause with Bioidentical Hormone Replacemenr Therapy (bHRT) as they say it is a "natural" treatment approach.  They prescribe hormones based on individual testing for each patient and the the patient has the prescrption made up at a compounding chemist.  The argument is that bHRT is a more natural approach as the body is more accepting of these hormones, and that it knows how to metabolize them.  Some of the dangers with conventional HRT ere due to the way the body synthesized the drug.

The herbs I use to help patients manage menopause are natural, so I wondered "where these bioidentical hormones were sourced".



Plants don't contain hormones, they merely bind to the same receptor site and mimic hormonal action.  Some plants do contain chemical compounds that bind to human hormone receptors.  The body then responds the same way as it would have, had it in fact been a real hormone that had bound to the receptor.  So, if an isoflavone from the soy plant binds to an oestrogen receptor in the ovaries, the body will behave the same way that it would have done if it had in fact been it's own true oestrogen hormone that had attached to the receptor.  You could say that the body was almost "tricked" into thinking it had more oestrogen than it really did.  Bioidentical hormones work in a similar way, by binding to the hormone receptors in the body and triggering a response. 

"Bioidentical" refers to the SHAPE of the molecule, in that it has the exact same chemical shape as our own hormones.  But they are not natural - they are synthesized or chemically manufactured in a lab from a "natural source" just like some of the conventional HRT drugs.  This is most often a plant derivative from Soy, Mexican Yam or Sarsparilla (Smilax).



A few years ago a link was established between conventional HRT, which consists of hormones that are slightly different to our naturally occurring hormones, and an increased risk of breast cancer and heart disease which led to women looking for an alternative.  As an answer to this problem the research laboratories went on to develop a subtly different preparation of chemically manufactured hormones. 

To make bioidentical progesterone, for example, the starting molecule is often a sterol derived from Wild Yam (Dioscorea villosa).  Our own body used cholesterol as a starting block to make our sex hormones.  This is then synthesized in a laboratory to create a compound that matches the shape of the progesterone our body makes.  The only real difference, as far as I can tell, from conventional HRT drugs and bHRT is the shape of the compound.  There is in fact no credible evidence to suggest that bHRT is any better than HRT.

I would have to give huge amounts of herbs to get the same result as a Doctor gets from high dose bHRT.  This is one of the main reasons I question how "natural" it is in fact.  A woman's hormones are constantly fluctuating and affected by stress and weight-loss so to take a blood test and then prescribe in just one blood test seems questionable.  What I can see is a difference in, is the way bHRT is prescribed.  When done by a trained specialist, it seems bHRT is almost similar to a naturopathic approach to menopause.  The individual patient is taken into account and rather than a one-size-fits-all approach, a unique prescription is created based on the hormones this patient needs.  Often the adrenals are addressed via the administering of DHEA, and we naturopaths have been working with the adrenals for menopause for centuries.  Still, bHRT uses synthetically created drugs, so don't let anyone try to tell you they are "natural".


Some of the leading bHRT doctors and clinics will use nutritional therapy, herbal medicines and lifestyle changes first and only prescribe bHRT medications as a last resort.  I achieve such great results using herbal medicines that I really wonder whether we need replacement hormones after menopause.  Remember that a good Naturopath will address the whole picture of your health, and won't just focus on the hormones.  The health of your digestive system, your liver, your nervous system and adrenal glands all come into play with menpause and this where a Naturopath using herbal medicine - straight from the plant and not via a laboratory - can really help.  I do believe however that a woman that goes through early Menopause before fifty years of age and struggles with the transition symptoms may benefit from bHRT in the short term. But long term....  Surely if we were meant to have hormones after Menopause our bodies would keep making them???


Date posted: 2013-10-16 | posted by: debras

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