The Balance on Bioidentical Hormones

As soon as a product claims to contain "all natural ingredients" consumers are usually happy to pay more for that distinction.

As people become more health conscious, they generally prefer natural alternatives to those synthesized in a laboratory.

This preference is largely based on the assumption that "natural" equals "better," which is not always the case.

While some "natural" foods are a better alternative to processed foods, consumers should be wary about jumping to the same conclusion when it comes to medical supplements, such as hormone therapy.

Many women choose hormone replacement therapy (HRT) to treat the symptoms of menopause and guard against postmenopausal conditions, such as osteoporosis. But in 2002, estrogen and progestin-estrogen replacement therapies were found to carry significant side effects. Now a "natural" alternative is gaining popularity.

Recently, compounded bioidentical hormones have received significant attention simply because they are derived from yam and soy plants - and are matched to be identical to the hormones your own body produces.

Proponents of these manufactured hormones claim a simple saliva test will determine the exact dose and hormone combination required for a patient to have perfect balance in their hormonal chemistry.

An effectively customized dose of hormones sounds like a long-awaited solution for millions of women going through menopause.

However, these compounded bioidentical hormone medications have not been approved by the Food and Drug Administration.

The real question is whether the medical community is as eager to endorse bioidentical hormones as some celebrities have done.

According to Dr. Christine Derzko, chief of endocrinology at St. Michael's Hospital in Toronto, "the basic problem is that we have no safety or efficacy data to support the use of compounded bioidentical hormones."

Bioidentical hormones are rapidly increasing in popularity as consumers hope that these compounds will not come with the same risks associated with traditional HRT.

The risks attributed to extended use of HRT in the 2002 Women's Health Initiative trial included heart disease, stroke, and breast cancer. Proponents of bioidentical hormone therapy argue that these results are based only on studies with synthetic hormones.

Whether the subtle differences between synthetic and bioidentical compounds will have a profound effect on the health of the recipient is questionable.

At this time, there is no way to know. "There is no quality control," Derzko says, "Which is not to say that these products are always bad or ineffective." Derzko said doctors need more studies to draw conclusions about these therapies one way or the other.

Studies conducted on traditional hormone replacement therapy have shown there are many variables that contribute to risk factors. Even the manner in which a hormone is administered to the patient can have an impact on its side effects.

When estrogen is taken as a pill, it first passes through the liver, stimulating the body to produce proteins linked to heart disease and stroke. This side effect is largely eliminated when estrogen enters the body through the skin, using a patch or a gel.

Cautious and wise consumers should opt for therapeutic supplements that are tested and approved. According to Derzko, there are some bioidentical hormones that have gone through this process: "We do have 'bioidentical hormones' in the form of transdermal preparations such as patches or estrogen gel."

The same holds true for Promentrium, a hormone that is basically 'natural progesterone'. These products have been tested and found equivalent to the other standard hormonal preparations which we use," Derzko said.

Due to the absence of data supporting the safety and consistency of compounded bioidentical hormones, the medical community is not yet supporting these as alternatives to standard HRT.

Derzko suggests that "we need to practice 'evidence-based medicine', and the lack of evidence supporting the use of the compounded bioidentical hormones makes a decision to use or prescribe them currently inappropriate."

More research involving bioidentical hormones could help doctors determine if these compounds are an appropriate and safer alternative. "I think we would all welcome this evidence, be it good or bad, so that we could make the appropriate recommendations for their use," concludes Derzko. health writer Christine Buske contributed to this report.

For more great information on living healthy through every decade of life, click here to check out Dr. Manny's book The Check List (Harper Collins, 2007).

Dr. Manny Alvarez is the managing editor of health news at, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.