Menopause is the permanent cessation of menses due to loss of ovarian follicular activity which can only be recognized retrospectively after 12 consecutive months of amenorrhoea.
Loss of ovarian follicular activity causes a sharp decrease in levels of 17 β estradiol which is the main premenopausal estrogen in women. This 17 β estradiol is mainly involved in maintaining vaginal tissue and bone mass.
Common Menopausal Symptoms are
- Acute Symptoms:
Vasomotor – Hot flashes, night sweats, palpitations, insomnia
Psychological – Mood changes, depression, irritability, poor memory
- Intermediate Symptoms:
Genital tract atrophy, dyspareunia, urethral syndrome, dysuria, loss of libido
Joint/muscle pain, genital prolapse, stress urinary incontinence
- Long term Sequale:
Osteoporosis, Cardiovascular risk
Since estradiol is decreased during menopause, exogenous estrogen replacement therapy is considered the best choice to alleviate menopausal symptoms. Progesterone supplementation is added to avoid the unopposed endometrial proliferation in the uterus and prevent endometrial carcinoma.
The Women’s Health Initiative Trial (WHI) in 2002 for post-menopausal women found an increased risk of breast cancer, coronary heart disease, stroke, and thromboembolism in women on HRT. This led to serious concerns among women and sudden decline in the use of HRT. Bioidentical hormones have since evolved with an aim to improve efficacy and minimize side effects of HRT.
Bioidentical hormone (BH) is any hormone mainly derived from plant material or from synthetic sources with molecular similarity to that of endogenous hormones in the body. These hormones are mainly produced by chemically extracting diosgenin from plants such as yams and soy.
Due to the structural similarity to endogenous hormones, bioidentical hormones offer several advantages over non-bioidentical HRT. Bioidentical progesterones such as FDA-approved micronized formulation of oral progesterone, premetrium have improved bioavailability and tolerance.
Bioidentical progesterones do not exert a negative effect on blood lipids when compared to their synthetic counterparts. Studies of both bioidentical estrogens and progesterone suggest a reduced risk of blood clots and coronary vasospasm compared to non-bioidentical preparations.
Bioidentical hormone use is associated with better sleep efficiency and cognition benefits. Progesterone has numerous beneficial effects on the nervous system, including supporting myelin formation and activating GABA receptors.
Progesterone opposes the proliferative effects of estradiol in the breast and hence carries less risk of breast cancer compared to synthetic progestins.
FDA-approved bioidentical hormones –
Custom compounded BHT formulations are individualized prescriptions for patients whose needs cannot be met by a commercially available FDA-approved preparation. It may provide a different strength, dose, or alternative forms like capsules, vaginal creams, suppositories, sublingual drops, topical gels, rapidly dissolving tablets, or transdermal gels.
The use of bioidentical hormone therapy relieves symptoms, minimizes side effects, and caters to health needs on an individual basis for menopausal and perimenopausal women.
So from now on, be proactive in taking care of your own health and choose the natural way through menopause.
- Compounded or confused? Bioidentical hormones and menopausal health
Alyson L Huntley
Menopause international 2011; 17: 16–18.
- A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks
Deborah Moskowitz, MD
Alternative medicine review • volume 11, number 3 • 2006
- Bioidentical hormones: an evidence-based review for primary care providers
Eileen Conaway E,
J am osteopath assoc. 2011;111(3):153-164