Red Hot Mamas In Charge of Change.
By: Red Hot Mamas
Published: February 16, 2009
Red Hot Mamas medical advisors recently issued the following press release regarding The Bioidentical Conundrum – Cure or Curse on February 17, 2009 to address the recent flare-up of conversation on the issue of bioidenticals. To comment, please visit our bulletin boards.
Roswell, GA, 30075 2/17/09—Estrogen is back in the news thanks to the popular "Oprah" television show. As a result, bioidentical hormone therapy has become more controversial and confusing. Much of this stems from actress, author and bioidentical expert advocate, Suzanne Somers, unequivocally professing bioidentical estrogens are better and safer.
So are they? Read on…
"Bioidentical is not a medical term," says Dr. Mache Seibel, Professor of Obstetrics & Gynecology and Director of the Menopause Program at the University of Massachusetts School of Medicine in Worcester, MA. "It's a lay description for a manufactured hormone whose chemical structure is identical to its counterpart hormone made in the body. It doesn't mean natural, even if it originates from soybeans and sweet potatoes – all bioidenticals are synthesized in chemical plants."
"For women, there are three bioidentical estrogen hormones," states Seibel who is also founder of Healthrock® (http://www.healthrock.com/): "estrone, estradiol and estriol. There's also bioidentical progesterone, and bioidentical testosterone."
Estradiol is the major estrogen because it's the most potent, and levels vary depending on the day of the menstrual cycle – from 50 picograms per milliliter (a picogram is one trillionth of a gram) to six to eight times higher – about 400 picograms per milliliter. After menopause, ovaries make less estrogen and the estradiol blood levels are less than 30 picograms per milliliter.
Lower estrogen levels cause many of the symptoms of menopause – hot flashes, dry skin and vaginal dryness, poor sleep, loss of calcium from the bones (osteoporosis) and bladder problems. "Hormone therapy raises blood estrogen levels and even a little helps control symptoms," says Dr. Mary Jane Minkin, Clinical Professor of Obstetrics & Gynecology at Yale University School of Medicine.
"Gynecologists have been prescribing estradiol for years as pills (such as Estrace), patches (such as Vivelle-Dot and Climara), spray (Evamist), and gels (such as Divigel and Estrogel). So bioidenticals are not just compounded." Premarin is also estrogen but it isn't estradiol or bioidentical; it is called conjugated equine estrogen because it contains many types of estrogens and is processed from pregnant mares' urine.
Karen Giblin, Founder of Red Hot Mamas explains, "All drugstores carry estradiol that is regulated and inspected by the FDA for efficacy and safety, and doses are accurate. Compounding pharmacies can also provide estradiol. They mix it (and/or other hormones) into a cream or gel so it can be rubbed on the skin or placed into the vagina."
Many are very good and accurate, but the compounding process is not FDA inspected, and dosages can vary considerably from batch to batch. "These compounded 'bioidentical' products are commonly marketed as being natural, however they are not," states Giblin. "These products are drugs and carry the same risks as those who have gone under the scrutiny of FDA testing."
So are bioidenticals safer than other estrogens? "Consider this question," states Seibel. "Which weighs more, a pound of feathers, or a pound of bricks? They both weigh the same. So if equivalent amounts of estrogen are used, whether bioidentical or conjugated, their benefits and risks will also be equivilant."
The real question is, "Is taking any estrogen a good choice for me?" Talk with a clinician who is knowledgeable about this question. There are menopause clinicians listed on websites such as the North American Menopause Society (http://www.menopause.org/) and good general information on http://www.redhotmamas.org/.
"If taking any estrogen is a good choice for you, taking a bioidentical estrogen may be a good choice too," the experts agree. "It's neither a cure, nor a curse." Just evaluate the facts, avoid faddish claims that bioidenticals are natural, safer as there is really no good evidence to support these claims.
The Red Hot Mamas® is the nation's largest menopause education program in the United States, offered within hospitals across the nation and in Canada. For more information contact Karen Giblin at kgiblin@redhotmamas.org or call 770.640.1018.
To learn more about the authors, visit Red Hot Mamas Advisory Board of Healthcare Professionals.
For more information about this topic, go to NAMS Confirms Its Support of FDA Warning About Custom-Compounded Bioidentical Hormone Therapy.
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