Healthy Habits: The Benefits of Bioidentical Estrogen

By Rebecca Mendoza, CNP, NCMP, Care Provider at the Menopause Center of Minnesota

If you’ve heard the concerns of animal rights’ organizations about the production of Premarin, you should know that there are alternatives for people who need hormone replacement therapy. Bioidentical estrogen is identical on a molecular level to the estrogen produced in a woman’s ovaries. It can typically be taken orally in pill form, applied as a cream or gel, worn as a patch, taken orally as drops or a lozenge, or injected. Unlike many of the natural, plant-based supplements that have been sold for years to help with menopausal symptoms like vaginal dryness and hot flashes, bioidentical hormones are synthesized from many of those same plant sources into hormones indistinguishable from natural estrogen.

Bioidentical hormones can be prescribed in two different ways: standard pharmaceutical formulas available anywhere, and compounded formulas that are available only at compounding pharmacies. Standard pharmaceutical estrogen, as well as progesterone and testosterone, are available only in certain dosages. Many people can and do benefit from static dosing without the need for a custom formula.

But compounding allows hormones to be individualized to the needs of each patient, and may also help eliminate inert ingredients and preservatives in pharmaceutical options that some patients may be sensitive to or simply not wish to take. It allows for combinations of hormones in a different delivery system than they might be available in a standard pharmacy. Compounding also offers the option of lower dosages that aren’t normally available, which can help reduce or eliminate side effects like bleeding or breast tenderness in some women and may help allay fears about future health risks that are associated with hormone replacement therapy.

Premarin and other replacement hormones break down into forms of estrogen that can’t be measured in a typical hormone test. Bioidentical estrogen is the same as the estrogen produced by the ovaries, however, so it shows up in a standard lab test. While some experts think this is a huge benefit, since actual estrogen levels can be monitored easily, others argue that there’s no baseline recommendation for hormone levels, so the ability to measure it doesn’t make much difference.

It’s important to note that while compounded formulas contain ingredients that are FDA approved,the formulas themselves are not. This shouldn’t be seen as a black mark, however. The FDA won’t approve any type of compounded medication since each individual mixture can’t be exhaustively tested. Some health insurers may also refuse to cover compounded hormones but may cover standard pharmaceutical dosages as normal.

For women who suffer with menopausal symptoms like hot flashes, vaginal dryness, moodiness and night sweats, hormone replacement therapy can offer relief. Bioidentical hormones, whether in standard or compounded formulas, are an exact replica of the estrogen a woman’s body naturally produces and provide a cruelty-free and typically cost-effective option.