Bio-identical Hormone Therapy for Women

What bio-identical hormone replacement therapy for women consists of

The main points are:

• As with standard HRT, bio-identical hormone replacement therapy (BHRT) consists of regular treatment with oestrogen and progesterone, the two main female hormones;
• In both HRT and BHRT the oestrogen given is in a bio-identical form (usually called oestradiol); 
• In BHRT the oestradiol is taken in through the skin, either as a cream or as a skin patch. In standard HRT the oestradiol is given as a pill, which is known to come with a risk of side-effects, such as heart disease and stroke. These risks are almost eliminated by passing the hormone through the skin.
• In BHRT the progesterone used is always a bio-identical form, taken either as a pill or a cream, a treatment that has few, if any, side-effects. In standard HRT, however, the progesterone used is usually a synthetic form that is known to carry risks and side-effects. 
• The bio-identical progesterone used in BHRT is prepared in what is called a micronised form, meaning that the grains of the dry hormone powder have been ground down to a consistent and minute size of about one micron (a millionth of a metre) across. When taken as a pill, this form maximises the progesterone’s availability once in the tissues.

Other hormones used in bio-identical hormone replacement therapy in women

Testosterone: In BHRT a small amount of the male hormone testosterone is also given to women. Normally present in younger women, it declines during menopause, but it is important in promoting libido. The amount used is at most one-tenth of that given to men. Adding this small amount of testosterone boosts libido, vitality, mood, motivation and memory, and helps to increase bone density (thus protecting against osteoporosis);

DHEA: A hormone that is both responsible for a general sense of well-being and confidence, as well as being physiologically a precursor of both oestrogen and testosterone. Almost unheard of in classical medicine, DHEA is increasingly recognised as a valuable addition to any menopause treatment. Its use has been shown to greatly improve quality of life, boosting energy levels, memory, libido and strength, promoting weight-loss and alleviating joint pain;

Pregnenolone: Another steroid hormone that is a precursor of both DHEA and all the sex hormones, and which itself directly helps to maintain mental abilities, including memory and ability to concentrate and to analyse.

Starting the bio-identical hormone therapy process

Before starting treatment you will need to have a consultation with Dr Drucker to allow her to assess whether BHRT is suitable for you. It is possible that if you have been menopausal for 10 years or more and have had no prior HRT treatment during that time then BHRT will not work for you. Apart from this, BHRT will be highly applicable to the great majority of menopausal women.

During the consultation Dr Drucker will:

• Describe the treatment to you;
• Ask you to fill in a form that provides your medical history;
• Ask you about your menopause symptoms, if you have any;
• Take a sample of blood, which will be sent to a laboratory for tests.

The tests will measure a number of things in your blood, including of course oestrogen, progesterone, testosterone and DHEA levels. 

Dr Drucker will use all the information, including the test results, to determine what doses of hormones you need in your treatment. She will then write up a prescription, which will be sent to a specialist pharmacy, who will put together your own personalised formulations for you to start taking.

Switching from standard HRT to bio-identical hormone replacement therapy

For anyone already receiving standard HRT it is usually quite straightforward to make the switch to bio-identical HRT (BHRT). It should be noted, however, that changing from one to the other is not always an exactly equal swap, for at least two reasons:

• Changing from oestrogen taken as a pill to one given as a skin patch will involve a change in dose due to the different ways the hormone is processed in the body;
• Bio-identical progesterone needs to be given at a higher dose than is normal with the synthetic progesterone, due to the latter’s strong efficacy. This does not, however, mean any increase in risk with the bio-identical progesterone: quite the opposite in fact, as the bio-identical progesterone is much safer than its synthetic cousin at any dose.

The equivalent doses needed when making the switch away from standard HRT have been closely studied and so are well known. However, since BHRT is tailored to your personal needs (unlike standard HRT), any small adjustments that are found to be needed can be easily made.

How to take the BHRT hormones

A huge amount of research has gone into working out the best ways for you to take these hormones to get the best results risk-free. 

The best methods for the hormones are as follows:

• Oestrogen is best applied as either a skin cream or a skin patch;
• Progesterone is best taken as a pill or a cream, every evening;
• Testosterone is best taken as a skin cream applied every morning;
• DHEA is best taken as a daily pill on an empty stomach (principally first thing in the morning, before breakfast);
• Pregnenolone is best taken as a daily pill, every evening.

These are the methods favoured by Dr Drucker. 

Remember: This is a long-term treatment process that you may decide to stay on for a good number of years, during which you will need to take the prescribed hormones every day.

Details of the treatment process

Before deciding to join up for BHRT please read the full description of the treatment process, including the consultations and tests you will need to have, and what you will need to pay for.