Treat the Problem, Not Just the Symptoms, with Bioidentical Hormones

As explained in previous articles in this series, menopause is not just a collection of bothersome, temporary symptoms – it is the time when you experience the permanent loss of the ability to produce adequate amounts of the sex hormones estradiol and progesterone due to normal aging.

In simplest terms, menopause is a natural occurrence that creates a permanent hormone deficiency state.

Since all the various hormone systems of your body are interconnected and interdependent, the absence of any hormone, even minor hormones such estradiol and progesterone, will, over time, cause all of your hormone systems to become imbalanced. You see, once you lose the ability to produce estradiol and progesterone, there are no natural, healthy, physiological adjustments the body can make to compensate for their loss in order to balance out the other hormone systems.

This hormone system imbalance accelerates aging and contributes to the onset of the degenerative diseases of aging, such as heart disease, cancer, type 2 diabetes, Alzheimer’s dementia, osteoporosis, and stroke.

This is why menopause should never be ignored; it is a permanent condition with significant, continuing, health consequences.


There is Only One Effective and Safe Way to Treat Menopause

The only way to treat menopause is to correct the hormone deficiency it causes – the loss of estradiol and progesterone. Remember, the body has no “back-up” system for producing adequate estradiol and progesterone.

So, what must be done to restore hormone balance is to correctly restore the missing sex hormones with bioidentical estradiol and progesterone, NOT with hormone drugs.


Bioidentical Hormones versus Hormone Drugs

The longstanding method for the treatment of menopause has been to use hormone drugs. The differences between bioidentical hormones and hormone drugs are significant, but are not often understood or appreciated. You should be familiar with these differences and also be aware of the elements of the debate that has surrounded their use.

A bioidentical hormone is a synthesized (made in a lab) substance that has the same chemical structure as the naturally produced hormone it is restoring – a chemical structure familiar to the body, whic allows it to continue to function as if the missing hormone were still present.

The chemical structure of synthesized bioidentical estradiol is identical to the human estradiol made in the ovaries. However, the chemical structure of a conjugated equine estrogen preparation, used in estrogen hormone drugs such as Premarin® and Prempro®, is not identical to human estradiol, even though these drugs have been widely prescribed for many years to treat menopause.

Similarly, synthesized, bioidentical progesterone is identical in structure to human progesterone, whereas, medroxyprogesterone acetate, a progestin drug found in both Provera® and PremPro, is not.

Bioidentical sex hormones are synthesized from natural substances found in soy and yams. Despite popular belief, these plants, themselves, do not actually contain the hormones. What these plants contain are precursors. Precursors are chemicals that are converted into the hormones under the right biochemical circumstances.

The bioidentical hormones used to treat menopause are synthesized in a laboratory. This means they are synthetic. However, even though they are synthetic, they have the same chemical structure as the hormone they are being used to restore. The body responds to them as if it had naturally produced them itself. In other words, these synthetic, bioidentical hormones take the place of the body’s own hormones and can restore hormone balance.

In contrast, while a conjugated equine estrogen preparation can be considered a “natural substance” because it comes from the urine of pregnant mares, it is not bioidentical. Horse estrogens are not the same as human estrogens. They do not have the same biochemical structure; a woman’s body does not respond to horse estrogens the way she responded to the estradiol her body formerly produced.

Although, taking horse estrogens can help with hot flashes and other symptoms, that is all they can do – treat symptoms. They certainly do not take the place of human estradiol and they cannot restore hormone balance. You should never use hormone drugs. To treat your menopause safely and effectively, you must use bioidentical hormones.

Unfortunately, however, the treatment method recommended by the FDA and other “authorities,” and, thus, the method most often recommended by physicians, is to use hormone drugs, and to do so using the lowest possible dosage for the shortest amount of time to treat the symptoms of menopause. This treatment method is what is known as the “Standard of Care.”

There are several significant problems with the Standard of Care.

  • First, hormone drugs are not bioidentical; they do not share the same chemical structure as the hormones they are prescribed to replace. They have only some of the characteristics and effects of the naturally produced human hormone, and have certain other characteristics and effects that are both foreign and detrimental. This treatment method remains in use despite the fact that it is well established that hormone drugs such as Premarin®, Provera®, and PremPro® – have harmful, long-term side effects such as promoting heart disease, strokes, blood clots, and breast cancer.
  • Second, it is critically important for you to understand that hormone drugs do little or nothing to address the metabolic imbalance caused by the loss of the sex hormone system. Therefore, hormone drugs do little or nothing to slow down the aging process or the onset of the degenerative diseases of aging. To do so, you must treat the hormone imbalance by restoring the missing sex hormones, not use chemical substances foreign to the body to simply treat some of the symptoms.


Caution: Bioidentical is Not Enough

Just because you use bioidentical hormones doesn’t mean that what you are doing is either effective or safe. The other essential element for the effective and safe treatment of menopause is that the bioidentical hormones must be administered in what is called a bioequivalent manner

There are numerous ways to administer bioidentical hormones, many of which will not remedy the hormone imbalance caused by menopause, and some of which are actually harmful.

In order to be both effective and safe, the bioidentical hormones must be administered in what is called a bioequivalent manner. Bioequivalent manner means the manner that most closely mimics the way in which your body produced estradiol and progesterone prior to menopause.

It is important that you become familiar with the various methods for administering hormones, and learn more about what it means to administer bioidentical hormones in a bioequivalent manner. A good way to get started is to read my paper: Take the Bioidentical Hormones in a Bioequivalent Manner.


But What About Those Symptoms?

The good news is, that while treating the symptoms does not treat the hormone imbalance caused by menopause, treating the hormone imbalance does treat the symptoms. It just makes sense.

The symptoms of menopause are caused by inadequate levels of estradiol and progesterone. By restoring your baseline estradiol and progesterone levels the symptoms go away. It’s that simple.

Over the last twenty years, in my clinical practice, I have proven this fact time and again with thousands of women in menopause.


A Final Note

While my approach to treating menopause with bioidentical hormones may appear to conflict with “conventional wisdom,” it actually does not. In fact, it is entirely consistent with the way in which nearly every other hormone deficiency is treated. Restoring the missing hormones is the accepted, time-tested, proven method for safely and effectively treating other hormone deficiencies. For example, type 1 diabetes, the body’s inability to produce adequate levels of the hormone insulin, is treated by restoring the missing insulin with bioidentical insulin administered in a bioequivalent manner. Hypothyroidism, a deficiency of thyroid hormones, is also treated the same way – replace the missing hormones with bioidentical hormones, not hormone drugs, again, in a bioequivalent manner. The same is true of treating diseases of the adrenal glands.

So, why is menopause treated differently? In short, it’s because of confusion, misinformation, profit motives, conflicts of interest, and the failure of the medical profession to properly educate physicians. It has nothing to do with science and physiology – or your best interests! So keep reading and learning so that, when it comes to your health, you can be your own best advocate!


To your health and happiness,

Diana Schwarzbein, MD