Bio-Identical Hormones for Peri-Menopause? An Irreverent Look Back

Yup. Been there: “What the F*&%! It’s 3 AM! I’m exhausted! Why can’t I get back to sleep?”. . . for the next 3 hours. The raging over absolutely NOTHING! And more. . . Bio-identical hormones for Peri-Menopause! “What!? There’s a CREAM for THAT? I want it. . . . Shoulda started months ago!”

“Why does (God/nature) put us through this?!”

“I’m ready to just kill him!” (spouse) and them (the kids). . . .

Red-faced, shirt soaked… .again! “Maybe I should just cancel ALL my clients & business meetings for the foreseeable future!? Oh, wait, I can’t, I have a business to run, people to serve & a family. . . “

“What was I calling him/her about?” “Why did I come into this room?” “Tell me that again. I didn’t quite follow that. The brain fog; again.” “Give me a sec.”

Above all: “Just make it go away!”

Your doctor has told you about ‘the options:’

First of all, your choices, to medicine’s understanding: Bio-identical hormone creams (made from plants) (BHT-bioidentical therapy) or pharmaceutical grade stuff made from pregnant mares’ pee (traditional hormone replacement therapy – HRT).

Seems like there was little choice in that, for me. But truth be told, I just took my doctor’s word… .that bio-identical hormones for peri-menopause would be safer and that they would work. Since the idea of ‘them’ impregnating a mare and collecting her pee so I could eat it in a pill nauseated me, the cream was really the ‘only’ choice. Besides, I’m the anti-drug, natural type.

I now know I could have made better choices; at least for me; choices that included neither of these options. Your choices are always your own in the end. I can’t blame anyone else for my folly. (I’ll tell you more about ‘alternative approaches’ in another article soon.)

I also know; as you soon will, about the risks of ‘bio-identicals’ or BHT.

So, over the next 2 months, my symptoms disappeared! Great! But wait! My clothes. . . they’re all too small! And what’s this!? The scale, it’s going up almost daily… .10 lbs. . . 15 lbs. . . .  20 lbs. heavier in just 2 months… not great! If I kept gaining weight at that rate, I’d be fatter than my mother ever was! (Excuse the irreverence; she’d be ok with it.)

So, (2 months & 20 lbs. later) I start my research! I tell myself, “Next time, I’ll do the research before I act. It was worth a try.” Now (as in today)… I’m not so sure it was. The positive thing that did come from this was the reinforcement of the understanding that what we think we know, and the truth are often two different things: especially in the realm of health & drugs.

Checking out references for ‘bio-identical hormones,’ ‘HRT’ and more:

So: Fast forward: several articles found. Now comes the love/hate part, getting through them! The dry writing bores me to tears but I’ve got to get through. I also know I have to read the entire article since the abstract may or may not arrive at a logical conclusion, the study methods may or may not be designed to draw the conclusions they do, there may be questions about the author’s ties to Big Pharma and more.

Since it’s estimated that less than 5% of medical journal articles represent well done, well-documented studies, sometimes it seems easier to throw all the articles in the air & just pick one to read & believe! But I know that’s no better than where I was before so I started my research! And I slog through & persist.

In order to not bore you tears with all the details, I’ll just summarize a couple of points:

(1) The Cochrane Collaborative (a non-profit whose mission is to do systematic reviews of studies and evaluate evidence in a non-biased way) concludes:

• There is data that is of ‘low to moderate’ quality that bioidentical hormone therapy (BHT) is more effective than placebo.
• There is evidence to suggest higher doses of BHT have more effect but that higher doses come with a higher risk of adverse events.
• No data is yet available regarding long term safety for the most serious risks of HRT: heart attack, stroke and breast cancer (see below for updated info on breast cancer).
• There is no good evidence to say that BHT is more effective than (traditional) HRT and the findings regarding adverse events are inconsistent.

(2) Several Journal articles told me a few things:

• The ‘safety’ of BHT seems to be based on the concept of ‘it’s from (safe) plants so it must be safer’. There is little real data to support this but also not a lot of good data to refute it.
• Some studies conclude that many of the ‘minor’ side effects attributed to traditional HRT, things like headaches, depression & my 20 lb. weight gain happen just as often with BHT.
• Until very recently there was little data about long term health effects. (see below regarding breast cancer).

(3) A study published in The Lancet in August 2019 (too late to help me with my decision but hopefully not you with yours) drew some interesting and scary conclusions.

This was a review of 58 studies involving 143,887 estrogen-positive breast cancer cases and 424,972 controls (without breast cancer) undertaken by The Collaborative Group on Hormone Functions in Breast Cancer in the UK and funded by Cancer Research UK and the Medical Research Council.

• There is a ‘small but significant’ increase in breast cancer rates from all types of hormone replacement therapy and the risk increases with increased time taking the drugs.
• Statistically speaking, the increased risk has amounted to approx.. 1 million additional cases of estrogen+ breast cancer in Western women since 1990!
• The relative rate of breast cancer for women on oral (traditional) HRT was calculated at 1.33. The relative rate for women using transdermal (Bioidentical cream) was 1.35! In English: a relative rate of 1.0 would represent no increase. A relative of 1.3 actually indicates a 30% increased rate! There was basically NO difference i the breast cancer rate for the 2 therapies!

So, there you have it: in a nutshell; Bio-identical creams have NOT been shown to be safer or more effective and are associated with the same increased rate of breast cancer as traditional HRT.

In my next post, I’ll review a few of the many natural things you can do to begin to regulate your hormones.

Update 2024

There has been significantly more information put forward about hormonal therapy in the past several years. Most of it seems to say that the drug are safer than what’s indicated above. However, I still have serious concerns as most medical/drug research is done by the pharmaceutical industry. They retain ownership of the data and only publish the data they choose to. (Do I hear the terms “bias” and “cherry-picking” here?) You can learn more about that in a book by John Abramson, MD.