Estradiol and Progesterone for Menopause
How are Bioidentical Estradiol and Progesterone Produced? What about Compounding Pharmacies?
“Bioidentical” is the term that signifies that the molecule is exactly the same as the one in our bodies.
Biodentical steroid hormones are made from yams, soy, and other plants that contain diosgenin. It is
easily converted by chemical processes into bioidentical estradiol and progesterone. The source does
not matter—only the chemical structure matters. The body accepts and metabolizes bioidentical
hormones as if it made them. There are FDA-approved bioidentical estradiol and progesterone products,
but they are often expensive, inconvenient, and hard to individualize. There isn't any FDA-approved
testosterone for women. Many physicians prefer to prescribe these hormones from compounding
pharmacies. They use the same USP-certified hormones used in FDA-approved products. They combine
carefully measured amounts of a hormone powder into a delivery vehicle—a cream, gel, tablet, or
capsule. Pharmacists are certified as experts in the production of such preparations. Any slight batch tobatch differences in concentration or delivery that may occur are insignificant to hormone replacement.
Compounded hormones work perfectly well, are more convenient and are less expensive.
What of the Recent Studies that prove that "HRT" is Dangerous?
“Hormone replacement therapy” was never hormone replacement at all; it was hormone substitution.
The Women’s Health Initiative study (WHI) reported in 2002 looked only at the effects of Premarin®
(pregnant mares’ urine estrogens, yes, from horses) and a test-tube progestin (Provera®). A progestin is
not progesterone; it is a drug. Progestins have progesterone-like effects non-progesterone-like effects.
Progestins do not raise serum progesterone levels nor support pregnancy. Likewise, “estrogens” are any
molecules with some estradiol-like effects. Many women can’t even tolerate alien hormones, but all
women benefit from the correct hormones given by the correct route, since this simply restores a more
youthful hormonal state. The arm of the WHI study using Premarin® and Provera® (PremPro®) was
discontinued early because an increased risk of breast cancer was detected. This risk was attributed to
Provera®. Provera® also caused a large increase in heart attacks and strokes. There is no evidence that
bioidentical progesterone increases the risk of breast cancer, heart disease or strokes. Progesterone
does not increase the risk of breast cancer (Campagnoli, 2005), nor does estradiol combined with
progesterone (Fournier, 2005, E3N-EPIC). Premarin® alone also caused an increased incidence of blood
clots and strokes in older women—a complication that we know is caused by swallowing estrogen. Oral
estrogen affects the liver in an unnatural way, increasing the production of clotting factors and the risk
of blood clots. However, estradiol delivered transdermally (through the skin) does not increase a
woman's risk of blood clots, heart attacks, or strokes at all. Unfortunately, the pharmaceuticallyfunded media and professional organizations have misrepresented the WHI and other studies as
implying that all “hormones” are equally dangerous. This is an understandable legal strategy given the
thousands of pending and potential lawsuits over the diseases and deaths caused by PremPro®.
How Long should I Stay on Hormones?
Women are being told that they should take hormones for menopause only if they have unbearable
symptoms and then only for 5 years maximum. However, this recommendation is based on the known
dangers of Prempro® and other hormone substitutes as revealed in the WHI and other studies.
Bioidentical transdermal estradiol combined with oral/sublingual/transdermal progesterone does not
increase the risk of breast cancer or heart disease. Indeed, these diseases are rare in premenopausal
women who have higher levels of both hormones. Estradiol and progesterone restoration is also vital to
a woman’s health: maintaining bone mass and sexual function; improving cognition, mood and sleep;
and preventing heart disease and dementia. Women should replace these hormones for the rest of
their lives in order to maintain their health and vitality as long as possible.