The use of bioidentical hormones, including progesterone, estradiol, and estriol, in hormone replacement therapy (HRT) has sparked intense debate. Of special concern is their relative safety compared with traditional synthetic and animal-derived versions, such as conjugated equine estrogens (CEE), medroxyprogesterone acetate (MPA), and other synthetic progestins.A recent study examined published primary literature comparing the effects of bioidentical and synthetic hormones, including clinical outcomes and in vitro results. The results showed that patients report greater satisfaction with HRTs that contain progesterone compared with those that contain a synthetic progestin.
Bioidentical hormones have some distinctly different, potentially opposite, physiological effects compared with their synthetic counterparts, which have different chemical structures. Both physiological and clinical data indicated that progesterone is associated with a diminished risk for breast cancer, compared with the increased risk associated with synthetic progestins. Estriol has some unique physiological effects, which differentiate it from estradiol, estrone, and CEE. Estriol would be expected to carry less risk for breast cancer. Synthetic progestins have a variety of negative cardiovascular effects, which may be avoided with progesterone.
In conclusion, physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT (Postgrad Med. 2009 Jan;121(1):73-85.)
Working with you and your prescriber, our compounding pharmacist can prepare hormones in a variety of strengths and dosage forms, including topical or vaginal creams, capsules, sublingual drops or troches, and suppositories. Contact us directly for more information.