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Considering Bioidentical Hormones: Support and Warnings

Introduction and Thesis

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In considering the use and effectiveness of bioidentical hormones, it is essential to have an overview of the contemporary research conducted in this field.  In the case of beginning any type of therapy involving consumed medications, it is essential to have a scholastic overview of the effectiveness of such remedies.

The medical health industry is mammoth sized, and considering wellness options from an alternative point of view, where the consumer is encouraged to be able to purchase over the counter remedies without prescriptions, is hotly contested by the large and powerful drug companies.  Rich drug companies often want to bounce out new and competitive fledgling remedies which can threaten their business.

Although the alternative movement is smaller and more cutting edge in regard to its newness and antiestablishment mentality, it is good to consider both sides of the debate regarding the use of bioidentical hormones.  Bioidentical hormones can be purchased over the counter, so they can be considered a part of the alternative medicine movement, which aims to place more power in the hands of the consumer as well as turn to natural remedies and solutions.

Whether bioidenticals are helpful or harmful, progressive or extremist, natural or dangerous, it is good to have as much information possible in order to draw one’s own conclusions regarding the efficacy of these hormones in the lives of individuals.

Uses of Bioidenticals

There are many applications in the use of bioidentical hormone products.  Some individuals claim to use bioidentical hormones in order to balance out the effects of menopause and other people say that bioidenticals can remedy cases of infertility.

In aiming to replace the hormones which may be lower or absent during the menopausal (for females) and andropausal (for males) years of older adulthood, bioidentical hormones offer themselves as over the counter natural remedies for people who are having a difficult time transitioning into a life with less fertility.  For older people, these bioidentical hormones, in small doses, can offer effective relief for the women who are used to the rhythmic surges of estrogen and progesterone as well as the men who find themselves more deficient in testosterone.

In looking to the use of bioidentical hormones in cases of infertility, it is important to note that both men and women are candidates for bioidentical hormones.  Women and men who suffer bouts of infertility and impotence due to lack of a nutritional diet, poor exercise, health conditions, or environmental factors may benefit from the use of bioidentical hormones in regulating their hormone levels and surges.

Aiming to restore hormonal balance can be vital to an overall sense of wellbeing.  The question remains, however, whether bioidentical hormones are effective treatments for men and women searching to replace the missing links.

Support for Bioidenticals

There is much support for the use of bioidenticals from many individuals, businesses, researchers, and organizations.  In contrast to synthetic hormones, the drive for bioidenticals is primarily instigated by consumers desiring over the counter alternatives rather than being driven by the marketing strategies of large drug companies.

 The most neutral research levels the claim that bioidentical hormones and synthetic hormones are equal in effectiveness and dangers, providing similar effects and symptoms (Bythrow & Fugh-Berman, 2007).  However, if these two types of hormone medications are exactly the same, then wouldn’t it make sense to purchase the over-the-counter bioidentical brand over the synthetic hormone which can only be distributed by a doctor?

Boothby and Doering (2008) also claim that there is no sufficient evidence to warrant that bioidenticals are less effective than synthetics and aptly state that the pharmacy profession is authoritarian and needing to address the issue on its own terms, lending insight to the idea that perhaps the drug companies resist the consumer driven demand for furthered research in regard to learning more about the effectiveness of new bioidenticals.

Cirigliano (2007) purports the use of synthetic hormone use is declining and that bioidentical hormone use is accelerating due to the many studies which point to the negative side effects of synthetic hormones, such an increased risk of stroke, venous thrombosis, and breast cancer.  Due to the search for safer alternatives, people are turning to bioidenticals.

Other research claims that bioidentical hormones are clearly superior in nature than synthetic hormones.  Moskowitz (2006) notes that there is already enough research that points to the fact that bioidenticals are less harsh on the body than synthetics.  Where synthetics carry the risks to blood lipids and vasculature and incidence of breast cancer, bioidentical hormones are safe and well worth continued research and use over synthetics.

In a 2008 study of women’s health in regard to bioidenticals, Sites notes that there is currently the availability of self administered saliva testing which can support and work in conjunction with self administered bioidenticals.  The saliva testing is one of the ways in which the consumer can protect oneself from overdosing on hormones.

Warnings against Bioidenticals

            There are some researchers who consider bioidentical hormones to be equal in effectiveness to synthetic hormones or even believe that bioidenticals are harmful, discouraging the use of these over the counter products.  The case can be made that conventional therapy, mainly in the form of synthetics, can be asserted as equal to or greater in quality than bioidentical hormone therapy.

            Boothby, Doering, and Kipersztock (2004) illustrate that bioidentical hormones have no proven advantage over conventional synthetic hormone therapies and that promoting the use of these new products is not supported by evidence in research regarding safety and efficacy.  The authors discourage the use of new bioidenticals based on the idea that there is no reason to switch from synthetics.

A 2006 article by MacLennan & Sturdee strongly claims that bioidenticals are a scam, a hoax which confuses the minds of innocent consumers.  They report that bioidentical hormone therapy has not been proven as better or safer than synthetic, and that in fact the supposedly “natural” bioidenticals are actually made from some of the same sources as conventional hormones, such as wild yams.

            The discussion offered in Rosenthal’s 2007 research study centers on the idea that bioidentical hormones are able to be used and administered in any dosage and any combination, heightening the risk of danger to consumers.  Due to the fact that bioidentical hormones are available without a prescription, the author discourages “ethical” practices of using medication without the oversight of a physician.

In 2005, Jaffe, Salomone, and Santen made the claim that bioidenticals can be written as a prescription from a physician or bought over the counter from a store.  In support of the superiority of physicians, they encourage going to the doctor for an evaluation and obtaining a prescription which could be more accurate than self administering medication.

Conventional hormones are often animal derived or synthetic, and natural bioidenticals are derived from plant sources.  Holtorf (2009) states that there is no reason to care where the conventional or new alternative hormones come from, because there is no evidence to suggest that the recent use of bioidenticals is safer or more effective than conventional therapies in treating people.

Conclusion

            Although there is much evidence in support of the recent trend in bioidenticals and much evidence against the use of new bioidentical hormone treatments, there is certainly not sufficient evidence against the new bioidentical remedies, while retaining support for continued use of conventional treatments in some cases.  Many people suffer from hormonal imbalances, and if a person is able to self diagnose, self test, and self medicate, aiming to administer correct hormone replacement therapy, then more power to the individual.  However, if a person feels more comfortable in a doctor’s office, then perhaps conventional treatments would suffice.

Physicians should not have the market cornered on medications, and consumers should be encouraged to self administer their own hormone therapies.  In reviewing the warnings against bioidentical hormones, much of the literature simply states that bioidenticals are not proven as better.  If natural and alternative bioidenticals are just as good as conventional synthetics, then the consumer should certainly be supported in purchasing these over the counter products.  There is also some evidence that bioidenticals are in fact safer, and further research should be encouraged.

Doctors should refrain from claiming utmost authority in supervising the needs and desires of the consumers.  Many times, the drive of the will of the people will produce sufficient testing and research for themselves, without the necessary help or advice of an MD.  However, if people are concerned about the effects of self administered hormones for the treatment of issues such as menopause transitions and infertility, then seeking the guidance of a physician may be in order.

Works Cited

Boothby, Lisa & Doering, Paul.  “Bioidentical hormone therapy: a panacea that lacks supportive evidence.”  Reproductive Endocrinology 2008: 400-407.

Boothby, Lisa, Doering, Paul, & Kipersztok, Simon.  “Bioidentical hormone therapy: a review.”

Menopause 2004: 356-367.

Bythrow, Jenna & Fugh-Berman, Adriane.  “Bioidentical Hormones for Menopausal Hormone Therapy: Variation on a Theme.”  Journal of General Internal Medicine 2007: 1030–1034.

Cirigliano, M.  “Bioidentical Hormone Therapy: A Review of the Evidence.”  Journal of Women’s Health  2007: 600-631.

Holtorf,  K.  “The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?”  Postgraduate Medicine 2009: 73-85.

Jaffe, Robert, Salomone, Leslie, ; Santen, Richard.  Bioidentical (Natural) Hormones and Menopause.  The Journal of Clinical Endocrinology ; Metabolism 2005.

MacLennan, Alastair ; Sturdee, David.  “The ‘bioidentical/bioequivalent’ hormone scam.”  Climacteric 2006: 1-3.

Moskowitz, D.  “A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks.”  Alternative Medicine Review 2006: 208-23.

Rosenthal, M.  “Ethical problems with bioidentical hormone therapy.”  International Journal of Impotence Research 2008: 45–52.

Sites, Cynthia.  “Bioidentical hormones for menopausal therapy.”  Women’s Health 2008: 163-171.

I.                    Introduction and Thesis Statement

a.       Based on current research, people need to figure out for themselves whether bioidenticals are right for them.

b.      Thesis statement: Whether bioidenticals are helpful or harmful, progressive or extremist, natural or dangerous, it is good to have as much information possible in order to draw one’s own conclusions regarding the efficacy of these hormones in the lives of individuals.

II.                 Uses of Bioidenticals

a.       General health conditionals which instigate the use of bioidentical hormones, particularly menopause/andropause and infertility/impotence.

III.              Support for Bioidenticals

a.       Research based support for the use of bioidenticals.

b.      Descriptions of five expert opinions: Bythrow and Fugh-Berman; Boothby and Doering; Cirigliano; Moskowitz; and Sites.

IV.               Warnings against Bioidenticals

a.       Research based warnings against the use of bioidenticals.

b.      Descriptions of five expert opinions: Boothby, Doering, and Kipersztock; MacLennan & Sturdee; Rosenthal; Jaffe, Salomone, and Santen; and Holtorf.

V.                 Conclusion

a.       What does the research mean for consumers/the general public?

b.      Concluding statement: Although there is much evidence in support of the recent trend in bioidenticals and much evidence against the use of new bioidentical hormone treatments, there is certainly not sufficient evidence against the new bioidentical remedies, while retaining support for continued use of conventional treatments in some cases.

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