BHRT: Benefits & Safety (1)

The medical literature supports the safety and efficacy of bio-identical hormone replacement therapy. Numerous clinical studies and expert reviews in peer-reviewed journals have documented the benefits of hormone replacement in appropriate individuals. I have listed below some of the findings that have been expertly documented by one of the world’s leading authorities on the subject, Dr. Neil Rouzier. Journal references are listed in the second part of the article.

DHEA:

  • Increases insulin sensitivity, decreases abdominal fat, prevents and treats the metabolic syndrome and thereby prevents diabetes
  • High DHEA levels are related to lower carotid intimal wall thickness
  • High levels of DHEA decrease mortality from heart disease. Low levels of DHEA are associated with increased mortality. The higher the DHEA, the better the protection against mortality from any cause.
  • Low levels of DHEA demonstrate an increased risk of cancer and cardiovascular disease.
  • It is beneficial in the treatment of major depression in women.
  • It improves well-being, sexuality, and cognition.
  • It improves immune function.
  • The goal of replacement therapy is to restore DHEA to the upper level of normal of a young adult range. Those patients experience a reduction in fatigue, improvement in mood and psychological well-being.
  • Restores well being, increases bone density and decreases vaginal dryness.

ESTRADIOL:

  • Postmenopausal HRT protects against heart disease and stroke.
  • The most powerful study to date definitively demonstrated that estrogen does not cause an increased risk for cancer. The increased risk was associated only with taking the progestin (Provera®) and not estrogen.
  • All women on natural estrogen and progesterone had a decrease in cholesterol and increase in HDL. Women on synthetic HRT had no improvement in cholesterol and many side effects.
  • Long term estrogen use is associated with lower mortality rate primarily through reduction in cardiovascular disease.
  • Recent studies have identified a protective effect of estrogen in the development of Alzheimer’s disease and new studies show that testosterone may exert an even stronger preventive effect.
  • Bone density is rapidly lost when HRT is stopped HRT should be continued indefinitely.
  • In the final analysis of the estrogen only arm of the WHI, there was no increased risk of breast cancer or heart disease. There was a 35% decrease in hip fractures, 35% decrease in diabetes and a 60% decrease in urinary sepsis. This leads to a significant decrease in all causes of mortality.
  • Estrogen reduces obesity.
  • Estradiol and progesterone demonstrated no increased risk of breast cancer. Synthetic estrogen (Premarin®) and synthetic progestins (medroxyprogesterone and noesterone) all dramatically increased the risk of breast cancer. This was a ten-year study of over 100,000 women, the largest and longest study to date comparing natural hormones to synthetic hormones.

 

PROGESTERONE:

 

  • Progesterone should be administered to all women, hysterectomy or not.
  • Due to the side effects of synthetic progestins, natural progesterone is preferred. Progesterone has proven bio-availability and no side effects making it the preferred hormone for menopause.
  • Synthetic progestins (medroxyprogesterone) cause depression, bloating, breast swelling, excessive bleeding, and are not tolerated by many women. Natural progesterone has none of these side effects. In fact an unexpected improvement in well-being was observed when progesterone was added to estrogen.
  • MPA (Provera®) stimulates breast receptor sites thereby increasing breast density. Progesterone down regulates breast receptor sites thereby de-stimulating breast tissue. Natural progesterone cause no side effects.
  • Progestin, (Provera®) dramatically increases risk of breast cancer 8 times.
  • The estrogen-only arm of the WHI Trial demonstrated no increased risk of breast cancer increase was due to medroxyprogesterone (Provera®) and not due to estrogen.
  • The metabolic, vascular and psychiatric side effects of medroxyprogesterone can be eliminated through use is natural progesterone.
  • Natural progesterone, but not MPA, decreases myocardial ischemia and causes vasodilatation of coronary vessels.

 

TESTOSTERONE:

 

  • Testosterone lowers fat, improves body composition, protects against diabetes and heart disease. Low testosterone levels are associated with an increased risk of diabetes, heart disease, and carotid atherosclerosis.
  • Development of prostate cancer does not depend on levels of testosterone. High levels of testosterone do not increase the risk of prostate cancer.
  • None of the 12 longitudinal population based studies such as the “Physician’s Health Study” found any increased risk of prostate cancer in men with higher levels compared to men with lower levels of testosterone.
  • Testosterone administration in the highest dosage resulted in increased sexual activity, pleasure, and orgasm in women. There was an increase in sexual fantasies, masturbation and frequency of sex. There was an improvement of well-being and mood.
  • High testosterone levels protect against cardiovascular disease.
  • Testosterone replacement in women significantly decreases carotid atherosclerosis and cardiovascular disease.
  • Low testosterone levels adversely affect women’s health. Testosterone improves women’s energy and well-being. Treatment should begin when a woman’s testosterone drops below mid-range of normal. Testosterone administration has many benefits and no risks.
  • Higher testosterone levels increase cognition and memory.
  • Testosterone increases bone density in women. Testosterone protects against heart disease in women.

  • Testosterone protects against Alzheimer’s dementia, type I I diabetes, depression, osteoporosis, muscle wasting, cognitive decline, loss of libido, erectile dysfunction and cardiovascular disease.

THYROID HORMONE

  • Combined T4 and T3 therapy resulted in improved symptoms, well-being, and weight loss in comparison with straight T4 therapy. A decrease in weight resulted from using higher T3 levels.

  • Patients that took a combination of T4 and T3 experienced better mood, energy, concentration, and memory, and improved well-being. Patients on just T4 experienced no change.

  • Women with low-normal thyroid levels had a four-fold increased risk of heart disease. This increased risk was equal to the risk of smoking and high cholesterol. Low normal thyroid levels are a strong predictor for heart attacks.

  • Low levels of free T3 in patients resulted in increased disability, depression, decreased cognition, energy, and increased mortality.

  • Thyroid levels should be raised to the upper normal range for a young person. This results in optimal cognition, memory, and cerebral function.

RISK OF CANCER:

  • HRT after treatment of breast cancer has not been demonstrated to increase risk of recurrence or mortality.

  • Estrogen replacement therapy in breast cancer survivors results in increased survival and improved quality of life. HRT was not associated with any cancer recurrence.

  • Progesterone produces breast cancer resistant protein (CRP); estrogen by itself does not. However, when estrogen is added with progesterone, the effect is synergistic by increasing the release of CRP.