Are Bio-identical Hormones Safe?

Why the FDA is cracking down on these `natural' menopausal therapies.

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  • Posted By: kbcrazy @ 02/12/2009 8:12:03 PM

    I do agree that the public does want things fast and they dont like to wait for results. Maybe it isnt just the FDA's fault but they should have to do more indepth studies before putting a drug on the market to make sure they are safe and to find out the side effects and all. I dont care if people are yelling for them or not! No, maybe its not all the FDA's fault but if they dont have their hands in it so they can make money, it seems they try to shut the other sources down.

  • Posted By: kbcrazy @ 02/12/2009 8:04:26 PM

    We all know that the FDA is in cahoots with the Big Pharma to make money off drugs that KILL! They do not care about what is safe for us to take, they are in it for the big bucks and that is all! They dont like women taking these others because they cant regulate them and make money off them. They are afraid of losing money is all ! It is a sad day when money is more important than the health and well being of people! I am outraged that they have so much influence over our rights as people...we have the right to choose how we take care of ourselves and what kind of treatments we want to have! The FDA needs to be revamped.

  • Posted By: Brinna @ 01/22/2009 6:51:57 PM

    Any one who still believes that the FDA, as it is presently run, has the safety of women at heart...well, I got a bridge to sell you. The FDA is in bed with Big Pharma, and, make no mistake, it is Big Pharma (specifically Wyeth, that erstwhile and financially hurting pharmaceutical giant, that made all its big bucks poisoning women with synthetic HRT products) that objected to natural hormone sales cutting into its profits, NOT as this pandering article suggest, woman's groups or independent physicians.

  • Posted By: cynful66 @ 12/25/2008 1:21:40 AM

    It is common knowledge that bio-identical hormones cannot be patented because they are identical to the hormones our bodies produce naturally. There fore, the pharmaceutical companies will never make money on them. They DO, however, seem to have pushed Premarin, a poison that causes more problems than it helps. Women are NOT horses, and horse urine is not an option for me. Using natural progesterone cream helped me with a lifetime of hormone imbalance, including PMDD and post partum depression. I sought help for years and was only offered therapy or anti-depressants. Finally, after using this cream, I feel better. Melatonin also helps me sleep better than any xanax pill ever did, is not habit forming, and helps your immune function.It's a shame that bio-identicals are now being attacked when in Europe, studies have shown them to be safe and effective. Only in the USA, where most medical research is funded by the pharmaceutical companies, do we fight their availablity. I'm a fan of them, and I feel I should have that option. If you want to ban a drug, try banning Premarin, a known cause of breast and uterine cancer.

  • Posted By: MayflowerRPh @ 11/07/2008 3:12:32 PM

    I am amazed at the misinformation out there. I have always tried to educate my patients so they clearly understand everything about their medications. If you have tried bioidentical hormones, and they work well for you, that's great. These "natural" or "bioidentical" hormones are actually synthesized in a lab. The thing is that they are chemically identical to the hormones made by our own bodies. No different than the estrogens commercially available as prescription estrogen pills. The greatest controversy seems to be about the estriol portion. Our bodies actually don't have that much except during pregnancy. All 3 estrogens and progesterone are designed to help us during our child-bearing years; we were not intended to keep these hormones in our bodies once we have passed that point. As miserable as my hot flashes and some of the other menopausal symptoms are, I would rather tough it out than put hormones back into my body that are no longer supposed to be there. I know that the risk of developing breast cancer (or any other cancer that is exacerbated by estrogens) is small, but I would rather not take a chance.
    I've seen a lot of FDA-bashing here, too. There have been some mistakes on the part of the FDA, but the mistakes are not all their fault. They have been given certain powers and authority by the Federal Food, Drug, and Cosmetic Act by Congress in 1938, and those have been modified by Congress from time to time. The biggest problem (as with anything to do with the Federal Government) is that the FDA has all this responsibility, but no money or staffing to properly do the job. You see, the FDA is under constant pressure to approve drugs more quickly so they can help people. On the other hand, everyone wants these drugs to be perfectly safe. As an old pharmacist colleague used to say, "Do you want it fast, or do you want it right?"
    In order to review and approve drugs relatively quickly, the studies often do not have vast numbers of people in them, nor are they for long periods of time. It is only after the drugs have been used for a longer period of time and/or by many more people that these safety issues come out.
    As for estriol in other products, there is absolutely no FDA-approved drug on the market today that contain estriol. As I said before, if you have been taking bioidentical hormones and they are working for you, great. I hope I have helped clear up some of the confusion.

  • Posted By: jpotterrph @ 02/15/2008 1:25:49 PM

    Hey everybody, just a reminder. They DID NOT STUDY progesterone in WHI. They studied medroxyprogesterone acetate (MPA) a counterfeit substitute for bio-identical progesterone. This is why there is conflicting information. Ever the doctors are being misled. Not a single study has ever shown progesterone to have negative effects on the body. I've had many grad students confirm this. One thing we did find was that in many medical articles they used the term "progesterone" in the title and abstract but in the methods section they actually used MPA. So the negative effects of MPA have now been conferred onto progesterone. These came from so called peer reviewed medical journals. WHI is one of the most misquoted studies too. It's always reported they studied estrogen and progesterone but in fact they studied conjugated equine estrogens (horse urine) and medroxyprogesterone acetate. No wonder the entire medical community is confused. The drug companies are intentionally using the wrong terminology in a coordinated effort to confuse the physicians and nurse practitioners. Now they are trying to say that all estrogens are bad. That is like saying that all pain medications or all high blood pressure medicines are bad just because a select few have removed from the market...or how about all doctors are bad because of a select few. ...Just doesn't make sense.

    • Posted By: MayflowerRPh @ 11/07/2008 2:25:12 PM

      Wow. I am shocked. A little history...when the WHI was started, there were no other products commercially available, and Premarin and Provera had been around for years. As a "natural" product, which the Premarin really is, you don't know exactly which compounds are the active ones. Scientists have known about estradiol, estrone, and estriol for a long time. When you add in the trace amounts of
      other compounds, they can't always figure out whether or not they have any medicinal value as well. And for medroxyprogesterone acetate...progesterone, itself, is destroyed by the stomach so it is not absorbed. Hence, medroxylation and the addition of acetate as a "salt". Once Prometrium became available, things changed. (Reminder...progesterone suppositories, gels, and SC injection are absorbed very differently than oral meds.) I do have a question, though, jpotterrph...I am (maybe mistakenly) assuming that you are a pharmacist with the "rph" at the end of your screen name. If this is true, you sound more confused than most of my pharmacy students. My question is this: how have "many grad students" confirmed that progesterone has no negative effects on the body? Was this an actual study, or just a poll? If you remember, progesterone is one of the "biggy" hormones of pregnancy. Trust me, I would certainly call "morning sickness" a negative effect. If you are, in fact, a pharmacist, I'm afraid you were somehow misled in your pharmacy education. You really do have some misinformation.

  • Posted By: kamille @ 02/08/2008 7:46:40 AM

    If women had been getting effective care through traditional means, the market for natural hormones would have never mushroomed. Because hormonal changes are unique to every woman, symptoms are difficult to treat, especially for a physician who believes there is a standard method of care. Hormonal imbalances can wreck lives. Women want help. When this is taken seriously by researchers and physicians, maybe progress will be made. God bless those suffering in the meantime.

    • Posted By: Sewwhat @ 05/09/2008 9:26:09 AM

      I totally agree with you. Women's health care isssue have been on the bottom of the list forever. My new doctor told me that the insurance companies are now approving lab tests for men over 50 to determine their level of testostrone because once their levels drop they are prone to cancers. Doctors have been fighting with insurance companies for years to get them to pay for women's hormone labs. Remember they used to lock up women in the good ol days for mood swings or their husbands had them committed.

  • Posted By: Sewwhat @ 05/09/2008 9:12:03 AM

    My sister-in-law was on the synthentic hormones for years and now at the age of 48 is diagnosed with breast cancer. I started having menopause sympthoms so bad it affected my personal and professional life. So I went to a doctor who took 5 minutes to listen to me and throughout the two years I was with him gave me three of the worst anti-depressants on the market. I gained lots of weight and was sick to my stomach all of the time and NOT EVEN DEPRESSED. I finally got off the FDA approved anti-depressants myself and started doing my own research. My doctor just pacified me and said all women have to go through this and it will get better. How does he know? He has never been at a meeting at work and got such bad hot flashes he wanted to throw up in front of everyone?
    Finally, relief, at my local library. From the informatin I found there, I was able to find a very kind doctor who is a savior. She actually talked to me for TWO AND 1/2 HOURS. She took my blood work and I was on the biodentical hormone therapy within 3 weeks.
    Guess what? I am feeling like my old self again. I am actually showing up to work and getting projects completed because I don't have to run to the bathroom several times and day to get sick. And everyone around me likes to be around me again because I am not biting their heads off when they look at me wrong. And best of all I am losing all of the weight I gained being on the anti-depressants. I would not wish the symptoms of menopause on anyone. People make fun of it and really do not know how bad it makes you feel. I lost TWO years of my life that is suppose to be the best part of life. I will stay on the biodenticals until my NEW doctor tells me otherwise. God bless the doctors who are working with women and actually take the time to LISTEN to them instead of rushing them out the door. One thing I don't get is how can a male doctor TRUELY know what we go through? I had such bad hot flashes I broke out in blisters. You can not know how bad that is until you actually have one yourself.

  • Posted By: Lilacsnroses @ 05/03/2008 12:54:59 AM

    Once again Big Pharma is trying to take away a natural remedy that works ONLY becuase they can not make money off it. Do you see any studies quoting statistics of problems with bio-identicals? No? I didn't think so! And, they will never do any studies because they would never spend money to prove that something natural that they won't make money on actually WORKS! I tried everything before bio-identicals and NOTHING worked! In addition, most caused horrible side-affects! Thank God for bio-identicals! Big Pharma is all about money - NOT our health!

  • Posted By: Daisy's Mom @ 03/24/2008 5:44:44 PM

    I am a 65 yrs old, and have taken bio-identical estrogen for 12 yrs. I aways had a problem with the hormone levels in my body as I did not menstruate normally even in my twenties. I was regulated with birth control pills, but when they were discontinued, I ceased menstruation in my thirties. I was told that I had the normal balance of hormones ( I had two children), but they were not triggering properly for menstruation.
    When I hit (50), I felt like my life was over. I had insommnia, depression, hot flashes. urinary tract infections that persisted even with treatment, gastro problems, and everything in between.
    My doctor first put me on Prempro which did alleviate my symptoms, but then gave me symptoms of it's own.
    When he suggest the Tri-est HRT, my life changed completely. It is absolutely the best thing I ever did.
    I am a firm believer that your body know what is good for it, and this had been the best for me.
    This deal with the FDA is absolutely nothing but $$$$$$$$$$$$ for the Pharmaceutical companies who control this country.
    Additonally, this would never happen to a drug that was helping men.
    Let's fight back

  • Posted By: Asian-American @ 03/22/2008 3:50:44 PM

    I believe the issue is choice. Some believe that The FDA is simply protecting the finanial interest of Wyeth, while others believe that the FDA is an honest entity. I believe the best action would be to simply categorize bio-identical estrogen as a "supplement" and then let customers experiment, just like customers choose to do with any supplement. They can put the "non-FDA" approved labels on them. But, it seems to me that the FDA is indeed just looking out for the financial interest of key Pharma companies, which is why when a prescription substance harms thousands of people, the FDA is still hesitant to take it off the market, while supplements are quickly banned for unproven reasons, like effedra. Congress is now trying to ban the natural hormone DHEA, which is the only substance that has helped my depression and ADD symptoms: I tried all the synthetic prescription products, but they did not work as well as DHEA.

    I think if we believe in "Freedom", that means the freedom of people to have choice over their health, not having an authoritarian government department dictate what each individual is allowed to choose.

    I would suggest taking a look at the Life Extension Foundation for more information on what is the best policies for your health.

    Regards.

  • Posted By: Earring Lady @ 02/17/2008 10:24:08 PM

    I spent five years taking every kind of hormone replacement, working with mainstream doctors. The things they gave me caused me to have terrible acne, and they sent me to dermatologists who gave me medicines, both internal and external that interfered with the HRT. When I made complaint, they upped the doses of everything until I was spending all my disposable income and NOTHING worked. We're talking hundreds upon hundreds every month. I finally stopped it all, and was so uncomfortable, with vaginal dryness, I couldn't stand my life. I had to use over the counter remedies HOURLY, to survive. I went to an alternative integrative medicine clinic, in North Carolina, and in 16 months after trials, tests, and changes, I use bio-identical hormones, balanced to my body needs, and am comfortable and sexually functioning for over a year, now. I think these people and their work is a God send, and it is much less expensive than the traditional "care"which is a traditional nightmare! Please investigate these treatments with patients, instead of AMA rhetoric, before advising women to abandon alternatives that may the ONLY thing that can help them!
    Sincerely,

  • Posted By: oroyce @ 02/12/2008 6:15:44 PM

    Wyeth wants the FDA to stop compounding pharmacies from using the term bio-identical because their products are not bio-identical.

  • Posted By: oroyce @ 02/11/2008 10:44:59 PM

    Estriol is produced in the placenta and its lack is indicative of a child with Downs Syndrome. It is unconscionable or ignorant for the FDA to make a decision that such a substance should not be available.

  • Posted By: oroyce @ 02/11/2008 6:08:57 PM

    Since the following guideines by the FDA were published much research has been done on the bio-identicals however apparently no one has bothered to instigate changes to FDA's guidelines. I would judge that the FDA still thinks that all estrogen is identical to equine estrogen which apparently does not contain estriol.

    http://www.fda.gov/cder/guidance/6932dft.pdf

    Page 3

    "Other doses of oral conjugated estrogens with medroxyprogesterone acetate, and other combinations and dosage forms of estrogens and progestins were not studied in the WHI clinical trials and, in the absence of comparable data, these risks should be assumed to be similar. Because of these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman."

  • Posted By: opuswrites @ 02/11/2008 11:31:27 AM

    The HRT available from "Big Pharma" is made from mare's and other animals urine and other bodily fluids. Last I checked, I was not a mare. I would much rather go to my local compounding pharmacists and get a plant-based estriol product (which, by the way, IS approved by the FDA when used in other compounds.

  • Posted By: Lifesaver3x3 @ 02/11/2008 10:03:34 AM

    People act as if compound pharmacies are doing the marketing. This article, books by doctors and patients like Suzanne Summers are the marketers. Compounding pharmacies don't have the finances to market the way big pharma does. Also, a compounding pharmacists does not ship hormones without a doctor's prescription. If I was a physician prescribing bio-identical hormones, I would be insulted by the recent actions by the FDA considering the fact that compounding pharmacies act on the physician's consent.

  • Posted By: michdoc @ 02/08/2008 10:18:23 AM

    As a physcian, I get daily requests for help with menopausal symptoms. Treatment needs to be individualized. Just like pregnancy, menopausal patients are not ill. They just need short term hormonal therapy to help bridge the uncomfortable symptoms of menopause. I do get annoyed when patients think that they need "natural" hormones supplemented to reach a blood level equivalent to a 20 year old's premenopausal estrogen level and I suspect it could be very dangerous due to breast cancer risk. Then there are the yam creams that contain plant based progesterone. If one reads the Women's Health Initiative study, the higher risk of breast cancer is seen in the patients who had the progesterone given in addition to estrogen. So my recommendation is that of the American College of Physicians: give the least amount of hormone for the shortest period of time to alleviate symptoms only. The ballpark figure is to try to get women off of hormone replacement therapy within 5 or 6 years. Of note: women who haven't had a hysterectomy need both estrogen and progesterone to protect the uterus from cancer caused by unopposed estrogen. Since the WHI study came out, there are now numerous strengths of prescription hormones available to individualize and minimize the dosages given. When tapering a woman off of hrt, my method is to go very slowly, like reducing by 1/4 the dosage over a month or two. Mainstream medicine can be very helpful to menopausal woman. Just seek out a doctor who has an interest and knowledge in the field. This can be an ob/gyn, internist or family practitioner.

    • Posted By: jpotterrph @ 02/10/2008 12:11:31 PM

      Hey Docs, just a reminder. They DID NOT STUDY progesterone in WHI. They studied medroxyprogesterone acetate (MPA) a counterfeit substitute for bio-identical progesterone. See people, this is why there is conflicting information. Ever the doctors don't understand the difference because they don't understand the chemistry of the body. Not a single study has ever shown progesterone to have negative effects on the body. I had a grad student confirm this. One thing she did find was that in many medical articles they used the term "progesterone" in the title and abstract but they actually studied MPA. So the negative effects of MPA have now been conferred onto progesterone. These came from so called peer reviewed medical journals. WHI is the most misquoted study too. It's always reported they studied estrogen and progesterone but in fact they studied conjugated equine estrogens (horse urine) and medroxyprogesterone acetate. No wonder the entire medical community is confused. The drug companies are intentionally using the wrong terminology in a coordinated effort to confuse the physicians and nurse practitioners.

    • Posted By: nraden @ 02/08/2008 1:11:46 PM

      If you would like to understand the SCIENCE behind a different point of view, read Sex, Lies and Menopause by T.S. Wiley. I'm sure you've heard about it, but you should acquaint yourself with the argument for restoration of hormine levels before you reject it. It is quite compelling. (Full disclosure - I am related to Wiley).

    • Posted By: dancingdiamonds4 @ 02/08/2008 10:34:33 AM

      Doctor, please tell my why, if these hormones are the natural state for women to be in, would you want to take us off of them over time. It would seem to me that the ideal situation would be to maintain a certain level of these hormones indefinitely to prevent such things as vaginal atrophy and loss of libido. Both of these occur and are devastating to the woman. My mother is 80 years old and has vaginal atrophy so bad that she was in constant terrible pain with severe burning upon urination. Her OB/GYN would not prescribe any hormone replacement therapy for her because she had had breast cancer 20 years ago. I told her to use a tiny bit of my cream on her arm a few days a week and over a period of about a month the pain and burning slowly subsided. She is now pain free. Unfortunately, I have to share my prescription with her in order for her to maintain any quality of life. How dare you doctors treat women so badly! Estrogen and progesterone are a natural part of a womans body chemistry and should remain in balance throughout her entire life not just when doctors say it's time to end them. I suspect you are a man or a woman who hasn't experienced menopause yet.

  • Posted By: concernedrph @ 02/09/2008 7:08:59 PM

    Premarin is FDA approved but 3 women who took it and developed breast cancer SUED AND WON a lawsuit against Wyeth (the drug maker and leading critic of bio-identical products). 134.5 million dollars later, Wyeth wants to make some of that money back. So much for "rigors of main stream testing". Check out this link
    http://lawsuitsandjudgments.com/breast-cancer-survivors-win-lawsuit-against-drug-company-36.html#more-36

  • Posted By: concernedrph @ 02/09/2008 7:08:52 PM

    Premarin is FDA approved but 3 women who took it and developed breast cancer SUED AND WON a lawsuit against Wyeth (the drug maker and leading critic of bio-identical products). 134.5 million dollars later, Wyeth wants to make some of that money back. So much for "rigors of main stream testing". Check out this link
    http://lawsuitsandjudgments.com/breast-cancer-survivors-win-lawsuit-against-drug-company-36.html#more-36

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