Are Bio-identical Hormones Safe?

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  • Posted By: endacottmd @ 02/07/2008 4:17:33 PM

    Yea! Finally the myth is being formally dispelled. Compounding pharmacies have been makeing loads of money and misleading women. As I primary care MD I finally gave up and bit my lip when a patient came to be with bioidentical hormones on their med list despite my urging that plants do not make steroids and hormones are steroids, and that progesterone absorbed throught the skin .

    • Posted By: concernedrph @ 02/09/2008 6:42:13 PM

      Why are you concerned if compounding pharmacies sell a product for a profit? Do you see patients for free?? The money pharmacies make are tiny compared with the billions big pharma makes off just 1 drug, such as Lipitor or Celebrex. That is why they feel these hormones are invading their turf. And yes, progesterone gets absorbed very well through the skin as many thousands of women will tell you.

    • Posted By: incensed7777 @ 02/08/2008 10:33:52 AM

      This reply is to endacottmd - It's funny -you are the only one who commented that you are happy about the FDA shutting the natural hormones down and you are a doctor - who probably has never suffered from the hot flashes and other menopausal symptoms and therefore has never even tried natural hormones - all I can say to your arguments about "plants do not make steroids and hormones are steroids" is that you cannot argue with results - it works - I know, I have been taking natural hormones for over 15 years with absolutely no adverse side effects! I don't have hot flashes- I don't take any prescription meds - I am healthy and live a vibrant life because of natural therapies, eating healthy unprocessed foods and not taking prescription drugs! Maybe you are just happy that now you will be getting more money from the pharmaceutical companies - you will be able to write more harmful prescriptions!

  • Posted By: michdoc @ 02/08/2008 10:55:57 AM

    The only gifts I receive from drug reps are pens and paper which I usually give to teachers and educators because their budgets don't give them enough for their classrooms. The pens do not in any way influence my prescribing. As far as payments from drug companies, we get absolutely none for prescribing their medicines over somebody elses medicines. The decisions are purely clinical. Since Michigan's in a recession, I sometimes would choose a Pfizer drug (Lipitor) over a competitor hoping it kept fellow Michiganders in work. Now Pfizer has left the area and that's a moot point.

    • Posted By: concernedrph @ 02/09/2008 1:48:17 PM

      To Michdoc: We are not implying you or any other doctors in"normal practice" take money from drug companies. BUT, the physicains speaking out the strongest against BHRT are often paid by drug companies, namely Wyeth, as consultants. These are the doctors that have a serious conflict and have sold out their education to the highest bidder.

  • Posted By: michdoc @ 02/08/2008 10:31:01 AM

    Most of us doctors are not "in bed" with the pharmaceutical companies. We are too busy in our practices to care who makes which drug. In my area, Ann Arbor Michigan, we have both mainstream and compounding pharmacies that are very good. A skillful physician will focus on the patient's needs and prescribe the most suitable medicine. Sure the FDA has its flaws, but to get a medicine through requires very rigorous testing using placebo controlled, randomized, double blind studies. That may not be perfect, but usually is more substantiated than the testimonial of a person feeling better on an untested supplement.

    • Posted By: kam77 @ 02/09/2008 8:31:56 AM

      To michdoc: help me, I am in Virginia, and have researched "bio-identical"hormones extensively. At 49 years old, and suffering with lack of sexual desire, horrible hot flashes and mood swings. Weaned myself off of Paxil.(Wow, now that's an FDA approved disaster!) Now I would like to pursue treatment using bio-identicalhormones, before my marriage suffers any further from lack of desire. I need help finding a Doc who will work with me on this! Can't find anyone in this area. An unnecessary Hysterectomy five years ago has made me miserable!! How do I find a Doc for this....This topic is a sea of conflicting information!

  • Posted By: Giesela @ 02/09/2008 8:21:09 AM

    The medical community offer some FDA approved drugs but know next to nothing about even the drugs they offer. Very few studies, conflicting results.
    I thought it hilarious the quote about bio-identicals was "there is no scientific basis in fact for this claim."
    You could say that about a shocking number of FDA drug therapies out there and there are certainly all sorts of negative effects associated with the drug company/FDA recommended regimens for menopausal women.
    The fact is that women's heath issues, especially aging women's health issues are at the bottom of the barrel for medical interest.

    The medical community, the FDA, CDC et al. reap what they sow. If they don't care women will go out and try to take care of themselves and find alternatives. What have they got to lose? As far as anyone really knows bio-identicals won't hurt them anymore than FDA approved drugs.
    Why are you pimping for the AMA, FDA and drug-company lobby?

  • Posted By: blurave3983 @ 02/08/2008 4:11:03 PM

    I am so relieved to read an article that rightly criticizes the "natural" movement and the growth of unregulated alternative medicine in this country. Just because something is derived from a plant or animal does not mean that it is any safer than a substance synthesized in a lab. In most cases, the synthesized substance is much purer and hence safer. I hate it when shady pro-natural companies take advantage of people who are either sick or in need.

    • Posted By: Melinda43 @ 02/08/2008 6:15:20 PM

      Since you're so thrilled about this article criticizing the "natural movement", then go ahead and try Lupron Depot - it was produced in a lab. Then about 4 weeks into your treatment, let the rest of us know how you and your hormones feel. You'll be begging for something else to get rid of the horrible side effects. You'll be out of your mind.

      Chances are you are either a male or a female that has never taken bio-identical hormones. If you had, you'd see it differently.

    • Posted By: SueWil @ 02/08/2008 4:54:25 PM

      As an FYI, compounded hormones are not "unregulated alternative medicine." The hormones are created and dispensed by licensed, regulated pharmacies, not witch doctors. The main difference is that they are not synthetically created in a laboratory by adding or subtracting chemical structures -- which is how pharmaceutical companies can patent medicines. The bio-identical hormones are derived from plants and their chemical structure is identical to that produced by the human body, not ALTERED as they are by the pharmaceutical companies laboratories and manufacturing plants. That's why BIG PHARMA wants the bioidentical hormones to go away: they cannot be patented, therefore, BIG PHARMA cannot make BIG money on them. At the end of the day, it's all about money -- not health or well being.

  • Posted By: pharmdmb @ 02/08/2008 6:06:28 PM


    How NIH Misread Hormone Study in 2002 (Wall Street Journal)

    http://online.wsj.com/public/article_print/SB118394176612760522.html

  • Posted By: michdoc @ 02/08/2008 4:30:48 PM

    Well put! And they are not bound by the rigors of mainstream testing. So their profits may be all the greater.

  • Posted By: michdoc @ 02/08/2008 3:52:26 PM

    To nraden: You are right about the delicate endocrinologic balance between hormones in a woman's cycle being something that HRT cannot mimic. But we aren't trying to replace the reproductive cycle and most people don't want periods indefinitely. The triphasic birth control pill (Ortho Tricyclen or Triphasil) tried to mimic a woman's cycle by escalating hormone doses weekly until the week off when they are withdrawn. The effects were no better than straight dosage for pills.
    Basically the hypothalamus secretes releasing hormones on an hourly basis in pulsatile fashion and gets the cycle going. We could never replace that intricate of a mechanism and clinically it doesn't seem to matter. Women want control of symptoms of menopause, mostly of hot flashes and vaginal dryness, or mood swings. So giving a straight dose of a hormone seems to satisfy that need much of the time. If it doesn't, then that's where compounding pharmacies could help individualize yet further. But they won't be measuring pituitary levels. They will also treat symptoms which is what we clinicians do, but orienting our practice according to the medical literature to keep our patients as safe as possible. If we advised just blindly, patients would have no more benefit consulting a physician than they'd get by surfing the web for an hour.

  • Posted By: nraden @ 02/08/2008 1:36:24 PM

    Given the overwhelmingly negative response to this article, I think the authors need to take some time to rethink it. I'm not accusing them of being bought by the pharma/AMA cabal or swayed by Newsweek's dependence on advertising from them, but I'm not dismissing it either. But I think it's pretty clear that they are way off, in this article and others as well as their book and before they publish anymore, on this subject, they need to examine their bias and inform themselves. In other words, act like journalists, not yellow journalists.

  • Posted By: michdoc @ 02/08/2008 11:42:58 AM

    Don't you understand that science is inexact? The FDA may pass a medicine after rigorous testing (and not all the scientists doing the research are crooks). But when post marketing data shows a serious problem. I'm glad they pull the drug. Also, when a drug is brand new, I wait a while before trying it on my patients for that very same reason. Reading the medical literature on a weekly basis lets us know if there are concerns being raised on specific medicines. When Ketek was being marketed as a safe antibiotic but I was reading articles in my journals about liver failure, it didn't matter what the drug reps said. I simply didn't use it, then saw it pulled later, which validated the good science and peer reviewed journals we read. Surely as a nurse you have to believe that there are good people out there practicing their professions because they believe that what to do is good. Otherwise the glass would always be half empty.

    • Posted By: nraden @ 02/08/2008 1:24:54 PM

      Doctor, consider this. Dosing hormones at low levels, statically, the same every day, creates a metabolic effect that doesn't exist in nature. How can you possibly think that that is safe? The rise and fall of sex hormones over a menstrual cycle is an elegant symphony of feedback loops - when one reaches a crescendo, other hormones damp it down and take over. Hormones aren't like medicine, you can't titrate them where a little more or a little less has a little more or a little less effect. Progesterone receptors are called up when estrogen reaches the proper level and vice-versa. Receptor anticipation is the trick that makes most metabolic processes function. How does your method account for this?

  • Posted By: heathh @ 02/08/2008 1:13:01 PM

    Dont let the FDA and Big Pharma tell you what is good for your body. My bio identical progesterone has been a God-send for me. If the gov agencies that are supposed to protect our health were REALLY out to protect us, Vioxx would have never been approved and would never have killed the people it did! They cannot make any $ from bioidentical hormones! Nuff said!

  • Posted By: heathh @ 02/08/2008 1:10:27 PM

    Once again the FDA and Big Pharma prove that all they care about is $$$$$$$$! Bio-identical progesterone has been a God-send for me! Read people! Dont let Gov agencies tell you what is safe and what is not. They dont care about your health. If they did, Vioxx would never have been approved and killed the innocent people that it killed!

  • Posted By: erieangel @ 02/08/2008 1:02:54 PM

    My doctor told me it was good for my heart and would help me get my good cholesterol up. My good cholesterol was 20 and it now 40. Also, are gone the night sweat where my bed was soak and it was hard to sleep and I work the morning shift 6-2. Also, sex is no longer painful and I threw out KyJel. My mood swing are gone. I love Preprom. My dose is .45. Thank God every day for this drug. I am 57 and I got my life back ! June

  • Posted By: erieangel @ 02/08/2008 1:02:15 PM

    My doctor told me it was good for my heart and would help me get my good cholesterol up. My good cholesterol was 20 and it now 40. Also, are gone the night sweat where my bed was soak and it was hard to sleep and I work the morning shift 6-2. Also, sex is no longer painful and I threw out KyJel. My mood swing are gone. I love Preprom. My dose is .45. Thank God every day for this drug. I am 57 and I got my life back ! June

  • Posted By: e skewis @ 02/08/2008 12:48:04 PM

    This is the most asinine thing I have heard. I would be nuts without my progesterone cream. I use the smallest dose I need and only for the shortest time needed. It keeps me sane and easy to live with. I think the big companies are mad because they can't make money on the bio-identicals. The presidential candidate that supports total health choices and the disbandment of the FDA is Ron Paul. If you want complete health choice freedom, the highest quality care and complete confidentiality between you and your health care providers, check out this man and his platform.

  • Posted By: michdoc @ 02/08/2008 10:51:21 AM

    This is a response to dancingdiamond. That's a very good question about why would you want to take a person off of hormones that are a natural state for women to be in. (I'm a menopausal female who treats menopausal woman every day). The reason is that the breast cancer rates increase when the hormones are used over decades, but not in the first five or six years. Also, it is normal and natural that our hormones decline when we're menopausal. So we need a safe way to alleviate symptoms but not put our bodies at risk. Usually we don't have hot flashes for decades. Now vaginal dryness is different and debilitating. For that, if it's the only symptom, I'll use estradiol (human identical lab synthesized) cream vaginally. It works wonders. There are other forms, like vaginal pellets or estrogen rings. But women really need the moisture from a cream as it soothes the burning immensely. It takes a good month to restore vaginal tissue that has atrophied to comfortable resilient tissue. We'll often give this low dose topical form to breast cancer survivors. I sure hope my patients don't think I treat them badly. Mutual respect is important and if we're told what symptoms are bothersome, we can usually help.

    • Posted By: dancingdiamonds4 @ 02/08/2008 11:01:52 AM

      Thank you for your response. The only problem with gradually taking women off of these hormones is the loss of sexual identity and libido. I know because I suffer greatly from this situation even with the hormone replacement therapy. I do not have a doctor who is willing to work with me to get my hormones at a level where I can enjoy the sexual side life. It's as if I am no longer a sexual human being. I have very little of these feelings left. You have no idea how devastating this is to me. I know that something could be done I just don't know what. No woman wants to lose her sexual self that is why I don't buy the fact that women have to weaned from our hormones. I suspect that most women would take the small risk of cancer to remain sexually active.

      • Posted By: SueWil @ 02/08/2008 12:37:31 PM

        Hmmmm. BIG PHARMA sure jumped on the band wagon with Viagra and its clones, which certainly turn back the biological clock for middle-aged men. You just wait -- if BIG PHARMA could synthesize a female hormone -- ANY female hormone -- that would do the same for women, we'd see it all over the airwaves instantly. Instead.....many menopausal women are left with seriously reduced or no sex drives, but then, maybe that's OK with BIG PHARMA -- husbands/boyfriends buy lots more Viagra and just move on to 35 yr old girls who have their sex drives intact due to (surprise, surprise) FEMALE HORMONES!

  • Posted By: dmerwitz @ 02/08/2008 11:19:14 AM

    The fact that this article used ???safer??? and FDA in the same sentence is a joke. I was happy to see all the comments posted with a clear understanding that FDA recommendations have nothing to do with protecting the public and everything to do with protecting the interests of the Pharmaceutical Industry. As an RN, I see on a daily basis, the lengths pharma. reps will go to in order to push their "safe" products. The FDA may claim rigorous testing and double blind studies prove safer products, then we see those same products pulled. FDA approval does not equate to safety. The bottom line is that having more choices of products and therapies, allows more women to have relief. This is all about money lost for BIg Pharma, plain and simple.

  • Posted By: michdoc @ 02/08/2008 11:19:12 AM

    To dancingdiamonds: You're right about sex and sexual identity. So a patient like you would probably be best served on low dose hormones long term, understanding the small risk of cancer. In today's litigious society, docs are scared of malpractice. So they need a relationship with the patient to be a team in the person's best interest. I'll usually put a note in the chart that the patient understands the slightly increased risk of cancer and agrees to have regular mammograms.

  • Posted By: kindersa @ 02/08/2008 11:00:40 AM

    I don't mean to directly attack anyone but all of these testimonials are essentially meaningless. Maybe you do feel better taking this supplement, maybe you would have felt better even without taking it.
    During the 1920s there was a guy, John Brinkley running around implanting goat testicles and ovaries in people supposedly to increase virility. He had hundreds of positive testimonials claiming the the procedure worked, while hundreds more that became infected and some even died. But even famous people paid exorbitant sums for the procedure. It was the AMA that finally shut him down. In short just because an untested product worked for you doesn't mean it is safe for anyone else.

    • Posted By: Melinda43 @ 02/08/2008 11:14:16 AM

      to kindersa: why don't you have the goat testicles and ovaries implanted and give us an update. It didn't work for those others, but maybe it will work for you.

      Don't come on here and tell me or any other woman on here that we "imagined" our problems or the cures.

  • Posted By: Fabienne @ 02/08/2008 10:56:02 AM

    I totally agree with the author. There is no such thing as a "safe hormone" and that Suzanne Somers should be ashamed of herself for promoting them so vigorously, she of all people, as a cancer survivor should know better. In her vanity to be "forever young and sexy" she is jeopardizing her health. What is she going to say when her cancer comes back? She talks about this subject with such authority one would think she's a doctor. No wonder they say a little knowledge is a dangerous thing. I find her grating and insulting, a real know it all. To my knowledge she never graduated from medical school and she shouldn't promote her "magical hormones" so vigorously. She should do whatever she wants with her body but leave us alone, she's not an eminence on the subject.

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