The relatively safety and efficacy of bioidentical hormone replacement therapy (HRT) compared with traditional animal-derived and synthetic versions has been the subject of raging debate. The Endocrine Society says that there is little or no evidence to support the claim of superiority of bioidentical hormones over the synthetic versions of HRT.
The FDA has ordered pharmacies to stop offering compounding pharmacy medications containing estriol, with the reasoning that it is a new drug with unknown results. However, estriol has been used for decades and is a component of medications approved for use globally. There have been no reported safety concerns. The FDA acknowledges that it is unaware of any adverse events associated with the use of compounded estriol-based drugs.
The claims of the FDA and the Endocrine Society are in direct contrast to those who advocate the use of bioidentical hormones, arguing that these hormones are safer than comparable synthetic versions of HRT. American Integrative Pharmacy provides safe and proven compounding treatments for a variety of ailments to patients in Long Beach, Torrance, Los Angeles, South Bay Orange County, Southern California areas and nationwide.
Human clinical studies and animal studies have been conducted to compare bioidentical and non-bioidentical hormones, as well as in vitro experimental work focusing on various aspects of hormones has been performed.
Synthetic Progestins versus Progesterone
Four studies involving patients using HRT, including either progesterone or MPA compared efficacy, quality of life and patient satisfaction. Women in all four studies reported fewer side effects, higher satisfaction and enhanced quality of life when they were switched from synthetic progestins to bioidentical progesterone replacement.
In one of the studies, the effect of progesterone compared with MPA included a 50% reduction in anxiety, a 60% reduction in depression, a 30% reduction in somatic symptoms, a 25% reduction in menstrual bleeding, a 30% improvement in sexual function, and a 40% reduction in cognitive difficulties. Overall, 65% of patients felt that HRT with progesterone was better than the HRT with MPA.
Risk of Breast Cancer
A number of studies have evaluated the risk of breast cancer with the use of a synthetic progestin for HRT. Across studies with variable design, synthetic progestins have been clearly associated with an increased risk of breast cancer.
The Women’s Health Initiative (WHI), a large randomized clinical trial, showed that a synthetic progestin, MPA, as a part of HRT, significantly increase the risk of breast cancer. In contrasts, studies have consistently shown a lowered risk of breast cancer with progesterone.
Studies conducted on women after pregnancy with increased exposure to estriol showed a significant long-term reduction in the risk of breast cancer. Urinary estriol levels in post-menopausal women also revealed an inverse correlation with the risk of breast cancer.
A WHI study showed that the addition of MPA to Premarin led to a significant increase in the risk of heart attack and stroke. Progesterone, in contrast, has shown the opposite effect because it maintains and improves the cardio-protective effects of estrogen, thus reducing the risk of heart attack and stroke.
AIP provides a comprehensive range of services in compounding pharmacy, including online prescription refills, for patients in Long Beach, Torrance, Los Angeles, South Bay Orange County, Southern California areas, and nationwide.
American Integrative Pharmacy is located in Lomita, CA serving residents in and around Orange County, Los Angeles, Long Beach, Torrance and surrounding areas. Online prescription sales are available across the US.