• The Big Question: Are Hormones Safe?

    by Dr. Susan Sklar
    on Aug 14th, 2014

Let me address some hormone concerns that I hear frequently. One is the question of hormone safety. To answer this question adequately I have to explain some of the history of pharmaceutical development in the United States. Natural products such as estrogen, progesterone, pregnenolone, DHEA cannot be patented.

For this reason the pharmaceutical companies were not interested in the development and clinical use of these substances. They worked industriously to produce synthetic alternatives that were patentable. This has resulted in widespread risk to patients and untold suffering due to restriction on the use of hormones because of safety concerns.

In the 1940s, pregnenolone was used as an anti-inflammatory treatment for arthritis. It is safe and effective but it was not patentable. Witness the evolution of Prednisone, a potent steroid hormone with numerous side effects. Although Prednisone is effective in reducing inflammation, it also has serious side effects such as osteoporosis, skin changes, fat deposition, muscle wasting, and fluid retention.

Natural estrogen was not patentable. So Premarin was developed. Premarin stands for “pregnant mares urine.“ Pregnant horses are lined up and their urine is collected for the purpose of extracting estrogen-like components. These components are then put into pills for women to take. The problems with Premarin use are multiple. First of all they contain estrogen that is natural to horses not humans. Many of these estrogens are more risky and carcinogenic. In addition, Premarin was put into a pill to be taken by mouth. In this form, estrogen causes increased risk of blood clotting. When estrogen is taken orally it gets processed through the liver. This processing results in increased production of clotting factors. These increased clotting factors result in an increased tendency to have heart attacks and strokes. This was seen in older women in the results of the Women’s Health Initiative, a large study conducted by the National Institutes of Health.

The other, very frequently prescribed synthetic steroid that was produced was Provera (medroxyprogesterone acetate), a pharmaceutical substitute for progesterone. Medroxy-progesterone acetate has some progesterone-like effects in a woman’s body, but it also has a number of undesirable effects. The Women’s Health Initiative clearly showed an increased risk of breast cancer with women who used Provera. The conclusion following the release of these results was that Provera, not Premarin, was the cause of an increased risk of breast cancer in women who are on this type of hormone replacement therapy. So, when you ask the question “are hormones safe,” the answer is “yes” but it depends upon the hormones. Bio-identical hormones have a proven safe track record as seen in numerous studies.

What are Bio-identical hormones?
I have to be honest with you. When I was practicing gynecology as a traditional type of doctor I said that Bio-identical was a marketing term used to sell hormone programs. Now that I understand the scientific bases of this restorative medicine approach, I have a clear understanding of the benefits of Bio-identical hormones versus other types of hormones. Bio-identical means that the hormones are chemically and molecularly identical to the hormones in the human body.

Why is this important? This is important because the risk of using Bio identical hormones is less than using other types of hormones. The other types of hormones are pharmaceutical products that have been developed by drug companies in order to patent them and profit by their sales. Some of these are bioidentical products, but some are not. The non-bioidentical hormones include some naturally occurring ones such as Premarin(conjugated equine estrogens) which is made from pregnant mare’s urine and some completely synthesized ones such as Provera (medroxyprogesterone acetate) which is found nowhere in nature. Using hormones that are exactly like our own human hormones, and using them in balance with each other, maintains the benefits while reducing side effects and risks. So you can see Bio-identical is far more than a marketing term.

Author Dr. Susan Sklar

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