Hormone Replacement Therapy;
What You Should Know

by Karen Sun, M.D.
Printable Article

There has been controversy on the topic of Hormone Replacement Therapy (HRT) for the last 15 years. Negative attitudes drastically dominate the media since 2002. Combine this with the Women's Health Initiative (WHI) study that was halted three years ago because of health risks, and we have caused ultra-confusion for women trying to make an informed decision about hormones and their health.
It is essential to understand the the WHI study and the subsequent media reports about HRT, are based on commercial synthetic HRT only. They are based off findings about the combination of conjugated estrogens and medroxyprogesterone (called PremPro). Thus, when you hear about HRT in the news, this is what they are referring to. But there is another type of HRT called bio-identical hormone replacement therapy (BHRT) that is very different than commercial synthetic HRT.  Let’s explain:

What are hormones?
Hormones are complex chemicals secreted by our endocrine glands. They stimulate or inhibit the actions of cells everywhere in our body. They are vital for repairing and regulating our bodily functions. The endocrine system includes the pituitary gland which is the CEO of the endocrine system.  It secrets growth hormone (HGH), and controls hormone production in other glands, such as TSH for thyroid hormone regulation, ACTH for adrenal hormones, and FSH/LH for ovaries and testicles.  Then there are the thyroid gland, adrenal glands, ovaries in women and testicles in men which are the organs of production of  the hormones produced by the endocrine system which regulate processes of the entire body.

What are sex hormones and their functions?
The sex hormones are estrogen, progesterone and testosterone. Both men and women have all three. Estrogen and progesterone are the dominant hormones in women and testosterone is the dominant hormone for men.

The function of estrogen is to make everything grow. It makes the lining of uterus grow, makes the breast tissue grow, keeps the vagina moisturized, along with other functions:
            1. prevents bone destruction thus prevent osteoporosis
            2. reduces the blood pressure by relaxing the lining of blood vessels, also preventing plague build up resulting in a cardiovascular protection effect
            3. lowers insulin levels by protecting insulin sensitivity and reduces incidence of diabetes
            4. protects nerve cells and brain function helping our memory, improves learning abilities and gives a better quality of sleep;  also works as an antidepressant by increasing serotonin levels

The progesterone is made in the ovaries after ovulation. Progesterone keeps the estrogen in check by preventing the overgrowth of endometrium, protects against fibrocystic disease, other functions of:
            1. serving as a natural antidepressant and helps to restore the normal sleep pattern
            2. cardiovascular protection
            3. prevents bone loss
            4. increases use of fat
            5. is a natural diuretic.

Testosterone helps to promote muscle strength and exercise endurance. It improves libido, increases energy level, improves bone density and increases body hair and male characteristics, along with a cardiovascular protection effect which normalizes blood sugar and helps us sleep better.

What is the purpose of hormone replacement therapy?
            1. To improve the quality of life by reducing menopausal symptoms such as hot flashes, insomnia, depression, vaginal dryness, painful intercourse and decreased libido-sex drive
            2. To prevent osteoporosis, diabetes, Alzheimer's disease and cardiovascular diseases.
            3. To slow down the aging process. One of the theories of aging is the decline of hormones which reduce our body's ability to repair and regulate itself. Hormone replacement helps to slow down the bodies hormone clock and delay the aging process.

What's the difference between bio-identical hormone and synthetic hormone?
Both bio-identical hormones and synthetic hormones are produced by pharmaceutical companies and are FDA approved.  But bio-identical hormones have the same structures as our own hormones while synthetic hormones have similar structures but not exactly the same which it is felt causes different reactions when in our bodies that the hormones identical to our naturally produced hormones.  It makes sense to use bio-identical hormones then, to reduce the possibility of side effects.

Examples of bio-identical hormones and synthetic hormones are:





estrace, estrodial,
Vivelle dot, biestrogen, triestrogen







methyl testosterone

Bio-identical hormones have been used in Europe and Australia for over 30 years with good results.  Studies have not been done up to this point due to lack of funds.  Currently, the National Institutes of Health (NIH) has undergone a study of bio-identical hormone therapy.

Can bio-identical hormone therapy cause breast cancer ?
There is no long term study done on bio-identical hormone to date, so we don't know for sure. Estrogen is a type of growth hormone so if you have cancer cells on board, they will grow faster when estrogen is present. Nature designed progesterone to balance the overgrowth action of estrogen, so it is very important to use estrogen together with progesterone in a balanced ratio (unless the uterus is removed). Our body makes thousands of new cells every day and if we have a lot of toxins accumulated in our body , some of the new cells may become cancerous. If the immune system works well, it will destroy the cancerous cells thus preventing cancer. To reduce breast cancer risk, it is essential to :
            1. avoid toxins and carcinogenic exposure: such as xenohormones (from meat, eggs or milk products of animals injected with hormones), pesticides, artificial food colors, artificial sweeteners and preservatives
            2. improve our immunity: good nutrition, regular exercise, stress reduction, detox, and a good nights sleep are the foundations of strong immunity


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