Bioidentical hormone replacement therapy (BHRT), also known as bioidentical hormone therapy or natural hormone therapy refers to the treatment of menopause using hormones that are molecularly identical to endogenous hormones in hormone replacement therapy. The primary hormones used in BHRT, estradiol and progesterone, are available as FDA-approved products and as pharmacy-compounded products. Estrone, estriol, testosterone, and dehydroepiandrosterone are available only in compounded and non-prescription forms. The term "BHRT" is also used to describe certain practices associated with pharmacy compounding of hormones and with monitoring blood or saliva levels during therapy. While Europeans have used government-approved bioidentical hormone products for many years, conventional hormone replacement therapy (CHRT) has been the common practice in North America. The prescription of pharmacy-compounded BRHT is almost completely limited to the United States.
BHRT, in its various forms, differs from CHRT in several ways. CHRT, as defined by the statements of professional associations in North America, is prescribed to relieve the symptoms of menopause and to prevent and treat osteoporosis. CHRT includes estrogens and progestins that are not bioidentical, is prescribed for the shortest amount of time necessary, and uses only estrogen if the woman has no uterus. In contrast, BHRT practitioners use only bioidentical hormones, consider replacing lost hormones to be beneficial for both quality of life and general health, continue BHRT throughout the woman's life, prefer transdermal estradiol over oral, and always include progesterone with estradiol.[1][2]
The American College of Obstetricians and Gynecologists, Society of Obstetricians and Gynaecologists of Canada, the Endocrine Society, the North American Menopause Society (NAMS), United States Food and Drug Administration, American Association of Clinical Endocrinologists, American Medical Association, American Cancer Society and the Mayo Clinic have released statements stating that all FDA-approved hormone products, bioidentical or non-bioidentical, oral or transdermal, should be assumed to have similar risks and that compounded hormone products may have additional risks related to compounding. BHRT advocates hold that the risks found with some CHRT products cannot not be generalized to bioidentical hormones, and that research shows that transdermal estradiol does not increase venous thromboembolism and strokes as some oral estrogens have been shown to do, and that progesterone neither increases thromboembolism nor the risk of breast cancer as some progestins do.[3]
References
edit- ^ Schwartz, E (2008). "Hormones in Wellness and Disease Prevention: Common Practices, Current State of the Evidence, and Questions for the Future". Prim Care Clin Office Pract. 35 (4): 669–705. doi:10.1016/j.pop.2008.07.015. PMID 18928825.
{{cite journal}}: Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Reiss U (2001). Natural Hormone Balance for Women. Pocket Books.
- ^ Holtorf K (January 2009). "The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?" (PDF). Postgrad Med. 121 (1): 73–85. doi:10.3810/pgm.2009.01.1949. PMID 19179815.
{{cite journal}}: CS1 maint: date and year (link)
Discussion
editI believe that this lead is neutral in tone, is more informative about what BHRT is and how it differs from CHRT, and allows the minority to present a response. I believe it provides a better starting point. The rest of the article will deal with issues in depth including the nature of the scientific evidence, the history of BHRT, BHRT practices, criticisms, etc. Hillinpa (talk) 21:48, 4 May 2010 (UTC)