Female Hormone Restoration
Until 2002, mainstream physicians routinely prescribed conventional hormone replacement therapy (HRT) pills to alleviate menopausal symptoms. Conventional HRT comprises oral conjugated estrogens, derived from the urine of pregnant mares (horses), and synthetic progestins (compounds that activate progesterone receptors) such as medroxyprogesterone acetate (NAMS 2017). In 2002, however, the landmark Women’s Health Initiative study identified substantial risks associated with conventional oral HRT:
- 26% increased risk of breast cancer,
- 29% increased risk of coronary heart disease,
- 41% increased risk of stroke, and
- double the risk of blood clots relative to the untreated group.
With time, much of this risk was attributed to medroxyprogesterone acetate, the synthetic progestin used in the WHI studies (Stanczyk 2015). As awareness about these risks associated with conventional oral HRT spread, many women became concerned about using HRT. In the United States, the use of conventional HRT dropped dramatically (Schonberg 2005). A sharp decline in breast cancer incidence observed in 2003 among women over 50 correlated with this decrease in conventional HRT use (Ravdin 2007).
Life Extension was not surprised by the results of the WHI study. The equine estrogens and synthetic progestins used in the study differ in chemical structure from the natural hormones produced in a woman’s body (Samaras 2014). Many studies have shown that the synthetic progestin medroxyprogesterone acetate poses several health risks, including increased risks of breast cancer, stroke, and cognitive dysfunction (Stanczyk 2015). Life Extension has long recognized the value of bioidentical hormone replacement therapy, which uses hormones that are identical to those naturally produced in the body (Moskowitz 2006; Whelan 2011).
Bioidentical HRT may be associated with fewer side effects than conventional HRT. Bioidentical topically applied estrogens appear to pose less blood clot risk—and possibly overall cardiovascular risk—than oral equine estrogens used in conventional HRT (L'Hermite 2017). This was demonstrated in a large case-control study that showed that use of oral equine estrogens alone (not in combination with synthetic progestins) resulted in about 50% greater risk of venous blood clots compared with controls. When equine estrogens were used in combination with synthetic progestins, the risk increased to about 90% greater than that of control participants (Vinogradova 2019). Also, bioidentical progesterone, unlike the most widely used synthetic progestin, does not increase cardiovascular or breast cancer risk (Holtorf 2009). Indeed, the appeal of bioidentical hormone therapy has not been lost on the public or the medical community: nearly one-third of women who now use hormone therapy do so with bioidentical hormones (Gass 2015).
Many FDA-approved commercial preparations now utilize bioidentical hormones, which is helping spread acceptance of bioidentical HRT among conventionally minded physicians. See Table 1 for a list of FDA-approved bioidentical hormone preparations.
Moreover, supplementation with scientifically studied herbs such as Dong quai (Angelica sinensis) and licorice (Glycyrrhiza glabra) root can further promote healthy metabolism of female hormones and complement the actions of bioidentical HRT.
In this protocol, you will learn how to approach bioidentical HRT judiciously. You will also learn how using readily available blood tests may help guide your therapy in partnership with a qualified healthcare provider.