Bioidentical Hormone Treatment for Hysterectomy Patients

Women who have undergone a hysterectomy may consider hormone replacement therapy in order to cope with symptoms associated with the loss of estrogen. A number of bioidentical hormones have been approved by the FDA and may be prescribed by a doctor to treat post-hysterectomy symptoms. Always consult with your doctor before making any treatment decision.

Hysterectomy

• A hysterectomy is the removal of the uterus through an incision in the abdomen or vagina. A hysterectomy may be performed for the following reasons: tumors in the uterus, uterine cancer, cervical cancer, ovarian cancer, endometriosis, chronic vaginal bleeding, prolapsed uterus, adenomyosis, chronic pelvic pain and complications during childbirth.

Hormone Replacement Therapy

• Hormone Replacement Therapy was once prescribed to all hysterectomy patients. HRT consists of prescribing either estrogen or progestin, or a combination of both. HRT is given to help patients to cope with symptoms associated with surgically induced menopause (when both ovaries are removed) such as depression, hot flashes and vaginal dryness. Since certain symptoms, such as depression, may be relieved with other means, HRT is not a necessity. In some cases, the side effects and risks of HRT outweigh the benefits. According to Cornell University, estrogen plays a role in stimulating breast cell division and works during central periods of breast development. Based on these factors, estrogen is linked with an increased risk of breast cancer. HRT is intended for women with severe symptoms as a result of a hysterectomy, according to Harvard Medical School.

Bioidentical Hormones

• Estrogen used in HRT (most commonly known as Premarin) is made from a pregnant mare’s urine. Bioidentical estrogen, on the other hand, mimics the molecular structure of estrogen produced by a woman’s ovaries. Bioidentical hormones are plant based and made from soy and yam extracts. They are called "bioindentical" because the body can't tell the difference between these hormones and the one's made by a woman's ovaries.

  Estradiol is bioidentical estrogen. Brand names include Estrace (pill), Alora (patch), Estrogel (transdernal gel) and Estring (vaginal ring). Micronized progesterone USP is the bioidentical progestin treatment. Micronized means that the progesterone has been made smaller for better absorption. All of these bioidentical hormones have been approved by the FDA. Your doctor will determine the dose.

Compounded Hormones

• Some of the controversy surrounding bioindenticals has to do with compounded hormones. Compounded Menopause Hormone Therapy drugs have not been approved by the FDA. Compounded hormones refer to customizing the combination, dose or preparation of both FDA approved and non-approved hormones such as bioidentical testosterone. Since compounded drugs are mixed to order, there is no testing to ensure their safety and effectiveness. Some clinicians who prescribe compounded hormones determine dose levels based on saliva tests. According to Harvard Medical School, these saliva tests offer little values in determining hormone levels.

Dispelling Myths

• The manufacturers of BHRTs (Bioidentical Hormone Replacement Therapy) have spread a number a myths regarding their products. For example, the manufacturers claim that BHRT is safer than prescription drugs and that this therapy prevents Alzheimer’s disease. According to the FDA, there is no proof that BHRT treatments prevent Alzheimer's disease. In addition to preventing chronic illness, BHRT is marketed as a kind of weight loss therapy. The FDA stresses that there is no evidence that backs any of these claims, and there is also no proof that BHRT treatments carry less risk than conventional HRT.