What Is the Source of Bioidentical Hormone Replacement Therapy?

Hormone therapy is implemented for the management of symptoms related to menopause. It involves the use of estrogen and progesterone. Bioidentical versions of these hormones are one of the forms currently available.

Definition

• Bioidentical hormones have the same chemical structure as the body's own naturally produced hormones.

Sources

• Precursors to bioidentical estrogen and progesterone are derived from either soy or Mexican wild yam root.

Synthesis

• The bioidentical compounds that are actually administered in hormone therapy are different from those originally extracted from the plants. Plants do not manufacture ready-made bioidentical hormones. The chemicals naturally found in plants are beta-sitosterol and diosgenin, which are not what the female body produces. These substances are synthesized into the bioidentical 17 beta-estradiol, estrone, estriol and progesterone.

Versions

• Bioidentical hormones come either as standardized preparations approved by the FDA or as compounded preparations customized specifically for each individual. The custom version is not approved by the FDA but is not necessarily of lower quality or effectiveness.

Controversy

• The argument over the purported superiority of bioidentical hormones in the scientific community is heated. Respected physicians, including Dr. John Lee, the pioneer of bioidentical hormone therapy, Dr. Erika Schwartz, one of its major proponents, and Dr. Kent Holtorf, an expert on the topic, among many others, vehemently claim that compounded bioidentical hormones are better tolerated and offer an improved safety profile over conventional hormones. On the other hand, highly reputable organizations, from The American Congress of Obstetricians and Gynecologists to the North American Menopause Society to Harvard Medical School, have all rejected these assertions, citing lack of sufficient evidence. This status may change as more data are gathered.