Bio-identical hormones: why they could be an alternative to HRT if your hormones are haywire
March 21, 2014 | By:
Dr Anu Arasu, who specialises in bio-identical HRT, explains the role of our different hormones during menopause and how hormone therapy could help to reduce the signs of ageing

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Age is definitely not just a number. These days, what’s more important than your chronological age is your biological age, which is calculated by looking at a number of parameters that measure your cognitive function, cell and tissue function and physical structure of the body, and compare them with healthy young adults.

It has been discovered that these biomarkers of age are closely linked to hormone levels. Dwindling hormone levels result in many of the diseases and disabilities of ageing, and restoring hormone levels to a functional balance can help alleviate many of the symptoms associated with it.

It’s a misconception to think that hormones are just responsible for our sex lives and reproduction. They control everything to do with our vitality, which is why, when they decline, we end up with a lot more to deal with than just decreasing fertility.

Signs of hormone decline

Hormonal decline is responsible for loss of energy and muscle strength, sleep disorders, thinning bones, a decline in blood lipid balance and heart health, and a decline in memory.

Hormones are responsible for repairing and regulating body functions, and ageing is a result of a decline in the body’s ability to repair itself.

Take skin: up to the age of 30, skin naturally renews itself every month or so. But as our hormones start to decline, the interval between skin dying and new skin being produced is prolonged.

Another example? The loss of lean muscle mass and its replacement with the middle aged spread. Yup, gentlemen, that male mid-life crisis really is the fault of your hormones.

The only hormones that increase from our mid-thirties onwards are the catabolic ones, such as cortisol, which break down muscle tissue. Cortisol is also responsible for increasing blood pressure and blood sugar, and reducing immune responses. So why don’t we talk about hormones more?

What hormones do for you

  • The thyroid hormone is the only one that gets any attention, because it controls so much: our mood, our weight, our temperature and our appearance.
  • Lack of oestrogen is responsible for wrinkles, fatigue, poor memory, mood swings, recurrent urinary infections, itching skin, dryness of eyes and mouth, and hair loss.
  • Then there’s progesterone, known as the ‘calming hormone’. Low levels can cause anxiety, poor sleep, bloating and water retention.
  • A lack of testosterone can cause depression, impaired memory, cellulite and lack of confidence.
  • And DHEA, a hormone produced by our adrenal glands (above the kidneys), which we hear virtually nothing about, is pretty important as it’s the key to our energy levels. In fact, although GPs hardly talk about or test adrenal function, they really should, because abnormal adrenal hormone rhythms can cause all sorts of problems, from muscle and joint pains to reduced bone thickness, reduced sleep quality and decreased immunity against infections.

Should I take hormone top-ups?

This is not to say that everyone should be taking hormone top-ups or replacements. Too much can be as bad as too little and, as in all aspects of life, balance is the key. Men and women have the same hormones but in different ratios, and the ratios of each hormone within each individual are crucial for optimal health.

Hormone replacement therapy has received a lot of controversial media attention because of two big studies that showed an increased risk of breast cancer when using synthetic hormone replacement.

But the crucial point is that these studies only looked at synthetic hormones. Here I am on video explaining the difference between synthetic hormones and those made by the body.

Bio-identical hormones vs synthetic hormone replacement

Meanwhile, numerous studies of bio-identical hormones – that is, ones identical to those made by the body –have found that ‘natural’ progesterone actually protects against breast cancer and cardiovascular risk.

The medical establishment has to recognise the difference between synthetic and bio-identical hormones. This acknowledgment would, hopefully, pave the way for more studies into them. Until then, all the evidence we have shows that bio-identical hormones are the preferred method of replacement.

Your GP may not know the difference between synthetic and bio-identical hormones. It is not something taught at medical school. Unless your doctor continues studying and keeping up to date with what is developing internationally, there is no priority given to this subject in the UK.

Where to get tests and treatment

Which leads to the question: are bio-identical hormones available on the NHS? Yes, there are a few. Some bio-identical oestrogens are prescribed. But there are far fewer progesterone options available on the NHS.

Private treatment will cost you the consultation fees (which may run to hundreds of pounds) and the prescription, which can work out at around £1 a day. On the NHS, you will get a ‘one-size-fits-all’ dose. Whereas tailor-made prescriptions – although described by some doctors as ‘experimental’ by virtue of being bespoke – do offer two main benefits.

First, as the total hormonal dose is adjusted to the individual, it is frequently much lower than the one-size-fits-all dose. Second, the ratio of various hormones can be played with. For example, there are three types of oestrogen, all of which have different effects. With a tailor-made prescription, more of one type than another can be used, with the aim of providing the best results and best safety profile.

Currently, testing oestrogen and progesterone levels for symptoms such as PMS, resistant weight gain, depression, etc, is simply not done on the NHS. In the private sector, much more comprehensive monitoring – such as testing the way patients are metabolising their oestrogen replacement – is available. (Oestrogen metabolism is thought to have a role in predicting breast cancer and can be modified through lifestyle change.)

Finally, if there is a need to replace other hormones, such as DHEA, this is not a service that the NHS can routinely supply.

As in life, I suppose, you get what you pay for. I can only advise that you don’t pay for a harder middle age than you need to by ignoring the declines and imbalances of the hormones in your body.