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Estrogen Estrogen Bioidentical HRT and women's health

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The Carlton Clinic
Richard Snouffer, MD
1713 Hamric Dr. East, Suite B
Oxford, Alabama  36203

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Estrogen Bioidentical HRT and Women's Health

Estrogen is an extremely important hormone for women.  It is secreted primarily by the ovaries, and its production dramatically falls off with menopause.

Despite the fact that menopause is a low hormone, and in particular, a low estrogen state, the decreased estrogen levels found in menopause are not natural and certainly not healthyOptimal estrogen levels (not to be confused with laboratory-reported “normal” levels) are vital to women’s health.  Estrogen is the main factor that gives women their natural resistance to heart disease compared to men.  However, women’s rate of heart disease does rise parallel to men’s—about ten year later.  This corresponds to the drop in estrogen at menopause, and the ceasing of its protective cardiovascular effects thereafter.  High (optimal) estrogen levels also promote women’s health by providing protection against stroke, osteoporosis, Alzheimer’s disease and memory disorders.  It protects against vaginal atrophy and urinary incontinence.  It prevents the “hot flashes” common to menopause and other low-estrogen states, and promotes proper temperature regulation, particularly through regulating the vasodilation and constriction of arterioles that control the amount of blood reaching the skin.  Estrogen also contributes to women’s health by improving static balance, which helps to prevent falls. 

Estrogen deficiency results in urogenital atrophy, which leads to dyspareunia, (painful intercourse), incontinence, sagging skin and breasts, increased wrinkles on the skin and face, increased fatigue, depression, mood swings and decreased libido. 

The Problem with Synthetic Estrogens

It is therefore incumbent upon physicians to prescribe estrogen hormone replacement therapy (HRT) where appropriate to improve women’s health.  Most physicians accomplish this primarily with synthetic estrogens.  Synthetic estrogens are most commonly prepared from pregnant horse urine, called PREMARIN.  (PREgnant MARe urINe)  There is also a synthetic conjugated estrogen called Ogen.  Conjugated estrogens are derived from plants, but do NOT have the same structure and form as the bioidentical products.  Both may be called “natural,” but NEITHER is bioidentical!  Both have significant structural differences from the estrogens that humans make naturally.  For example, with Premarin, there are close to a dozen different forms of estrogen that our bodies know nothing about dealing with, and which cause increased stress on the liver which must break down and eliminate them.  Premarin also contains equilin which is a known cancer-causing agent.  These disadvantages severely degrade synthetic estrogen’s ability to improve women’s health.

Synthetic estrogen products are the hormones most often used for hormone replacement therapy (HRT) by non-Anti Aging doctors, despite the fact that there are more side effects and synthetic estrogens have been demonstrated in scientific studies to have increased risks of blood clotting and certain cancers.  NO study has EVER shown increased risk with bioidentical estrogens, as long as a physiologic balance is maintained.  So with the clear cut advantage of the bioidentical estrogens for women’s health, why are synthetics used so often?    

The Benefits of Bioidentical Estrogen

Bioidentical Estrogen hormone replacement therapy upgrades women’s health by protecting against major illnesses such as heart disease, strokes, colon cancer (risk has decreased by as much as 27% in some studies), osteoporosis, urinary tract infections or UTI’s, Alzheimer’s Disease, macular degeneration, cataracts and breast cancer.  Bioidentical estrogen HRT has been consistently shown to be helpful and NOT harmful—and certainly less harmful than continuing on in an estrogen deficient state.  Bioidentical estradiol also decreases visceral fat—that is, the fat around the internal organs in the abdomen.  Visceral fat is a known cardiac risk factor marker. 

Bioidentical estrogen hormone replacement therapy (HRT) is safer, better tolerated, and has fewer complications than synthetic estrogen HRT as demonstrated in many studies.  All of these things combine to give bioidentical estrogen the clear-cut advantage for improving women’s health.  A good Anti Aging physician will use nothing except the safer, more protective, bioidentical product in your HRT.  You should demand nothing less from any physician prescribing hormone replacement therapy.  (HRT) 

Your Doctor should monitor your estradiol levels before and after initiating estrogen HRT.  Estradiol is the main estrogen that causes the protective effects (both cardiovascular protection against heart attacks and protection of bone against osteopenia/osteoporosis and other factors affecting women’s health) as well as protection of the symptoms of estrogen deficiency.

You must continue with annual pelvic exams with PAP smears, and breast exam/monitoring (Current ACS guidelines recommend mammograms; discuss with your doctor.) while on estrogen HRT.  For maximal improvement of women’s health with a minimum chance of side effects, estrogen and progesterone levels must also be measured regularly while on estrogen hormone replacement therapy.

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Bioidentical Hormones and Anti Aging
Estrogen FAQEstrogen FAQSome common questions about the safety, efficacy and methods of estrogen hormone replacement therapy (HRT) are answered.

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The Carlton Clinic
1713 Hamric Drive East, Suite B
Oxford, Alabama  36203