Hormones are the chemical messengers that travel through our blood stream, enter cells by unlocking a door called a receptor, and flip the switches that govern growth, development, and mental and physical functioning.  The exact chemical structure of the body’s hormones is incredibly important, because in order for hormone therapy to fully replicate the normal functioning present in the human body it must match the original structure of that hormone exactly. 

Only a natural hormone key can fit properly into a specific cell receptor door’s lock.  A non-identical matching key (e.g. a synthetic hormone) can’t open the same doors as the natural hormone.  Bio-identical hormones have the same chemical structure as the hormones made by the human body.  Structural differences exist between bio-identical hormones and those available commercially, which are typically synthetic (i.e. esterified estrogens, medroxyprogesterone) or animal derived (i.e. conjugated equine estrogens).  In order to be patented, synthetic hormones have side chains added to a natural substance.  The structural differences that exist between human, synthetic, and animal hormones may be responsible for the side effects and risks commonly associated with them.  Synthetic hormones are not found in humans, and are not identical in structure or function to the bio-identical hormones they are intended to replace.

Hormone-related symptoms or problems may occur throughout the feminine life cycle:

Goals of Bio-Identical Hormone Replacement Therapy

• Alleviate the symptoms caused by the natural decrease in production of hormones by the body
• Give the protective benefits which were originally provided by naturally occurring hormones
• Re-establish a hormonal balance

Estrogens

• Estriol (E3), estradiol (E2), and estrone (E1) are often prescribed in combination to re-establish a normal physiologic balance
• Relieve menopausal symptoms, including vaginal thinning and dryness
• May increase HDL “good” cholesterol and decrease LDL “bad” cholesterol
• Help to decrease blood pressure and reduce plaque formation on the arterial walls
• Reduce the risk of colorectal cancer
• May improve mood, energy levels, and sleep patterns
• May reduce the risk of developing or the severity of type 2 diabetes
• May improve memory and cognitive function
• Reduce bone loss

Progesterone

• Is commonly prescribed for perimenopausal women to counteract “estrogen dominance”
• Alone, or with estrogen, may improve Bone Mineral Density
• Minimizes the risk of endometrial cancer in women who are receiving estrogen
• Is preferred by women who had previously taken synthetic progestins, according to one Mayo Clinic study
• May enhance the beneficial effect of estrogen on lipid and cholesterol profiles and exercise-induced myocardial ischemia in post-menopausal women (in contrast to medroxyprogesterone acetate)
• Produced by the ovaries and adrenal glands in women and, in smaller amounts, the testes and the adrenal glands in men. 
• Plays an important role in brain function and is often called the “feel-good hormone” because of its mood-enhancing and antidepressant effects.
• Especially beneficial because it keeps the other hormones in balance

Androgens (i.e. testosterone & DHEA)

• Enhance libido
• Testosterone is often called the “hormone of desire” because of its powerful effect on libido
• Testosterone is important in building strong muscles, bones, and ligaments, as well as increasing energy and easing depression
• DHEA has shown to protect against cancer and heart disease and to lower cholesterol.  DHEA has also shown to improve memory, strengthen the immune system, prevent bone loss, reduce body fat, and enhance libido
• Provide cardiovascular protection (lower cholesterol)
• Enhance bone building (increase calcium retention)
• Improve energy levels and mental alertness

Pregnenolone

• Referred to as the “parent hormone”
• Believed to be the most potent memory enhancer, it has also been shown to be beneficial in improving concentration, fighting mental fatigue, and relieving severe joint pain and fatigue in arthritis

Cortisol

• Primary hormone secreted by the adrenals in response to stress
• Involved in the regulation of glucose, protein, fatty acids, immune cells, inflammation, blood vessels, blood pressure, maintenance of connective tissue
• Symptoms of high cortisol; muscle and bone loss, abdominal fat, elevated blood sugar, sugar cravings, insulin resistance, high blood pressure, suppressed immune function, memory, mood, and sleep disturbances
• Symptoms of low cortisol; chronic fatigue, allergies, asthma, susceptibility to illness and infection, arthritis, fibromyalgia

Thyroid

• Affects every bodily function by regulating energy and heat production, growth, tissue repair, and development; stimulating protein synthesis; modulating carbohydrates, protein, and fat metabolism as well as digestion; modulating muscle and nerve action; and helping to regulate hormone excretion and oxygen utilization.
• Symptoms of thyroid imbalance include; tired/exhausted, sad/depressed, cold hands/feet, weight gain, can’t lose weight, forgetful, poor concentration, mood changes, depression, slow pulse rate, hair loss, brittle nails/hair, aches/pains, low libido, thinning skin, constipation

Melatonin

• Produced by the pinal gland
• Levels decrease with age
• Low levels are associated with difficulty in sleeping

Andropause – the “male menopause”

A delicate balance exists between all the different hormones in our body.  When in balance the body systems are stable, but as soon as that balance is lost unwanted symptoms, disorders, and disease occur.  With age hormone levels fluctuate, then decline triggering what is commonly known as the symptoms of Menopause (in women) and Andropause (in men).  Typically, men have a more slow and subtle hormonal decline compared to the rather sudden hormonal changes women experience at menopause.  Over time however similar symptoms are experienced including; weakness, fatigue, disturbed sleep, reduced libido, osteoporosis, heart disease, atherosclerosis, irritability, insomnia, erectile dysfunction, slow wound healing, prostate problems, low sperm count, depression, anxiety, reduced muscle mass, memory impairment, impaired cognitive function, impaired blood cell formation.  On average, a man’s testosterone levels begin to decline at a rate of 1% per year after the age of 40.  When hormones are replaced or restored back to physiologic levels, men may experience a dramatic reversal of many of the changes caused by aging.

Saliva hormone testing

Saliva testing is preferred over blood or serum testing because the saliva measures bio-available, active hormone levels.  Therefore saliva allows the measurement of hormones, which can be utilized by the cells.  It gives the most accurate picture of what the body is able to utilize.  Saliva testing is also painless (no needles), which is particularly important when testing for cortisol levels, because the stress and pain of a needle stick can result in an increase in cortisol levels.  Testing hormone levels is important because it correlates symptoms with exactly what is occurring hormonally.  Once hormone therapy is initiated, follow-up testing tracks progress and allows for the adjustment of hormone therapy doses.

To summarize,
SYNTHETIC = SUBSTITUTION
BIO-IDENTICAL = REPLACEMENT
Synthetic hormones are not found in humans, and are not identical in structure or function to the bio-identical hormones they are intended to replace

Compounding pharmacists work together with patients and prescribers to provide customized bio-identical hormone replacement therapy in the most appropriate strength and dosage form to meet each individual’s specific needs.

For more information

Article: What is Bio-Identical Hormone Replacement Therapy and Why Should It Be Considered?
Article: What is the Importance of Testosterone and DHEA Replacement Therapy in Females?
Article: Adrenal Glands and Your Health
Article: Bio-Identical Hormone Replacement Therapy
Article: Breast Cancer News
Article: Menopause News
Article: Perimenopause News
Article: Stress News