What are the benefits of bio-identical hormone replacement therapy (BHRT)? Is BHRT safe?

BHRT, bio-identical hormone replacement therapy, Guelph, ON, naturopathic doctor

Whether it be because of the world that we live in, the food that we eat, the lifestyles that we choose or simply because of our advancing age, one thing is for sure, hormonal deficiencies and imbalances are on the rise.

Estrogen, progesterone and testosterone naturally decrease over our lifetime.  It is a natural process of aging.  Women feel this hormonal decline especially as they approach peri-menopause and enter menopause.

Although this is a natural process, the decreasing levels of hormones, especially estrogen and progesterone, can have life altering side effects.

Low estrogen in women can lead to:

        - Decreased collagen in the skin

        - Decreased libido

        - Hot flashes

        - Vaginal dryness

        - Fatigue

        - Muscle weakness

        - Insomnia

        - Poor memory

        - Depression or mood changes

        - Foggy thinking

        - Cardiovascular Disease

        - Osteoporosis

        - Food cravings

        - Weight gain

Low progesterone in women can lead to:

        - Irregular menses

        - Menorrhagia (heavy menses)

        - PMS

        - Vaginal dryness

        - Decreased libido

        - Breast tenderness

        - Fibrocystic breasts

        - Thyroid dysfunction

        - Anxiety

        - Depression

        - Fatigue

       - Hypoglycemia

        - Weight gain

        - Headaches/migraines

        - Infertility or sub-fertility

        - Recurrent miscarriage


What is BHRT?

Bio-identical hormones are derived from natural soy or yam components.  These plant components are extracted and made in a laboratory to be identical to the hormones made in the human body.

A compounding pharmacist is able to make a tailored hormone prescription for individual patients.  The proper dose is determined by your Naturopathic Doctor through symptom tracking and lab testing.

The delivery systems of choice are usually topical creams or vaginal suppositories.  No pills required!

Proper estrogen and progesterone ratios can be restored with the use of BHRT.


Who needs BHRT?

Pre-menopause: these women are still cycling regularly but may have some hormonal imbalances.  These imbalances may manifest as symptoms like PMS, migraines, anxiety, miscarriage, infertility/trouble conceiving.

Peri-menopause:  these women will start to see changes in their menstrual cycles.  The average woman enters peri-menopause at the age of 45.  Symptoms during this phase may include: hot flashes, weight gain, low libido, poor memory, poor concentration, insomnia, hair loss and heart palpitations.

Menopause:  these women have not had a menstrual cycle for an entire year.  The absence of a period is due to the consistent decrease in hormones over time.  These hormones are deficient and therefore are unable to stimulate a menstrual cycle.  Symptoms of menopause include: hot flashes, weight gain, low libido, vaginal dryness, poor memory, poor concentration, insomnia, hair loss, heart palpitations, dry skin, mood changes, depression, decreased collagen, poor immune function and bone loss/osteoporosis.

Recurrent miscarriage:  women who have suffered the loss of multiple pregnancies may have a progesterone deficiency.  Progesterone is the hormone responsible for “holding”/maintaining the pregnancy.  If you have suffered a miscarriage, it may be wise to ask your Naturopathic Doctor to test your progesterone levels.

PCOS:  women with polycystic ovarian syndrome often suffer from androgen excess and progesterone deficiency.  These women experience irregular menstrual cycles, absent menstrual cycles, acne, depression/mood changes, weight gain, excess male pattern hair growth, hair loss of the scalp and infertility or difficulty conceiving.  Consult your Naturopathic Doctor if you are suffering from one or more of these symptoms.

General Deficiencies:  hormone deficiencies, especially progesterone deficiencies, are very common amongst women today.  The most common reason for the deficiency is chronic stress.  Progesterone and cortisol (the “stress hormone”) are both derived from pregnenolone.  When stressed, pregnenolone is converted into cortisol.  This is called a “cortisol or pregnenolone steal” leading to deficient progesterone and often times, relative estrogen dominance.

pregnenolone steal.jpg


How will my Naturopathic Doctor know if I need BHRT?

A Naturopathic Doctor will assess your hormone levels by completing a thorough intake, assessing your symptoms and ordering a dried urine test for comprehensive hormones (DUTCH) or blood tests.


Is it safe?

The Endocrine Society has defined bio-identical hormones as “compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body.”

Physiological data and clinical outcomes demonstrate that bio-identical hormones are associated with lower health risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bio-identical hormones remain the preferred method of hormone replacement therapy.

Custom compounded bio-identical hormone formulations provide practitioners the option to prescribe hormones for women who cannot tolerate synthetic products or the non-hormonal ingredients/additives contained in them. Your Naturopathic Doctors will discuss risks and benefits of the proposed therapy.

While rare, you may experience a variety of side effects while using BHRT, including but not limited to:

        - Headaches

        - Irritability

        - Mood swings

        - Increased acne

        - Insomnia

        - Breast tenderness

        - Irritation, itching at the application site

Usually these effects are simply due to inappropriate dosing.  Let your Naturopathic Doctor know if you experience any of these effects and they will determine if your bio-identical hormone dose may need to be increased or decreased.


How do I start BHRT?

Start by setting up an appointment with one of our Naturopathic Doctors!  During your appointment, ask your Naturopathic Doctor if BHRT is right for you.



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- The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy?.  https://www.ncbi.nlm.nih.gov/pubmed/19179815.  14 January 2018.

- A comprehensive review of the safety and efficacy of bioidentical hormones for the management of menopause and related health risks.  https://www.ncbi.nlm.nih.gov/pubmed/17217322.  14 January 2018.

- Bioidentical Hormone Therapy.  Mayo Clinic Proceedings.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127562/ 

- Image:  https://gutdetective.com.au/condition-resources/hormones/5-major-causes-...




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