Do compounded bioidentical hormones for menopause carry the same risks as conventional hormone replacement drugs, such as Premarin?
Plant-Based Bioidentical Hormones
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
As Martha Rosenberg noted (the author of an excellent book, Born with a Junk Food Deficiency), just as this lithograph tells you everything you need to know about slavery, the fact that electroconvulsive therapy (electroshock treatments) were prescribed for menopause in the United States tells you everything you need to know about Western medicine’s view about aging women.
Here, in this 1946 medical journal ad, amphetamines (speed) was recommended, in conjunction “with such fundamental measures as electric shock and estrogenic therapy.” Doctors could throw in a little thorazine, too, while they’re at it.
Hormone replacement therapy grew to prominence in the 1990s, when millions of women were sold hormones from pregnant mare urine, on the promise that it would prevent age-related diseases. But instead, it may have caused them. Women on hormone replacement therapy suffered increased risk of heart disease, stroke, pulmonary embolism, and invasive breast cancer. They said it would help preserve women’s memory—but may have, in fact, caused dementia, as it shrinks women’s brains.
When the truth got out in 2002, and the number of prescriptions dropped, so did the rates of breast cancer. And, horses got to walk around once again.
Thanks to high-profile celebrity endorsements, though, interest then switched to so-called compounded bioidentical hormones—from plant rather than equine sources, and advertised as not carrying the same risks.
What does the science say? A bunch of new reviews on the subject out from the American College of OB/GYNs, the Mayo Clinic, to the editors-in-chief of the Journal of the International Menopause Society. All concluded that bioidentical hormones, being bioidentical, carried the same risks, benefits, and side effects—which is not a good thing.
And, even worse, when the FDA actually analyzed them to see if the contents matched the label, nearly a third failed the analysis. Even in the same bottle, doses could be all over the place.
Okay, all universally opposed, but, look, how do we know everyone isn’t just in the pocket of the pharmaceutical industry—you know, just doesn’t want the competition?
Well, whenever I’m skeptical, I turn to The Medical Letter on Drugs and Therapeutics, considered to be one of the least-biased sources in medicine. They’re kind of like the Consumer Reports of the drug world, and, in fact, was actually co-founded by the co-founder of the publisher of Consumer Reports, more than 50 years ago.
As they like to brag on their website, The Medical Letter does not accept grants— from any source; donations—from any one; funding—from any entity. They won’t let their work be used for promotional purposes, and they don’t accept any advertising.
They recently reviewed bioidentical hormones, and came to the same conclusion: “There is no acceptable evidence that ‘bioidentical’ hormones are safe or effective. Patients should be discouraged from taking them.”
Please consider volunteering to help out on the site.
- Martha Rosenberg. Born with a junk food deficiency: how flaks, quacks, and hacks pimp the public health. Amherst, N.Y.: Prometheus Books, 2012.
- Panay N, Fenton A. Bioidentical hormones: what is all the hype about? Climacteric. 2010 Feb;13(1):1-3.
- Bioidentical hormones. Med Lett Drugs Ther. 2010 May 31;52(1339):43-4.
- Files JA, Ko MG, Pruthi S. Bioidentical hormone therapy. Mayo Clin Proc. 2011 Jul;86(7):673-80, quiz 680.
- American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and American Society for Reproductive Medicine Practice Committee. Compounded bioidentical menopausal hormone therapy.
- Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J; Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-33.
- Shumaker SA, Legault C, Kuller L, Rapp SR, Thal L, Lane DS, Fillit H, Stefanick ML, Hendrix SL, Lewis CE, Masaki K, Coker LH; Women's Health Initiative Memory Study. Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative Memory Study. JAMA. 2004 Jun 23;291(24):2947-58.
- Espeland MA, Tindle HA, Bushnell CA, Jaramillo SA, Kuller LH, Margolis KL, Mysiw WJ, Maldjian JA, Melhem ER, Resnick SM; Women's Health Initiative Memory Study. Brain volumes, cognitive impairment, and conjugated equine estrogens. J Gerontol A Biol Sci Med Sci. 2009 Dec;64(12):1243-50.
- Omar R, Sampson EL, Loy CT, Mummery CJ, Fox NC, Rossor MN, Warren JD. Delusions in frontotemporal lobar degeneration. J Neurol. 2009 Apr;256(4):600-7.
- Clarke CA, Glaser SL. Declines in breast cancer after the WHI: apparent impact of hormone therapy. Cancer Causes Control. 2007 Oct;18(8):847-52.
- U.S. Food and Drug Administration. 2006. Limited FDA Survey of Compounded Drug Products.
Images thanks to Dan & Corina Lecca; Lameer Witter; mtholyoke.edu; Bonkers Institute for Nearly Genuine Research; Quadell via Wikimedia Commons; and Marji Beach of Duchess Horse Sanctuary via flickr.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
As Martha Rosenberg noted (the author of an excellent book, Born with a Junk Food Deficiency), just as this lithograph tells you everything you need to know about slavery, the fact that electroconvulsive therapy (electroshock treatments) were prescribed for menopause in the United States tells you everything you need to know about Western medicine’s view about aging women.
Here, in this 1946 medical journal ad, amphetamines (speed) was recommended, in conjunction “with such fundamental measures as electric shock and estrogenic therapy.” Doctors could throw in a little thorazine, too, while they’re at it.
Hormone replacement therapy grew to prominence in the 1990s, when millions of women were sold hormones from pregnant mare urine, on the promise that it would prevent age-related diseases. But instead, it may have caused them. Women on hormone replacement therapy suffered increased risk of heart disease, stroke, pulmonary embolism, and invasive breast cancer. They said it would help preserve women’s memory—but may have, in fact, caused dementia, as it shrinks women’s brains.
When the truth got out in 2002, and the number of prescriptions dropped, so did the rates of breast cancer. And, horses got to walk around once again.
Thanks to high-profile celebrity endorsements, though, interest then switched to so-called compounded bioidentical hormones—from plant rather than equine sources, and advertised as not carrying the same risks.
What does the science say? A bunch of new reviews on the subject out from the American College of OB/GYNs, the Mayo Clinic, to the editors-in-chief of the Journal of the International Menopause Society. All concluded that bioidentical hormones, being bioidentical, carried the same risks, benefits, and side effects—which is not a good thing.
And, even worse, when the FDA actually analyzed them to see if the contents matched the label, nearly a third failed the analysis. Even in the same bottle, doses could be all over the place.
Okay, all universally opposed, but, look, how do we know everyone isn’t just in the pocket of the pharmaceutical industry—you know, just doesn’t want the competition?
Well, whenever I’m skeptical, I turn to The Medical Letter on Drugs and Therapeutics, considered to be one of the least-biased sources in medicine. They’re kind of like the Consumer Reports of the drug world, and, in fact, was actually co-founded by the co-founder of the publisher of Consumer Reports, more than 50 years ago.
As they like to brag on their website, The Medical Letter does not accept grants— from any source; donations—from any one; funding—from any entity. They won’t let their work be used for promotional purposes, and they don’t accept any advertising.
They recently reviewed bioidentical hormones, and came to the same conclusion: “There is no acceptable evidence that ‘bioidentical’ hormones are safe or effective. Patients should be discouraged from taking them.”
Please consider volunteering to help out on the site.
- Martha Rosenberg. Born with a junk food deficiency: how flaks, quacks, and hacks pimp the public health. Amherst, N.Y.: Prometheus Books, 2012.
- Panay N, Fenton A. Bioidentical hormones: what is all the hype about? Climacteric. 2010 Feb;13(1):1-3.
- Bioidentical hormones. Med Lett Drugs Ther. 2010 May 31;52(1339):43-4.
- Files JA, Ko MG, Pruthi S. Bioidentical hormone therapy. Mayo Clin Proc. 2011 Jul;86(7):673-80, quiz 680.
- American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and American Society for Reproductive Medicine Practice Committee. Compounded bioidentical menopausal hormone therapy.
- Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J; Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-33.
- Shumaker SA, Legault C, Kuller L, Rapp SR, Thal L, Lane DS, Fillit H, Stefanick ML, Hendrix SL, Lewis CE, Masaki K, Coker LH; Women's Health Initiative Memory Study. Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative Memory Study. JAMA. 2004 Jun 23;291(24):2947-58.
- Espeland MA, Tindle HA, Bushnell CA, Jaramillo SA, Kuller LH, Margolis KL, Mysiw WJ, Maldjian JA, Melhem ER, Resnick SM; Women's Health Initiative Memory Study. Brain volumes, cognitive impairment, and conjugated equine estrogens. J Gerontol A Biol Sci Med Sci. 2009 Dec;64(12):1243-50.
- Omar R, Sampson EL, Loy CT, Mummery CJ, Fox NC, Rossor MN, Warren JD. Delusions in frontotemporal lobar degeneration. J Neurol. 2009 Apr;256(4):600-7.
- Clarke CA, Glaser SL. Declines in breast cancer after the WHI: apparent impact of hormone therapy. Cancer Causes Control. 2007 Oct;18(8):847-52.
- U.S. Food and Drug Administration. 2006. Limited FDA Survey of Compounded Drug Products.
Images thanks to Dan & Corina Lecca; Lameer Witter; mtholyoke.edu; Bonkers Institute for Nearly Genuine Research; Quadell via Wikimedia Commons; and Marji Beach of Duchess Horse Sanctuary via flickr.
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Plant-Based Bioidentical Hormones
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URLNota del Doctor
Another way to rid ourselves of excess estrogen is in the way nature intended: Relieving Yourself of Excess Estrogen. We can also stop consuming steroid hormones Acne & Cancer Connection. For other ways to decrease breast cancer risk, see The Answer to the Pritikin Puzzle; Breast Cancer Survival and Soy; and Broccoli Versus Breast Cancer Stem Cells. And check out my new 2018 video Soy Phytoestrogens for Menopause Hot Flashes.
For more context, check out my associated blog posts: Stool Size and Breast Cancer Risk; Mushrooms for Breast Cancer Prevention; Treating Breast Pain with Diet; and Are Bioidentical Hormones Safe?
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