Bioidentical Hormone Replacement Therapy, or BHRT, is a natural hormone replacement therapy for treating pre- to post-menopausal symptoms that is gaining popularity. Unlike traditional hormone replacement therapies that use synthetic hormones, BHRT’s hormones are derived from soybeans and wild yams and are identical in structure and in function to the hormones that our bodies produce naturally

“Everybody’s kind of getting in on this now,” said Nancy Boyden, a nurse practitioner with Olympic Surgical Associates in Port Orchard.

BHRT has been around since the 1930s, according to Boyden, but the original methods used to deliver the hormones were painful, part of the reason BHRT never gained wider acceptance.

“The original method of delivery was a progesterone injection in a peanut oil base,” said Boyden. “Oil-based injections are very uncomfortable.”

Synthetic, oral equine-based estrogen therapies, which come from pregnant mare urine and are the basis for traditional HRT, really took off around the time of Marilyn Monroe. Pharmaceutical companies focused their marketing efforts on the synthetic hormones. Significant dollars were spent enticing women with promises of eternal youth and frightening them with images of turning into a dried-up old hag.

“Women felt that menopause was a disease, rather than something natural you go through in your life,” said Boyden.

Boyden suggested that pharmaceutical companies also focused on synthetic hormones because they could patent their formulas. BHRT hormones, conversely, cannot be patented.

“Obviously you can’t patent a wild yam,” said Boyden. “By and large, pharmaceutical companies don’t research things that can’t be patented.”

BHRT offers a number of benefits over traditional HRT, Boyden believes. Aside from the significant health risks some forms of HRT pose, such as an increased risk of stroke, endometrial cancer, and colorectal cancer, she asserted that the synthetic hormones often don’t treat all the negative symptoms associated with menopause, such as depression, and in some cases can even cause these problems. As a result, women on HRT often end up taking additional medications to treat corollary problems.

“Women are layered with different types of medicines, like anti-depressants,” said Boyden.

Because BHRT uses hormones that are organically identical to our own hormones, side effects are minimal. Our bodies recognize the hormones and can synthesize them more completely. Women who use BHRT can also choose from a number of delivery methods, including creams, drops, and even vaginal suppositories. These delivery methods more effectively mimic the way the human body delivers hormones over a period of time, and reduce stress on the liver. Pill-based HRTs must be broken down in the liver, which can cause problems.

Traditional HRT has come under fire recently as a result of high-profile studies that have shown increased instances of serious health risks. Boyden is quick to point out that a woman using traditional HRT will not automatically get sick.

“It’s not that it will cause cancer in everybody, because it doesn’t,” said Boyden. But she maintained that the risks are there and if there is a safer alternative, it makes sense to take advantage of it.

Getting started on BHRT requires a comprehensive medical examination and a prescription to a compounding pharmacy. The examination will involve lab work, such as a blood draw or a saliva test, to determine what type of hormones in what dose each woman needs. The compounding pharmacy can then mix the correct dosage into a delivery form that works best for the individual.

There are kits available for women to use to test themselves, but self-test results will have to be evaluated by a doctor before a prescription can be written. And while there are over-the-counter BHRT formulations available, Boyden doesn’t recommend them.

“There is a perception that because it’s made from plants you don’t need medical follow-up,” said Boyden. “But you shouldn’t be dosing yourself. With over the counter treatments you don’t really know what’s in it, or who made it.”

In addition, over-the-counter formulations will always contain a smaller dose of hormones, and so may not be effective. A better route is to see your doctor or nurse practitioner, then choose a compounding pharmacy that is a member of the Professional Compounding Centers of America. This organization maintains strict guidelines for producing medicines, including BHRT, and so you will be assured of getting a high-quality product.

Locally, a few doctors and health care clinics offer BHRT, including Olympic Surgical Associates. If you are interested in pursuing BHRT, Boyden recommended talking to your doctor or nurse practitioner, about it.

“You don’t learn about it in medical school,” said Boyden, “I didn’t learn about it in school, either. But doctors want their patients to be safe. The more women say ‘I really like this approach,’ the more doctors will learn about it.”.