Bioidentical Hormone Replacement Therapy, or BHT, is an alternative therapy that is becoming increasingly popular in the western world as an alternative to conventional HRT. This therapy is actually not all that well defined, but the general idea is that the hormones used in the treatments are identical to the ones that are endogenous in the body. The levels of hormones that the patient as are tested throughout the treatment using either saliva or blood tests, and the treatment also uses pharmacy compounding.
- Which Hormones Are Used in BHRT
There are several different hormones that can be used in BHRT, although the exact hormones offered depend on the country you live in. Bioidentical Hormone Replacement Therapy is offered in Canada, the USA and Europe, for example, but estriol is available only in Europe and has not been approved by regulators in the USA or Canada. Dehydroepiandrosterone and testosterone are available in most places, but are limited in terms of what they will be prescribed for in the USA and Canada. Oher hormones, such as progesterone, estrone, and estradiol are far more widely available.
- Is Bioidentical Hormone Replacement Therapy Safe?
The idea of custom-compounded BHRT is something that is generally limited to the USA. It is considered to be an alternative treatment, and there are some concerns about its efficacy, if not its safety.
BHRT is marketed as being a panacea for a lot of different conditions, instead of something that will relieve the symptoms of them. Traditional hormone replacement therapy is thought to help reduce the symptoms of things like going through the menopause, while also cutting the risk of osteoporosis. The idea that BHRT could do more than that is something that needs far more research. The evidence that is available today suggests that the risks and benefits that are associated with BHRT are actually more in line with the risks and benefits of existing drugs that have been approved by the regulators in different parts of the world.
One BHRT drug where this is not the case is progesterone – there is indeed some evidence to suggest that BHRT for progesterone could actually be safer than the equivalent traditional treatment.
However, it is important to note that the International Menopause Society, the Endocrine Society, Mayo Clinic and many other groups have expressed some concern that bioidentical hormones have not been studied extensively enough for claims to be made about the benefits or risks of using them. The non-bioidentical versions of the hormones are already known to be safe for the most part, and the risks of them have been well documented.
There is no current requirement for bioidentical hormones to have a pack insert detailing their risks, and this is something that a lot of medical professionals would like to see changed – because this means that patients are being encouraged to take the hormones without any awareness of the fact that they could have potentially life-threatening side effects in some (albeit very rare) cases.
Many doctors are advising patients that the risks associated with BHRT should be considered to be the same as the risks associated with more standard treatments. If a patient works on this assumption then they are more likely to remain safe and healthy, and will be aware of when to seek advice if they feel that they are experiencing unexpected or potentially dangerous side-effects. Treating BHRT like a risk-free option is a bad idea for most people, and could put the lives of many women at risk for no good reason given the alternatives available.