Do you take estrogen or other hormone therapy? Does it come from a traditional drug store or a compounding pharmacy (C-HT)? How are they different? Which one is safer?
These are some of the many questions asked by the North American Menopause Society (NAMS) in an Internet survey of over 150,000 postmenopausal women between 40 and 84 years of age. They wanted to understand how many women might be using C-HT because they are not FDA approved. Hormone therapy (HT) from traditional chain store pharmacies are FDA approved (FDA-HT).
When estrogen usage was at its peak in 2000, a little over 21% of women 50 and over were using some type of hormone therapy. However, after the 2002 publication of the Women’s Health Initiative (WHI) study, their incorrect assertion that HT caused breast cancer, blood clots and heart disease caused millions of women to discontinue using it. For a detailed explanation of how this happened, please check out my new book, The Estrogen Window or visit my online presentation at www.MenopauseBreakthrough.com. Up until 2002, conjugated equine estrogen products such as Premarin and Prempro were the most popular drugs prescribed in the United States.
After the 2002 WHI study reported the risks from taking FDA-HT, millions of women stopped using it and all of a sudden had to cope with all the symptoms of menopause with no comparable alternative treatment. Obviously, this caused a lot of women to suffer. Women were desperately looking for safer alternative hormones and there was a huge rise in the use of C-HT. C-HT are often referred to as bioidentical hormones, which means that their chemical structure is identical to those found in the body. But that isn’t the case; chemical analysis revealed that compounded hormones don’t contain all bioidentical hormones because some of the estrogen structures become altered to other estrogen forms during the manufacturing process. As a result, the FDA considers the word bioidentical to be a marketing term and not a term that has scientific merit.5 It also turns out that both FDA-HT and C-HT can contain bioidentical hormones, so for these reasons, I using the term FDA-HT and CHT to refer to where they are purchased.
In the NAMS survey, about one-third of women didn’t know whether or not their hormones were FDA approved. About 31% of women who have ever used HT have taken C-HT, and about 35% of current users are taking C-HT. Approximately 42% of C-HT users thought their hormone choice was safer than FDA-HT. C-HT users were also more likely to be recommended to use C-HT by a family member, friend, nurse-practitioner, or non-medical source such as a television personality, media figure or internet site. There was a higher rate of vaginal bleeding among users of C-HT than FDA-HT and there were also self-reported cases of uterine cancer among the C-HT users but not among the FDA-HT users. This may be because C-HT progesterone is often prescribed in a topical form even though published evidence shows that topical progesterone is not adequate to protect the uterine lining from uterine cancer. This is very interesting because the most common reason women chose C-HT was that they believed it was natural, which it isn’t, and that it is safer, which is not the case.
This survey is one all women interested in using estrogen should know about since nearly one-third of women who use HT choose C-HT, mostly because they think it is safer. But that’s not to be the case. And here is what you must know if you do use C-HT and you have a uterus: you must have the lining of your uterus checked annually to be sure you do not have uterine cancer.
Dr. Mache Seibel is an international health expert and a leading authority on women’s wellness and menopause. He is editor of My Menopause Magazine in the Apple Newsstand and Google Play and author of The Estrogen Window from Rodale in April 2016. Join him each month to get your most pressing questions answered at www.AskDrSeibel.com.
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