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Q: Natural Hormone Replacement vs. Traditional HRT ( Answered 5 out of 5 stars,   3 Comments )
Subject: Natural Hormone Replacement vs. Traditional HRT
Category: Health > Women's Health
Asked by: aane-ga
List Price: $15.00
Posted: 28 Apr 2004 14:33 PDT
Expires: 28 May 2004 14:33 PDT
Question ID: 337862
I want reputable information about natural hormone replacement therapy
instead of traditional HRT (with horse hormones).  ($15.00)
Subject: Re: Natural Hormone Replacement vs. Traditional HRT
Answered By: emjay-ga on 28 Apr 2004 23:49 PDT
Rated:5 out of 5 stars
Hello aane-ga,

Thank you for your question! I?ve sifted through the latest data on
synthetic HRT vs. NHRT, and if I can help to enlighten you even a
little bit, my work here is done. :)

As you mentioned, the widely used traditional HRT, increasingly
labelled simply ?HT,? uses synthetic estrogen, progesterone and
testosterone derived from horses, specifically the urine of pregnant
mares. It can have a number of unpleasant side effects, including
vaginal discharge and bleeding, depression, headaches, gallbladder
disease, nausea, fluid retention, swollen breasts, and more
frighteningly, increased breast and ovarian cancer risk.

It?s no wonder, then, that Natural Hormone Replacement Therapy, or
NHRT, is getting more attention these days. As you may already know,
despite the implications of the word, ?Natural? HRT is not the blend
of herbs and spices the label evokes. The ?natural? in Natural HRT
means that the hormones used in treatment are chemically identical to
those found in the human body. Derived from yams (progesterone) and
soybeans (estrogen and testosterone) rather than animal sources, these
?bio-identical? hormones share exactly the same chemical structure as
human hormones, much like a generic drug is a perfect clone of the
brand name. Synthetic HRT, by contrast, is only chemically *similar*
to human hormones.

Women?s Health America, in ?Let?s end the confusion about HRT,?
explains why this is a problem:

?Because they are not identical, synthetic hormones cannot be counted
on to act in the same way human hormones do. They may or may not
produce the PMS and menopause symptom control women desire. As these
studies show, they may also produce potentially dangerous side effects
such as an increased risk of heart attack, blood clots, stroke, and
breast cancer.?
< >

By contrast, the ?chemical equality? of natural hormones is one of
HRT's biggest attractions. On her ?Natural Hormone Replacement? site,
Jeannah McElroy explains her feelings on the subject (I had to slice
and dice the run-on sentence a bit, but kept the point intact :):

?Even [if] all your symptoms might not be resolved right away, the
fact that you are using a hormone compound that is an exact molecular
match to what your body *made* [makes it] much more effective [with]
less, if any negative side effects because the body doesn't have all
these foreign compounds to try and assimilate, [which], to me, makes
it worth it.?                                < >

Proponents of traditional HRT often argue that its
osteoporosis-fighting properties outweigh its drawbacks. Other
research indicates that conventional HRT may be effective against
Alzheimer?s disease, high cholesterol, colon and endometrial cancers,
and macular degeneration. However, should these claims prove true,
they would be true of all HT, synthetic or natural. This begs the
question ? why pick the one with the side effects? The following, from
?The Risk of Hormone Replacement Therapy? by the Physicians Committee
for Responsible Medicine, discusses the effectiveness of natural
progesterone in protecting against osteoporosis:

?When osteoporosis has developed, a different hormone, called natural
progesterone, has demonstrated the ability to actually encourage new
bone growth. Unlike estrogens, which simply slow bone loss,
progesterone actually increases bone density. It is derived from yams
or soybeans, has no significant side effects, and is sold without a
prescription as a transdermal cream.?
Dr. John R. Lee, author of What Your Doctor May Not Tell You About
Menopause, concurs, while describing further benefits:

?Physicians have been using NHRT to increase bone density up to 14%
per year in osteoporosis patients. Fibrocystic, lumpy and painful
breasts resolve rapidly with a natural progesterone supplementation
regimen. I have a thick file of testimonials from delighted women who
report that they are pain-free for the first time in years. Women on
NHRT are much less likely to suffer from depression, obesity,
hypothyroidism and many other illnesses associated with hormone
imbalance. NHRT also tends to restore libido, usually without
resorting to testosterone supplementation.?
< >

Again, women might find the same menopausal relief in traditional HRT,
but at what risk?

You?ll note that the above examples refer only to natural
progesterone, one of several hormones implicated in hormone therapy;
the others are estrogen, progesterone and DHEA. To begin NHRT, you?ll
need to see a compounding pharmacist.

This brings us to one of the major benefits of NHRT. Traditional HRT
is a one-size-fits-all approach to hormone replacement therapy. With
NHRT, however, the dosage and balance of sex hormones are tailored to
the individual woman. This involves discussing NHRT with your doctor,
and because natural hormones are not readily available from drug
companies, visiting a compounding pharmacy for a custom mix. According
to Women?s Health America, ?Individualization includes testing a
woman?s current hormone levels, determining the specific combination
of hormones she requires, and prescribing at the lowest effective
dosage, thereby minimizing unwanted effects. These prescriptions can
be administered in a variety of forms including tablets, capsules,
patches, and creams.?
< >

It may take a little time to find the ideal dosage for your needs,
according to the Natural Medicine Clinic of Chicago?s Caring Medical.
?It often takes several months to determine the optimum dosages for
NHRT,? their site explains. ?During this time it is possible to
experience some unwanted side effects such as bloating, menstrual
bleeding, and others, but the long term effects are well worth it.?
< >

You may have to educate your doctor a bit when it comes to NHRT ?
because naturally occurring substances can?t be patented, drug
companies don?t have enough financial interest in NHRT to produce
natural hormone products, thus making NHRT a less visible alternative,
even to some health professionals.

When it comes down to it, deciding if and how to pursue hormone
therapy is a deeply personal choice. However, you may be interested in
the fact that aside from the initial adjustment side effects mentioned
above, I found no evidence of side effects from natural hormone
replacement therapy, compared to the many associated with synthetic
hormone therapy. While this isn?t to say there are none, my
preliminary research suggests that there?s much less cause for

Here are some resources you may wish to check out:

The Anti-Aging Institute ? Hormone Replacement Therapy FAQ
< >

Canadian Women?s Health Network Hormone Therapy (HT) FAQ
< >

CBS News/ Dangers of Hormone Replacement?
< >

Eric?s Natural Pharmacy ? Natural Hormone Replacement
< >

HRT ? The right regimen for you
< >

Women?s Health America ? Natural HRT
< >

I used the following search strings to find your answer:

natural hormone replacement therapy
disadvantages nhrt
advantages benefits nhrt

Please let me know if I can be of further assistance!


Request for Answer Clarification by aane-ga on 29 Apr 2004 09:01 PDT
Your answer is perfect and VERY helpful.  Can you go one step further
(I'll be happy to pay more if necessary) and find info about whether
the same dangers/risks apply to NHRT as do to traditional HRT?

Clarification of Answer by emjay-ga on 30 Apr 2004 12:12 PDT
Hello again, aane!

Because NHRT's natural hormones are bio-identical to those produced by
women, they are recognized and easily integrated by the body, making
the risk of side effects minimal. While most experts are reluctant to
say there are absolutely no risks in taking NHRT, the general
consensus seems to be that side effects are unlikely and often related
to large dosage amounts. Lise Cloutier-Steele, in an article
subsection titled "But is NHRT any safer," shares the following:

"In his December 2002 newsletter on nutrition and healing, Dr.
Jonathan V. Wright of Washington says that in the 20 years that he has
prescribed NHRT for his patients, he has always been very careful
about explaining that even natural treatments are not entirely safe.
But he adds that he believes the bio-identical estrogens, progesterone
and testosterone are safer than estrogens made up of horse urine. He
cautions that large quantities of bio-identical estrogens can raise a
woman's risk of blood clots or stroke; however, he explains that these
risks are preventable if a woman adds omega-3 fatty acids (one
tablespoonful of cod liver oil) and vitamin E (400 IU) to her daily
regime. Finally, Dr. Wright says that it's better to be safe than
sorry, and recommends close monitoring by your doctor to make sure
that your natural hormone therapies remain safe and effective."
< >

Catherine P. Rollins, referring specifically to natural progesterone
in "Bioidentical Hormone Replacement Therapy (BHRT) Offers Women
Hope," offers this:

"It is referred to as 'natural' because the end result represents the
same (bio-identical) molecule naturally occurring in the body. It can,
therefore, be introduced into the body with a relative margin of
safety as progesterone replacement therapy with minimal side effects
because the body recognises it."

The Portland Professional Pharmacy is a bit more cautious, speaking of
"reduced" side effects as compared with traditional HRT:

"Clinical experience with nHRT has demonstrated that bio-identical
hormones produce the desired result while reducing some unwanted side
effects such as hot flashes, weight gain, depression and fatigue,
commonly reported side effects of synthetic hormone preparations."
< >

On the other hand, the Anti-Aging Institute, in its HRT FAQ, has no
reservations in bluntly stating that "There are no ill side effects
from the hormones when given to achieve a normal physiological range.
Most symptoms occur from increased or decreased levels of hormones.
Hence the importance of monitoring."
< >

It seems, then, that NHRT is largely safe, and certainly much less
likely to produce side effects than conventional hormone replacement
therapy. A final word of caution: if purchasing non-prescription
hormone creams (eg natural progesterone), always make sure that the
product is standardized.

I used the following searches for this clarification:

Side effects nhrt
Risks nhrt

I hope this has provided some clarification. All the best!

aane-ga rated this answer:5 out of 5 stars and gave an additional tip of: $5.00
This answer was precise, thorough, and articulate.  Very helpful.

Subject: Re: Natural Hormone Replacement vs. Traditional HRT
From: emjay-ga on 29 Apr 2004 11:19 PDT
Hi anne,
Thanks for the kind words and tip - I'll be happy to further my
answer! It will likely be sometime tomorrow as I have a committment
this evening.
Subject: Re: Natural Hormone Replacement vs. Traditional HRT
From: dr_bob-ga on 01 Jun 2004 12:09 PDT

I'm not really a doctor or one of the googlegeniuses. I don't know
much about nothin.  And my advice is free, so just remember: you get
what you pay for.

I would like to add a few comments regarding some vagaries associated
with much of what has been reported in regards to Hormone Replacement

1.) Natural, Bioidentical= Absolute Marketing Drivel.

Hormone Replacement Therapy = Giving a patient a COMBINATION of
hormones(individual compounds!) to effect a particular response.  In
this case to minimize the symptoms(biological response) associated
with a decline in VARIOUS hormones after menopause.  Patients should
expect to fine tune what they're trying to put in their body. 
Everybody is different, and we're talking very small amounts of stuff
here to manage symptoms. Some women need a little more of one than the
other.  It's no big deal, it just takes time, for your body to adjust,
change etc.

2.) Lets take one of these hormones specifically, Estrone.  This is a
single chemical.  It doesn't matter if you get it from horse pee, yams
or soybeans, it's still Estrone and it's the SAME as the estrone you
had plenty of when you were 20.  If you take something like premarin
which is a mixture, it will have some progesterone in it. 
Progesterone is another hormone, that may help your sympoms... what's
the right mixture?  Depends on you. That simple.

3.) HRT is more a matter of what combination of hormones is right for
you, BUT! you should be aware of the risks.  All of these compounds
are activators of various proteins that influence cell development and
growth. All of them!!!! Doesn't matter if you get them from horse pee,
yams or soybeans!

4.) HRT has been shown to increase a woman's probability of getting
cancer.  IT'S A SMALL INCREASE, BUT SIGNIFICANT! You can look up the
exact numbers somewhere.

5.) The cause of this increased probability is UNKNOWN!!!  That is to
say, there is ZERO scientific evidence that says one can manage
symptoms of menopause with herbs, phytoestrogens, natural,
bioidentical,, blah blah blah, without increasing one's risk of

6.) Phytoestrogens are compounds that also activate the same
regulatory proteins in cells as estrogens even though they have
different structures.  It is simply not known if the activation of
these proteins is the cause of increase probability of getting cancer
or if it is the increase in hormones(after menopause) themselves!

7.) Osteoporosis, Hot Flashes, and other symptoms are very real. 
People are working hard to find things that will help people manage
these symptoms and not increase risks of things like cancer.  Natural
isn't always better. If it was we'd all be going to work in horse and
buggy and dying of tuberculosis. Unlike the quacks and herbal geniuses
out there, the FDA requires that doctors PROVE things scientifically.

With that said, I suggest you look up a reputable doctor who isn't
just going to prescribe you a bunch of junk to get you out of his/her
office.  Try things like black cohosh if you've commited yourself to
this path and manage your symptoms, but be aware of the risks I stated
above and look at the real numbers(we're talking like 3 out of 1000,
vs 7 out of 1000 or something like that).  Read about things like
Evista, and the STAR trial.  You'll learn oodles.

Subject: Re: Natural Hormone Replacement vs. Traditional HRT
From: grandmam-ga on 07 Aug 2004 11:48 PDT
I was using NRT in the form of transdermal creams. After 6 months or
so it seemed that it was no longer being absorbed. (lots of hot
flashes)  I switched to NHRT in capsule form and the hot flashes
disappeared.  But now I'm worried about the first liver pass problem
with taking hormones orally. Do any readers know anything about the
skin possibly becoming saturated, reducing transdermal absorption?

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