Why are orthodox doctors critical of Bioidentical Hormones?
Unfortunately many mainstream medical doctors refuse to prescribe bioidentical hormones as they are considered unorthodox treatments and instead prefer to continue to prescribe traditional synthetic and horse urine derived hormones despite the evidence. Some so called hormone “experts” even argue that there has not been any research on bioidentical hormones and they have no proven improved safety or efficacay compared to what is already being used. This is most definitely misleading and incorrect information in two ways. Firstly this type of statement assumes that conventional hormones have undergone large trials demonstrating they are safe and effective and that they should be the standard benchmark to which bioidenticals should be compared to when in fact there has never been a large controlled trial of traditional hormone replacement therapies proving their safety. We should not establish a benchmark treatment to which all others should be compared if that benchmark has not been fully proven itself! Secondly there have indeed been a number of clinical studies over the years proving the safety and efficacy of bioidentical hormones and the evidence is continually growing.
Estriol, estradiol, estrone, progesterone and testosterone have all been individually approved for human use by the Therapeutics Goods Administration (TGA) in Australia and have been scheduled on the SUSDP. In addition all these hormones have been approved and listed in both the US and British Pharmacopoiea’s which are considered to be the medical industries bible. In addition hormones such as progesterone cream and DHEA are considered so safe in many other countries around the world that they are classed as a supplement and therefore available over the counter through health food stores and pharmacies while here in Australia they are only available on prescription.
A lot of confusion lies with the fact that in Australia no bioidentical hormone combination has been registered for commercial supply and therefore listed on the ARTG, even though several individual bioidentical hormones have. Single ingredient bioidentical estriol, estradiol and testosterone have all been registered and are commercially available and often prescribed as single ingredient preparations. Many doctors critical of bioidentical hormones are unknowingly prescribing them whenever they prescribe these products and do not even realize they are in fact bioidentical. The real problem occurs when hormone combinations are required because these hormone combinations have not been registered on the commercial ARTG list. Not being listed does not mean they have not been approved for human use and are therefore unsafe. The truth is that being natural hormones pharmaceutical companies legally cannot patent these hormones. If they can not patent these hormones they do not develop these combinations and have them registered with the TGA as they deem them unprofitable. If the pharmaceutical companies do not pay to have these hormone combinations registered then the TGA will not register them. In the end the patient suffers because the companies will not make enough money from it.
In addition there are several so called experts whom are publically outspoken about the erroneous dangers of bioidentical hormones and promote the use of traditional HRT combinations such as conjugated estrogens with medroxyprogesterone which have been used or the last 30 years or so without any large scale trials indicating any significant benefit and continues to be recommended even though recent large observational trials indicate considerable risk. These doctors have strong links and are financed by the pharmaceutical company whom produce these products and thus their motives for presenting much misinformation needs to be questioned?
Finally seminars that many doctor’s attend for their continuing education hosted by a certain organisation includes a poorly designed study which indicated progesterone cream was unable to effectively treat hot flushes, night sweats and other menopausal symptoms in order to teach doctors that bioidentical hormones do not work. This study also found that there was no increase in progesterone serum levels while on the progesterone cream thus teaching the doctors that the creams do not absorb. Two major problems with this study were that firstly menopausal symptoms are the result of low estrogens so why was progesterone used in this study and not a bioidentical estrogen which would normally have been used in a clinical situation? Secondly it has been proven that transdermal progesterone will not appear in serum tests due to limitations with the testing proceedure but does so in saliva tests within an hour after applying the dose. So why were serum tests used and not saliva? Was the test designed to fail from the start or was it innocent ignorance? Unfortunately when doctors are presented with this erroneous information they assume that it is correct and walk away thinking these hormones do not work. If your doctor tells you that you can bathe in progsterone cream and not absorb any of it you will know they have attended one of these seminars!