Bioidentical Hormone Replacement Therapy

Dr. Sima Aidun is a Naturopathic Doctor, focusing on women's health issues from puberty to menopause. Her office is in Scottsdale Arizona and she serves East valley cities of Gilbert, Chandler, Tempe, Scottsdale, Apache Junction, Queen Creek, and the greater Phoenix area.

Bioidentical, just one among many! With so many treatment modalities to choose from, one of the challenges facing perimenopause and menopausal women as well as their healthcare practitioner, is determining what approach to take regarding various treatments, especially hormone replacement therapy (HRT).

There are many options, ranging from no intervention at all to conventional, non-bioidentical HRT. Approaches which lie somewhere in between involve the use of herbal and nutritional supplementation or the use of hormone replacement regimens that are friendlier more gentle than those typically prescribed. While conventional HRT provides certain benefits, it is not without significant risks. This is where bioidentical HRT comes into play.

Bio-identical, natural hormones are made from plants: Estrogen from soy and progesterone from wild yam.
They are identical in their chemical structure to the hormones produced by the human body. Bioidentical hormones are the closest in chemical structure, actions, and interactions to those hormones produced by humans.

The Effects of Bioidentical HRT on The Body

Because bioidentical hormones are identical in structure to our own body's sex hormones, their actions are relatively gentle and effective. Bioidentical natural hormones attach themselves to the human cell binding sites, which are areas on the cell surface that specifically recognize substances cells need to use in order to maintain their healthy function. Estrogen and progesterone receptors recognize bioidentical hormones (taken as prescription) the same way that they recognize hormones produced naturally by our own human bodies.

Symptoms of hormonal imbalances occur as we get older due to deficiencies or lack of main female hormones in our body after menopause: estrogen and progesterone. These deficiencies require replacement in order for the imbalance to be righted and symptoms to be resolved. In our body, natural hormones act directly to target the root cause of hormone deficiency symptoms. Since they are made from plants and are identical to our body's natural hormones produced by the ovaries, they don't compete with human hormones in areas benefiting from them such as bone, brain, skin, and hair. They supplement the action of human hormones, but don't displace or replace our own from action sites (receptors) because they are recognized by the body as familiar substances. When administered in a medically supervised manner, bio-identical hormones can effectively treat the root cause of hormonal imbalances, deficiencies, and their attendant symptoms. On the other hand, natural bioidentical hormones do compete with hormones produced by the ovaries in areas such as breast and uterus. By displacing and competing with ovarian estrogen that has a strong stimulatory effect on breast and uterine tissue, bioidentical natural hormones exert a weaker effect on those two tissues.

Bioidentical HRT can help perimenopausal and menopausal women with the relief of:

• HOT FLASHES
• LACK OF LIBIDO
• VAGINAL DRYNESS
• FATIGUE
• LACK OF SENSE OF WELL BEING
• PROBLEM SLEEPING
• BONE LOSS
• URINARY INCONTINENCE

Bioidentical HRT Treatment

As previously mentioned, today there are more therapeutic options available to menopausal patients than ever before. At the same time, some experts have estimated that only small proportion (approximately 17%) of U.S. women for whom HRT is appropriate are actually taking with even lower rates among women of color and of lower socioeconomic status. This maybe partially blamed on the atmosphere of consumer mistrust of the pharmaceutical industry and the associated fears related to breast cancer. Conflicting data in the literature, the inability to ensure that cancer will not result as well as the potential for future litigation also predispose many doctors to avoid prescribing HRT. The healthcare practitioner's role must be to provide assistance to the patients in making a positive health-promoting as opposed to a fear-based decision when it comes to HRT whether it be for relief of symptoms or to address long term risk of disease risk.

In recent years, as more data has become available on the topic of bioidentical HRT, there has been a corresponding increase in public demand for "natural" management of menopause. While the bioidentical route is certainly a better choice for most, it is still important for a patient to know what to expect starting with that initial visit when asking the doctor for Bio-identical HRT?

First visit:

• Complete health history: looking for symptoms, risk factors for chronic diseases such as osteoporosis, breast cancer, cardiovascular disease, and thyroid function. As well as finding any contraindications to hormone replacement therapy.
• Pertinent physical examination
• Baseline blood-work including, not limited to lipid test, baseline hormonal evaluation, thyroid function, liver function, and cell blood count.
• Mammogram and DEXA (bone density), if the most recent tests were done more than a year ago
• Recent Pap Smear: less than a year. Same day Pap Smear Only can be done for $65.00 extra. Complete Well Women exam will be scheduled during Separate time($150.00).