HORMONE THERAPY: LEAVES A BAD  TASTE IN YOUR PHYSICIAN MOUTH 

By Dr. Mark James Bartiss-Revised 11-13-07

Ever since early 2002 after the initial results of the Women’s Health Initiative (WHI) study were released, fear has been instilled in the hearts and minds of nearly everyone taking or prescribing synthetic hormone therapy (estrogen/progestin).  This misinterpreted and controversial bit of information obtained from the WHI study has lead to a significant change in the way most patients and practitioners now feel about the safety and efficacy (value) of hormone replacement therapy.  It was also the stimulus for me writing an article in mid 2002 with the above title that ultimately  received National attention and publication (albeit probably more for its title than its content).  

The WHI trial is the largest study ever done in America and it was stopped short after concluding that the results obtained from a subset of women receiving HRT (Non Bio-Identical forms) were actually worse off in terms of disease prevention/risk than if they were not to take HRT at all.  This was in direct opposition to the opinions of many experts in the field that held the firm belief that HRT using synthetic estrogen from horse urine and a non bio-identical progesterone (a progestin) would  decrease the risk of; Breast Cancer, Colon Cancer, Heart Attack, Stroke, Alzheimer’s and possibly Parkinson’s Disease, and Osteoporosis. 

Literally overnight, there was an immediate impact on the medical community as well as patient compliance and concern regarding the continued use of these “safe” products that were being used to prevent and in some cases combat the above conditions not cause them.  To this day, fear continues in the eyes of  Big Pharma (pharmaceutical companies) especially Wyeth, since their  # 1 selling drug in America, Premarin has lost over 30% of its market share to a tune of a nearly 700 million dollars lost in yearly revenue and this figure is increasing.  This company-who previously would bash the use of Bio-Identical Hormones---even though they manufactured and sold them outside of the U.S. is now pushing the FDA on banning the manufacture of BHRT by compounding pharmacies stating that the little pharmacies should not be allowed compound Bio-Identical Hormones as they do not have the same standard of quality assurance as do the big pharmaceutical companies  This was certainly a change of heart situation in that when Premarin and Prempro were yielding hundreds of millions in profits, they could care less about what the small guys were doing.

But, after public release of the results of the WHI, Wyeth representatives-including physician “experts” were bought by Wyeth and went on public- make that national television to refute the benefits and safety profile of BHRT over the synthetic horse estrogen (HRT) stating that there is no difference between the two and that if BHRT was indeed safer and better that they would be producing it themselves.  Well guess what?  They were and still are!  In fact, Wyeth is the number one producer of various forms of BHRT to other countries just not the U.S.  How could this be so I ask myself (yeah right).  Okay so why now does Wyeth show concern about the safety of production of BHRT?  Could it be because THEY WANT TO GET IN ON THE BAN WAGON  since they realize that more and more women and medical providers are now aware that BHRT is the better way to go?  Who  are they kidding?  Where were they when the results of the WHI study came out??  They were in strategic meetings trying to save their sorry ass from losing billions of dollars without a concern for your health at all.

Why did we ever use the synthetic form of HRT over BHRT in the first place?

 The FDA does not allow anything to be patented that occurs in its natural state such as our own chemical makeup.  This is why the pharmaceutical companies alter these compounds a bit so that they  are similar but not exact to those found within our tissues, organs and blood stream.  It is the principle that although these compounds are similar in structure to our native hormones, they are not exactly the same.  Physiologically, once in the body they become active like our natural hormones but at more of a cost than the price of a prescription.  The results?.. Poorer performance and toxic build up not unlike when filling a tank in a high performance race car with regular gas as opposed to high octane fuels.  Sure the car will run but it won’t win the race and damage will be done to the engine long before its time. 

 For years women have been on the back burner when it comes to their healthcare.  Today that is changing, in part because women are finally becoming less selfless and are taking care of themselves and in part because of the power of advertising.  The market for anti-aging products, plastic surgery and other aesthetic procedures have flooded the homes of the baby boomers and continues to do so.  I only hope that with continued awareness and the demand for better healthcare, other “alternative” therapies will become more mainstream and available.

 The current practices of prescribing these now determined and labeled “use with caution” drugs (I am referring to synthetic estrogen, progesterone and testosterone products that are not biologically identical to our native hormonal milieu) had been common practice among nearly all physicians who dealt with women’s health issues since the late 1960’s.  Unfortunately at that time and up until and including today, most physicians would and do prescribe these medications without prior testing of hormone levels prior to or during therapy.  Equally negligent was (is) the trend to give all women the same dose regardless of other factors.  Admittedly, I too was a staunch promoter and provider of synthetic hormone replacement therapy for years and to this day feel guilty over the lack of insight I had regarding female health and preventive medical services.  Reluctantly I must push this aside (for now) and proceed with the mater at hand and which is how do BHRT and HRT differ?

 It boils down to this, safety and efficacy. What makes Bio-Identical compounded hormones so different than the cancer producing, heart attack causing, decreased longevity and poorly tolerated “synthetic” hormones?  The answer lies in the word bio-identical.  These bio-identical hormones are the exact same molecule that is produced within the body- in other words- they are our own native hormones.  This in turn means that the body will recognize it as being natural, innate or same and will utilize and metabolize it as such thus the better efficiency and safety reported with these agents. 

 I could go on and on but I would loose the attention of too many of you and this is a topic that must be addressed and understood by everyone.  REMEMBER: By not being an informed consumer You are throwing away your most prized possession- LIFE. 

 The Bottom Line: 

There are approximately 9 million women still taking some form of Premarin. Educating those 9 million women (and their doctors) as to how Premarin is actually produced as well as the linked health risks involved in taking these drugs and having them use and prescribe one of the many available forms of bio-identical hormones as a substitute for those unnatural synthetically derived hormones, is the first step in reversing the damage done and bringing light to patient and physician options.  Only by standing up as a unified majority will our demands for better medical care and options be heard and acted upon by today’s government.