Suzanne Somers is probably the most well-known voice being heard on the difficulties of menopause and aging and the joys and safety (her perception) of using bio-identical hormones, among other products, to improve quality of life, sexual libido and delay aging. Her prominence on the subject has increased with a best seller on the subject, and with Oprah's endorsing her platform (Oprah started taking bio-identical hormones soon after Suzanne's appearance on her show). Yes, some naysayers or doctors, were also in the audience on the show, however, their on air time was limited. So what are bio-identical hormones and just what is the controversy all about?
In the last couple of years, a large study of thousands of post-menopausal women revealed some troubling information. Though HRT (Hormone Replacement Therapy), now called simply HT (Hormone Therapy), was being used routinely by doctors to not only address menopausal complaints of hot flashes (mild, moderate, severe), but also to prevent heart disease, osteoporosis and other female risk factors associated with menopause and aging. The Nurse's Initiative revealed a significant increased risk of somewhat aggressive breast cancer among the women using hormones, particularly those who used the hormone therapy for significant durations of time. The study results caused a dramatic shift in doctor's use of HT, and even in the philosophical description of the hormone use - it was no longer being assumed that women needed hormone replacement; in certain circumstances, they simply needed some hormones for temporary relief of severe hot flashes. That was the new way doctors were told to dispense HT. Use of HT to prevent heart disease or to prevent or treat osteoporosis was no longer considered safe. And even when HT was used for severe, unrelenting hot flashes, a cut off of 2 years of use was recommended with the understanding that if you could stop using the HT sooner, it was the advisable approach. Mammograms would be considered crucial during use of HT (as well as breast self exam), and if you had a history in your family of breast cancer, you and your doctor would have to weigh the use of HT to relieve those symptoms versus an even higher risk of breast cancer. For moderate to severe vaginal dryness, use of a local hormone based cream is also considered safe when used according to new guidelines.
Traditional HT is made from horse mare's urine; bio-identicals are made from plant based hormones. Let's be clear - both are synthetic. Let's also be clear that the FDA's involvement in regulating traditional hormones, means that studies like the one mentioned above routinely continue (even after medications are approved,) and adverse reaction reporting is also ongoing. In the case of bio-identicals, there is no FDA oversight, there is no double-blind serious study to investigate any issues AND testing for hormone levels and subsequent compounding of the bio-identical hormones is a customized and again, unregulated sector of healthcare. So you are left to a small group of experts and celebrities like Ms. Somers for its "virtuous marketing campaign," while most well- respected, mainstream doctors, medical university researchers and experts express serious concern and a cautionary warning.