The Safety of Bio-Identical Hormones

by Jeffrey Dach MD
Are Women’s Bio-identical hormones safe? Bio-identical hormones exist naturally in the human body, so it is axiomatic that these are safe.  However, we are interested in a slightly different question. What is the safety of bio-identical hormones as routinely used in medical practice?  Let’s try to answer this question.

The Safety of Water compared to Bio-Identical Hormones

Water is safe, beneficial and required for health.  Yet, even so, drinking excess amounts of water causes death from Fatal Water Intoxication.(1)

Left Image: Water with Droplets Courtesy of Wikimedia

Similarly, just like water, bio-identical hormones are safe and beneficial when used at proper dosages.  Like excessive water, excessive hormone dosage may result in their own adverse side effects.  Excess estrogen, for example, causes fluid retention, breast sensitivity and enlargement, and  disordered mood.

Humans Have Bio-Identical Hormones.

Another answer to the safety question is that bio-identical hormones are found in the human body naturally.  Any harmful substance in the human body would impair survival, and over millions of years of evolution would be eliminated by natural selection.  This is the basic concept of Darwinian evolution which is accepted by mainstream medical science.

A 50 Million Year Medical Experiment

Consider the following medical experiment, performed over the last 50 million years with the help of our friend, Darwinian evolution.(2)  Bio-Identical Hormones have been present in the human body for 50 million years, and we humans are still here on the planet.  I would consider that a successful medical experiment, wouldn’t you?

Either Excess or Deficiency of Anything Can be Harmful

One of our routine labs tests called the Chem Panel measures electrolytes and glucose levels in the blood. The body automatically maintains these within narrow ranges to maintain health.  If levels deviate above or below these normal ranges, this causes a serious health disturbance.  For example elevated potassium levels causes cardiac arrest.  Magnesium deficiency causes muscle spasm and arrythmia. Excessive amounts of Vitamins A and D are toxic.  Hormones levels enjoy a considerably wide range of acceptable limits.  Even so, a deficiency or an excess of women’s bio-identical hormones can produce adverse symptoms.  This is called estrogen deficiency/excess, and progesterone deficiency/excess, and they each have typical signs and symptoms easily recognized.(3)

Common Signs of Estrogen Deficiency (4)

Mental fogginess
Forgetfulness
Depression
Minor anxiety
Mood change
Difficulty falling asleep
Hot flashes
Night sweats
Temperature swings
Day-long fatigue
Reduced stamina
Decreased sense of sexuality
Lessened self-image and attention to appearance
Dry eyes, skin, and vagina
Loss of skin radiance
Feel balanced 2nd part of cycle
Sagging breasts and loss of fullness
Pain with sexual activity
Weight gain
Increased back and joint pain
Episodes of rapid heartbeat
Headaches and migraines
Gastrointestinal discomfort
Constipation

Common Signs of Excess Estrogen (takes longer to notice)

Breast tenderness or pain
Increased breast size
Water retention, fingers, legs
Impatient, snappy behavior, but with clear mind
Pelvic cramps
Nausea

Common Signs of Progesterone Deficiency

No period at all (no ovulation)
The period comes infrequently (every few months)
Heavy and frequent periods (large clots, due to buildup in the uterus)
Spotting a few days before the period. (Progesterone level is dropping)
PMS
Cystic breasts
Painful breasts
Breasts with lumps
Most cases of endometriosis, adenomyosis, and fibroids.
Anxiety, irritability, nervousness and water retention

Above list courtesy of Uzzi Reiss MD OB GYN. (4)

No Reported Adverse Events from Bio-Identical Hormones

Over-the-counter pain pills (NSAIDs) such as aspirin, naproxen and ibuprofen are considered fairly safe.  After all, you don’t need a prescription to buy them, yet they cause an estimated 16,500 deaths in the US annually, mostly from gastric bleeding.(5)  Compare this to no reported adverse events from bio-identical hormones last year, according to an FDA press conference January 2008.(6)

Do Bio-Identical Hormones Cause Breast Cancer?(7)

The answer is no. According to the French Cohort study, there is no increase in breast cancer in women using bio-identical hormones.(8)  However, having said that, avoiding excess environmental estrogens as well as excessive estrogen levels from any source, is the key to preventing breast cancer.(9)  My previous article covers our program for breast cancer prevention which includes iodine supplementation, Indole-3-carbinol and fiber. To read about this, see: Iodine Prevents Breast Cancer (10)

Left Image: Eiffel Tower Paris France Courtesy of Wikimedia Commons

Do Bio-Identical Hormones Cause Heart Disease ?

Again, the answer is no. A study of CAT calcium scores by JoAnn E. Manson in the June 2007 JAMA actually showed less heart disease in the women taking unopposed estrogen (they had hysterectomies and were not given the synthetic progestins).(11)  These same results had already been published 2 years previously in a calcium score study by Budoff in J Womens Health 2005. (12)