Natural Hormone Replacement Therapy
by Michael B. Schachter, M.D., C.N.S., F.A.C.A.M.
There is a big difference between natural hormone
replacement therapy, which consists of hormones that are identical to those
produced in the body (bio-identical hormones), and synthetic hormones that are similar, but not
Most conventional physicians do not distinguish between the two
types and recommend synthetic hormones like medroxyprogesterone (Provera).
However the differences between them are seen clearly in a woman who is having
miscarriages early in pregnancy. Fertility specialists frequently
recommend natural progesterone as soon as the woman becomes aware that she is
pregnant. Progesterone helps to protect the pregnancy and increases the
chances of a normal child. On the other hand, all of the synthetic
progestins like Provera are absolutely forbidden during pregnancy because they
cause birth defects. This glaring difference between the two helps to
underscore the many other differences between natural progesterone and synthetic
progestins. So, whenever I recommend hormone replacement therapy, I
prescribe natural progesterone.
When it comes to estrogens, the body produces three
types, namely estrone, estradiol and estriol. The first two tend to be
stronger and also tend to be associated with a greater cancer risk.
Estriol tends to be weaker and seems to be less associated with cancer
risk. When prescribing estrogen replacement, I prescribe a preparation
that is high in estriol and relatively lower in estradiol or estradiol and
estrone. Combining these natural estrogens with natural progesterone and
titrating the dosage to the needs of the women may achieve excellent therapeutic
effects with little to no side effects and with little apparent risk for cancer.
A third hormone prescribed for women is natural
testosterone (not the synthetic methyl testosterone). This hormone is
particularly helpful when a woman suffers form a low sexual drive, fatigue,
weakness, and thin bones. Testosterone can drastically improve quality of
life and many physiologic functions. Dosages used in women are much
smaller than those used in men suffering from testosterone deficiency.
Natural hormones may be administered either by applying
them to the skin (as patches or creams) or in special capsules that can be taken
by mouth. Generally, the kinds that I prescribe are most available from
compounding pharmacies that prepare or compound the prescription according to
the doctor's instructions. Dosage adjustments are made depending upon the
clinical response and the results of laboratory testing. I have found that
measuring saliva levels of the natural hormones is more useful than measuring
© 2001 Michael B. Schachter, M.D.