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My Menopause Doctor Dr Louise R Newson BSc(Hons) MBChB(Hons) MRCP FRCGP GP and Menopause Expert Body Identical Hormones What are “body identical” hormones are are they the same as “bio-identical hormones”? There are so many different types of HRT available. This means that the dose and type of HRT can be altered to suit your individual needs and will also depend on your health and risk factors for other conditions, for example if you have had a clot in the past or have high blood pressure. Many women want to take “natural” products for their menopause but you have to be very careful how you define “natural”. There are many medicines available which are derived from plants so therefore they are “natural” but many are unsafe and have been shown to be harmful to your bodies. For example, although black cohosh has been shown to be beneficial for hot flushes, some types of black cohosh have been shown to be associated with liver failure. The oesterogen that I usually prescribe for women is a type of oestrogen called 17 beta oestradiol. This is a “body identical” oestrogen and has the same molecular structure as the oestrogen which decreases in your body during the menopause. This type of oestrogen is available as tablets, in patches, gels and also in different types of vaginal preparations. It is also natural in that it is derived from a plant chemical which is extracted from yams, which are tropical root vegetables. Some types of older HRT contained a mixture of different types of oestrogens and were made from pregnant mares’ urine. So this types of HRT is “natural” but it is not “body identical” as it contains many types of oestrogens that you do not need in your body. Thankfully this type of HRT is not often prescribed by doctors any more; I certainly never prescribe it! There are many different types of progestogens (progestogens is the name for a synthetic progesterone) available for women. If you still have a womb (uterus) it is important that a progestogen is combined with the oestrogen for your HRT. When you take oestrogen the lining of your womb can build up which can increase your risk of cancer. However, taking progestogen completely reverses this risk which means there is not increased risk of cancer when you take HRT. The type of progestogen I commonly prescribe for my patients is a micronised progesterone. This is a “body identical” progestogen as it has the same molecular structure as the progesterone in your bodies. This means that is usually is associated with fewer side effects than other types of progestogens. Side effects of progestogens can include bloating, spots and mood swings. Micronised progesterone is also made from the yam. Some “natural” progesterone creams for your skin are available in some places over the Internet. These are not recommended as they are not absorbed into the body well and also many contain too little amounts of hormone to be effective. Many private clinics are using “bio-identical” hormones These are not the same as the “body identical” hormones I have just described to you. These are Spire Parkway Hospital, Damson Parkway, Solihull, B91 2PP Appointments: 0121 704 1451 | Enquiries: Sarah Davies 07866 479 991 [email protected] | www.menopausedoctor.co.uk My Menopause Doctor Dr Louise R Newson BSc(Hons) MBChB(Hons) MRCP FRCGP GP and Menopause Expert not regulated and are not subject to any quality control. It is important that you do your research before you commit to anything you buy. Also check that it is NICE-approved (National Institute for Health and Care Excellence). These bio-identical hormones are compounded. This means that they are custom made in order to prescribe hormones in combinations doses or preparations that are not routinely available. Some of the hormones used in these bio-identical hormones contain hormones that are not approved for women such as a hormone called DHEA (Dehydroepiandrosterone) or prednisolone. Many women are given progesterone creams which are actually not well absorbed in the body and are not available over the NHS. I see many women in my clinic who have spent considerable amounts of money on these bioidentical products and have experienced numerous side effects. The products used in this way are not regulated or approved and so could potentially be harmful. They have not been subjected to the same tests of safety, efficacy or dosing consistency as the type of HRT that are prescribed to you. In addition, there is no evidence that these compounded hormones have less side effects or are more effective that HRT. In summary, the risks of the hormones you are taking depend on your type of HRT and also your individual risk factors and health. It is very important that you are given the right type and strength of HRT for your individual needs and that the benefits and risks of your HRT are discussed with you by your GP or menopause doctor. Date created: 12 February 2017 Spire Parkway Hospital, Damson Parkway, Solihull, B91 2PP Appointments: 0121 704 1451 | Enquiries: Sarah Davies 07866 479 991 [email protected] | www.menopausedoctor.co.uk