Hi everybody and welcome to my VLOG. So this week's VLOG is going to be short
and sweet, but really important. So I'm going to explain to you the difference
between body identical hormones and bioidentical hormones. There's a very
good reason why I'm doing that! So I belong to a Facebook group of
11,000 women; it's called the Latte Lounge and it's for women over 40
to discuss absolutely anything they want, and it's amazing! So you should join (if
you're over 40 of course, because that's one of the prerequisites) and I will put
the address of that in the notes afterwards. Health issues are often
discussed and I'm often there to advise. And menopause is one of those as are
hormones generally. And there is a spin-off group from that called The
Menopause Support Network and I'm going to list that for you afterwards because
it's a really useful group. But I'm seeing more and more often in these
groups confusion between body identical and bioidentical as terms for HRT. So I'm
going to try and dispel that confusion today. So the first thing to know is that
what most women are after with their HRT, or any other drug for that matter is
that it's natural, and that's understandable because you want to think
that anything you're putting into your body is as natural as possible.
I think a warning to sound here is that just because something is natural
doesn't mean it's safe! So laburnum seeds on a tree are natural
but they're not safe they can kill a child. Deadly nightshade is natural but
it's not safe. So natural does not equal safe; that's the first thing to know. Many
many medicines are made from plants and they are therefore natural,
but they're not always safe. Getting your HRT from an NHS GP or a private GP (and
we subscribing the same things as an NHS GP) ie
as per the NICE guidelines, is safe and that's a really important point. And it
doesn't mean that because it's an NHS GP, or private GP prescribing the same,
that it isn't natural, it probably is! We'll go into that. But this
is why it's really important to understand the difference
between body and bio-identical hormones. So let's start with body identical
Oestrogen, because the oestrogen is the hormone that you lose at menopause and
the one that it's really important to replace because it's the one that takes
away the symptoms. So previously, and this is I think where the confusion starts,
HRT was made from horses urine! So it wasn't identical to our own hormones it
was identical to horses hormones. And therefore it contained oestrogens
that we don't use and it made oestrogens that we don't need. So most HRT is now
not made from horses urine, it's made from plant extracts. Body identical
oestrogens are readily available on the NHS from your GP and hopefully this VLOG
will allow you to go to your NHS GP armed with the information you need and
say "this is what I want`'. Body identical HRT is made under strict UK medicine
management guidelines, in a laboratory. Its tested, there have been trials and
every single product is made to a certain standard and we know what it's
going to deliver into your body with every dose. And that's really important.
You can't manage a medicine if you don't really know exactly how much of an
ingredient is in it. So that's crucial. It's made from plants, usually yam
extracts, but it's completely natural yet has the same molecular structure as the
oestrogen in our body; the one that we had before we lost it at menopause. And that
applies to Progesterone as well. Body identical progesterone is exactly the
same structure as the progesterone in your body. So body identical hormones are
natural, manufactured to an absolutely safe standard and identical to your body
hormones. So, to just start threshing that out a little bit; when you get your
prescription from your GP (whether that's private or NHS),
all patches that deliver oestrogen and all gels are body identical - that's all
you need to know. The tablets are not, so that's important. I will put some details
at the end and I've got one to show you here today so that you know what you are
asking for. So this is oestrogel and this is a body identical hormone
available from your GP. It's a pump. So it's a nice pump dispenser that delivers
exactly the right amount of hormone onto your skin to be rubbed in everyday. There
it is. So that's important to know. So if you're asking for a gel it's OESTROGEL.
So thats oestrogen. We also have body identical progesterone.
So there are many types of progesterone. So you get progesterone only pills,
progesterone only coils, progesterone only implants; they are not actually
progesterone. They are a mimic of progesterone; a synthetic progesterone which is
called progestin, and that is not body identical. So the only way you can have
body identical progesterone as part of your HRT is as a capsule that you
swallow or you place into your vagina. And that's micronised progesterone and
it is body identical and the brand that we use in the main in the UK is called
UTROGESTAN and I've got some here so you can see how that's spelt, there we
go. So that's utrogestan and these are
the vagina capsules so they're 200 milligrams but there's an oral one as
well which is a 100 milligrams. When you get the vaginal one or if we get the
vaginal one it comes with an applicator that you actually just pop it to the top
of your vagina. The vaginal one is actually not licensed for HRT but some
doctors do use it because if there are side effects when taking the oral one, the
vaginal ones sometimes avoids those side effects. Because this is a body identical
hormone and it's actually matching your own body's progesterone
there are less side effects than the synthetic ones. Progesterone you have to
have as a tablet or vaginal capsule - you can't have it as a cream to rub in the
skin. There is no evidence to suggest that that is safe and I'll go on to that
later. Sadly the progesterone that you get in
HRT patches and the tablets are not body identical, so if you want a completely
body identical HRT you need to have an oestrogen patch and the progesterone
tablets or an estrogen gel and the progesterone tablets. But I'm going do a
list for you afterwards so that you can refer back to this. And then there's body
identical testosterone. So we have that as a gel as well. Here's one now: this is
TESTIM. There are lots of different brands. But again this rubs into the skin
and it's absorbed straight into the bloodstream and that's the safest way to
have it. We don't give testosterone when we give it to women as anything but that
gel. All of these hormones; the oestrogen
the progesterone and the testosterone, are available from your GP on the NHS.
You might need to help them sometimes.. give them the information, and I will put
it afterwards, but they are all available. And they are completely safe
and we've tested them and we know how much is in every single dose that we
give you and that's the really important thing. So what's are bioidentical hormones?
Because you will hear this all of the time; it actually means exactly the same
as body identical, in that the hormones contained within them are completely the
same as your hormones in your body. They match your hormones, so in that respect
they are actually the same however they are absolutely not the same
as the body identical's available on the NHS! Bioidentical hormone
practitioners (and there are lots of them out there) use preparations which are not
regulated in any way by UK medicines management. There are no standards of
how much is in each preparation and there is no real quality
control. Quite often the practitioners use a saliva test to check your hormone levels
before before prescribing and there's no evidence that these saliva tests are
accurate or give a true picture of your hormone levels. The products that they
give you, which are normally creams and gels that rub in or tablets that
dissolve under your tongue, are made in what's called a compounding
pharmacy. And these pharmacies, as I've said, are not subject to the same
standards or checking or regulations as pharmacies that make these drugs (these
are pharmaceutical companies). They are custom made to you and there are
combinations of the different hormones so that oestrogen is mixed with
progesterone or testosterone. And you get an all-in-one cream that is made for
you. This has appeal, and I can see why people want to do it, and it all sounds
fabulous that it's made exactly for you, in the right dose and the right combination.
But there are several flaws.Firstly, as I've said, we don't know exactly how much
you're getting each time and it's the dose right? We also know that progesterone
delivered through the skin in a cream may not give enough protection to your uterus
and that's the most important role for progesterone in HRT. There haven't been
enough tests or trials to actually prove that it is adequate. And if it isn't
adequate, and you are using it for a period of time, you're putting yourself
at risk of endometrial hyperplasia. So the lining of your womb building up.
And that can cause cancer. So it's it's not an insignificant flaw, it's important!
And these creams often contain other non tested or unlicensed drugs, for example
DHEA, that you weren't intending on getting and don't actually need, and
that's a major concern as well. There is no evidence that these bioidentical
hormones that are made up in compounding pharmacies are any more
effective or have fewer side effects or are safer than the HRT that you can get from
your GP; the body identical preparations are safe and tested.
They're very expensive, they're potentially dangerous they're unregulated and
therefore they're not necessary because with the right GP and the right information
you can get the treatment you need with body identicals from them.
The British Menopsause Society, which is a great resource for all of the studies and
the research on what's new and whats current, have actually looked at
this in depth and I've got a quote here from them where they say;
"These products are an unregulated compounded mixture of
various hormones put together without the vigorous licensing standards which
apply to normal pharmaceutical products. The FDA in America is concerned about
the claims for safety, effectiveness and superiority of these preparations that
are made in compounding pharmacies they have no proven efficacy or safety
and their use is not recommended". And the BMS is the go-to resource in the UK for
practitioners and members alike to go to for well research scientific evidence on
all of these products. So I'm quite happy with the research that I've looked at to
actually make this video and you can see from the statement from the BMS (which
I'll also put in the notes) that it's not just my view on here, it's backed up by
this research and science. So what's the answer? So the answer is yes - you need
body identical hormones for the best HRT result and the fewest side effects.
Oestrogen delivered through the skin is the safest and has the fewest bad
estrogens to cause other problems which is why there is no risk of DVT or stroke.
Progesterone needs to be taken as a tablet or vaginally, not delivered
through the skin, for maximal safety. Testosterone needs to be delivered
through the skin. And if you have a combination of these, if you need
testosterone (and most women don't), all of these products are available on the NHS.
And they're all tested, proven and safe. And I'm going to put a list of the different
products that you can expect in the notes afterwards so that you've got a crib sheet
should you need to go and have this conversation with your GP.
So hopefully that's clarified everything for you.
And I hope it's been useful. Please don't hesitate to ask me any questions at all
at the end, and menopause always generates lots of questions! And please
suggest subjects that you'd like me to cover for the future because I'm more
than happy to do it! Take care and as ever thank you!