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URMC / Obstetrics & Gynecology / UR Medicine Menopause and Women's Health / menoPAUSE Blog / May 2019 / My sister said that she was on “Bioidentical Hormones” for her menopausal symptoms. What are they?

My sister said that she was on “Bioidentical Hormones” for her menopausal symptoms. What are they?

Our Response: The terminology associated with hormone replacement therapy may be confusing to some, largely because terms used in menopausal therapy do not necessarily reflect the evolution of hormone development. In 1897, long before awareness of hormones existed, a substance originating from ovarian extracts was found to reduce hot flashes. In 1906, secretions from ovaries were shown to produce estrus (cyclic, female sexual activity), and “estrogen” was established. Yet, it was not until 1929 that estrogen as a hormone was isolated. The first commercial preparation of estrogen was extracted from placentas. Then, in 1938, a report was published stating that chromogenic estrogens could be isolated from the urine of pregnant mares. This later was marketed under the name “Premarin®” (pregnant mare urine). By 1992, this collection of at least ten types of estrogens (containing less than 5% estradiol, the main ovarian estrogen) became the number one prescribed drug in the United States. Then, in 2002, the scientists involved in the Women’s Health Initiative reported that PremPro®, a combination of Premarin® and a synthetic progestin called medroxyprogesterone, was associated with a statistically significant increase in breast cancer. Moreover, as an oral preparation with a first pass through the liver increasing the production of many clotting factors, the reported increase in stroke also was a concern. The result was a dramatic drop in hormone replacement prescriptions. Yet, already laboratories were learning to produce hormones from plants such as wild yams, cactus, and soy. Called “bioidentical hormones,” their structures and functions were identical to hormones produced in the body. Today, delivered by estrogen creams or a transdermal patch, this method decreases the risks of blood clots and
breast cancer and now is prescribed and available in pharmacies and drug stores.

James Woods | 5/30/2019

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