Screen shot 2013-09-18 at 9.05.05 AMMany people are quick to dismiss bioidentical hormone therapy (BHT) as controversial, wacky or dangerous. But in reality, there is scientific research that confirms the benefits of BHT, particularly for women about to go through menopause. BHT is so successful because it goes beyond simple symptom control to proactively address the root of a given patient’s health issues. As I mentioned in my previous blog, Kent Holtorf, M.D., is a practicing physician who released a detailed research paper on the potential benefits of BHT, especially in comparison to conventional hormone therapy (CHT).


Here’s a sampling of what he discovered.

Is BHT more effective than standard hormone replacement therapy? 

  • Four studies that compared BHT with CHT found that women on BHT reported greater satisfaction, fewer side effects, and improved quality of life when switching from CHT to BHT.
  • In one survey, researchers found that patient satisfaction, quality of life, and body and psychological symptoms—including anxiety, depression, sleep problems, menstrual bleeding, hot flashes, cognitive problems, and sexual function—improved significantly more for women on BHT (specifically, with bioidentical progesterone) than for women on CHT (including the progestin drug MPA).
  • Sixty-five percent of the 176 menopausal women in this same survey felt that the BHT combo was better than the CHT combo including MPA.
  • Women using BHT with progesterone had less breast tenderness than women using CHT.

Is BHT safer for breast tissue than CHT? 

  • Fourteen test-tube and animal studies showed that synthetic progestins from CHT may reduce apoptosis (the natural, good cell death that works against cancer growth) and may increase the formation and growth of cancerous cells in breast tissue.
  • Other research showed that progestins in CHT upregulate cellular activities linked to breast cancer growth, and that progestins may increase conversion of less dangerous estrogens into more dangerous ones.
  • Overall, the studies show that progestins have pro-carcinogenic impact on breast tissue, while progesterone has neutral or opposite effects.
  • In the  monumental EPIC study, which involved 50,000 postmenopausal women, researchers studied two groups of women: one that took estrogen plus progestin, while the other took estrogen plus bioidentical progesterone. The women that were given progestin increased their risk of breast cancer by 40 percent; the other had no impact on risk.

Does BHT or CHT increase the risk of heart attack or stroke?

  • The well-known WHI study found that adding MPA to Premarin substantially increased risk of both heart attack and stroke.
  • MPA and other progestins negate the proven cardiovascular benefits of postmenopausal estrogen hormone therapy.  Progesterone does not have this effect; it supports and promotes the protective effect of estrogens on the cardiovascular system.
  • When given after menopause, estrogens raise “good” HDL cholesterol levels. Progestins cancel out this positive effect of estrogens, but progesterone has no impact on HDL.
  • Synthetic progestins increase insulin resistance, while bioidentical progesterone decreases it. Insulin resistance is a precursor to Type 2 diabetes, which dramatically increases the risk of heart disease
  • Both progestins and estrogens can cause arteries to spasm, which can lead to heart attack or stroke. Progesterone has an artery-relaxant effect.

For those willing to look for it, there is an abundance of scientific support in favor of the judicious and well-timed use of bioidentical hormone therapy for women entering or already experiencing menopause. Progestins are clearly the “problem child” in this family of medicine, and given the health risks associated with progestins, they should be avoided at all costs.

The ideal time to explore BHT is right around menopause; there is evidence that the benefits of BHT drop and the risks rise by about five years post-menopausal transition. Seek out the guidance of an integrative metabolic medicine (IMM) doctor to get started today.



Holtorf, Ken, “The Bioidentical Hormone Debate: Are Bioidentical Hormones (Estradiol, Estriol, and Progesterone) Safer or More Efficacious than Commonly Used Synthetic Versions in Hormone Replacement Therapy?” Postgraduate Medicine, Volume 121, Issue 1, January 2009.


Photo credit: Craig L. Moran