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Bioidentical hormones
by Dr. med. Bettina von Seefried
The term hormone replacement therapy with bioidentical hormones is used to describe therapies in which hormones are used that are identical to those produced naturally by the body. It is assumed that the use of such hormones has particularly few side effects. However, the advantages and disadvantages of each hormone therapy must be discussed individually and in detail.
However, the term bioidentical has nothing to do with whether the respective preparation is an authorised medicinal product or not. It only describes the structure of the hormone that is prescribed. Bioidentical hormones are therefore also available as preparations that are authorised by SwissMedic. The advantages of these SwissMedic approved preparations are quality control, a standardised and controlled manufacturing process and, in most cases, reimbursement of the preparation by the health insurance fund.
Bioidentical has nothing to do with individual dosage, which is an important aspect of high-quality individual counselling. The treatment is not only based on the level or depth of the individual hormone that causes symptoms, but also on the relationship of the hormones to each other, which become imbalanced during a certain phase. This imbalance can also be responsible for symptoms and not only the absolute level of the individual hormone.
Used hormones
During hormone replacement therapy in our consultation, we will discuss the following hormones and the advantages and disadvantages of taking them:
- Oestrogen: Probably the best known hormone when talking about hormone replacement therapy is oestrogen. It is mainly produced by the ovary and has multiple effects. If the production of oestrogen by the ovaries decreases, this has an effect on the occurrence of flushes, the skin and mucous membrane (dryness and elasticity), the bones, on the soul and probably also on the brain and the cardiovascular system. Oestrogen is replaced by the administration of bioidentical oestradiol.
- Progesterone is also called the "soul stroker". The lack of progesterone often leads to irritability and decreasing resilience. The quality of sleep deteriorates. Sometimes therapy with progesterone alone is enough to restore well-being in the menopause without adding other hormones. However, if a woman takes oestrogens as a hormone substitute, she must take progesterone to protect the lining of the uterus (women who have had their uterus removed are an exception to this rule).
- Testosterone is the hormone we think of as male power. But the female body also produces testosterone, 90% in the ovary and 10% in the adrenal gland. The drop in testosterone levels during the menopause can lead to a loss of drive and desire (related to all areas of life, including sex). Replacement with testosterone gel can give the woman back a lot of quality of life, but the dosage must be discussed carefully.
- DHEA is a precursor of testosterone and is widely available on the American market as a dietary supplement. The aim of taking DHEA is ultimately to raise testosterone levels (for effects, see there). DHEA and testosterone also have an influence on muscle building and fat metabolism.
- Pregnenolone is produced in the adrenal cortex and has a strong dependence on the daily rhythm. It is supposed to rise in the morning, reach its peak and give us strength for the day. Adrenal exhaustion is manifested by low levels of pregnenolone and cortisol. Symptoms range from poor concentration to symptoms of burn out. The risk of adrenal cortex weakness is increased by ongoing stress psychologically (mental pressure, strain), physically (excessive physical demands, illnesses) and sensory (excessive computer/mobile phone use).
- Melatonin is known for its effects on the day-night rhythm. Ideally, melatonin levels are significantly higher at night than during the day, and this curve typically flattens with age. Various studies suggest that taking melatonin not only improves sleep quality, but also acts as a fountain of youth. Whether this is simply due to the rest during sleep or due to direct effects from melatonin.
However, the term bioidentical has nothing to do with whether the respective preparation is an authorised medicinal product or not. It only describes the structure of the hormone that is prescribed. Bioidentical hormones are therefore also available as preparations that are authorised by SwissMedic. The advantages of these SwissMedic approved preparations are quality control, a standardised and controlled manufacturing process and, in most cases, reimbursement of the preparation by the health insurance fund.
Bioidentical has nothing to do with individual dosage, which is an important aspect of high-quality individual counselling. The treatment is not only based on the level or depth of the individual hormone that causes symptoms, but also on the relationship of the hormones to each other, which become imbalanced during a certain phase. This imbalance can also be responsible for symptoms and not only the absolute level of the individual hormone.
Used hormones
During hormone replacement therapy in our consultation, we will discuss the following hormones and the advantages and disadvantages of taking them:
- Oestrogen: Probably the best known hormone when talking about hormone replacement therapy is oestrogen. It is mainly produced by the ovary and has multiple effects. If the production of oestrogen by the ovaries decreases, this has an effect on the occurrence of flushes, the skin and mucous membrane (dryness and elasticity), the bones, on the soul and probably also on the brain and the cardiovascular system. Oestrogen is replaced by the administration of bioidentical oestradiol.
- Progesterone is also called the "soul stroker". The lack of progesterone often leads to irritability and decreasing resilience. The quality of sleep deteriorates. Sometimes therapy with progesterone alone is enough to restore well-being in the menopause without adding other hormones. However, if a woman takes oestrogens as a hormone substitute, she must take progesterone to protect the lining of the uterus (women who have had their uterus removed are an exception to this rule).
- Testosterone is the hormone we think of as male power. But the female body also produces testosterone, 90% in the ovary and 10% in the adrenal gland. The drop in testosterone levels during the menopause can lead to a loss of drive and desire (related to all areas of life, including sex). Replacement with testosterone gel can give the woman back a lot of quality of life, but the dosage must be discussed carefully.
- DHEA is a precursor of testosterone and is widely available on the American market as a dietary supplement. The aim of taking DHEA is ultimately to raise testosterone levels (for effects, see there). DHEA and testosterone also have an influence on muscle building and fat metabolism.
- Pregnenolone is produced in the adrenal cortex and has a strong dependence on the daily rhythm. It is supposed to rise in the morning, reach its peak and give us strength for the day. Adrenal exhaustion is manifested by low levels of pregnenolone and cortisol. Symptoms range from poor concentration to symptoms of burn out. The risk of adrenal cortex weakness is increased by ongoing stress psychologically (mental pressure, strain), physically (excessive physical demands, illnesses) and sensory (excessive computer/mobile phone use).
- Melatonin is known for its effects on the day-night rhythm. Ideally, melatonin levels are significantly higher at night than during the day, and this curve typically flattens with age. Various studies suggest that taking melatonin not only improves sleep quality, but also acts as a fountain of youth. Whether this is simply due to the rest during sleep or due to direct effects from melatonin.