Hurdity and I agree on most things, but we do have different opinions on the "bioidentical" term - but friends can disagree right?
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Out of interest I checked the NHS site because I wanted to learn more about the use of the "bioidentical" term in the UK, and I found that the NHS doesn't use the term for regulated HRT or recommend the use of "bioidentical" hormones. They use the word in the same context as other countries (ie compounded hormones or BHRT), and this points to the reason why so many GPs give blank looks when they are asked for "bioidentical" because it's simply not a term they use.
http://www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/Alternatives.aspx#bio-identicalBioidentical or "natural" hormones
Bioidentical hormones are hormone preparations made from plant sources that are promoted as being similar or identical to human hormones.
Practitioners claim these hormones are a "natural" and safer alternative to standard HRT preparations. However, bioidentical preparations aren't recommended because:
• they aren't regulated and it's not clear how safe they are – there's no good evidence to suggest they're safer than standard HRT
• it's not known how effective they are in reducing menopausal symptoms
• the balance of hormones used in bioidentical preparations is usually based on the hormone levels in your saliva, but there's no evidence that these levels are related to your symptoms
Many standard HRT hormones are made from natural sources, but unlike bioidentical hormones they're closely regulated and have been well researched to ensure they're as effective and safe as possible.
When you search for the different types of HRT the term isn't used there either, even when talking about things like patches and progesterone.
http://www.nhs.uk/Conditions/Hormone-replacement-therapy/Pages/How-it-works.aspxEven Dr Currie lists bioidenticals in the "Alternative Therapies" section, so it's really little wonder why doctors are getting confused when asked for bioidenticals.
http://www.menopausematters.co.uk/otherpreps.phpBio-identical hormones are marketed as being naturally produced hormones which aim to resemble our own hormones and which replace the hormones according to individual requirements. They are in fact very similar to the hormones used in Hormone Replacement Therapy, which are also produced from natural sources, but, unlike HRT hormones, are given in uncontrolled, unregulated amounts, with little evidence available on effect and safety. Measurment of salivary hormone levels is often used to determine the amounts of bio-identicals which are prescribed, but salivary hormone levels bear no correlation with hormone levels which are required to treat menopausal symptoms, or to provide beneficial effects on bone or the cardiovascular system. For more information, see this article on bio-identicals from our magazine. (PDF 1Mb)
Sorry, I don't want to turn this into a debate, but it's an issue that bothers me a lot especially for ladies new to the site, or to menopause and HRT. They could be getting mixed messages by reading one thing about bioidenticals from Dr Currie, where she clearly doesn't endorse them, and then something totally different on the forum. There are many women who will just read the posts on the forum and not necessarily post any questions to clarify anything or read the other information posted by Dr Currie, so they could be going along quite happily using compounded hormones because they are seeing people saying "bioidentical" hormones are the preferred option.
Technically there may have been a medical basis to the term at some point, but the popular culture meaning took over a long time ago (probably around the time of the WHI study or even before), to the point where doctors themselves don't use it and the FDA categorically states on their website that they only recognise it as a marketing term and not as a scientific term. All other menopause/medical organisations that I've researched (ie the Australian Menopause Society, The North American Menopause Society and The Society of Obstetricians and Gynaecologists of Canada - and now the NHS) all say more or less the same thing.
Like I said above, menopause is such a confusing time for a lot of women, where they are bombarded with so much information so I hate to see them get confused about something that shouldn't be confusing. I've seen other posts similar to michelle's on MM where women ask for something that the doctor gets confused about, then they get anxious and stressed on top of what they are already going through. I honestly feel it would be better to say exactly what is being referred to, ie estradiol, progesterone/Utrogestan/Prometrium (if that's the preference) or testosterone, as opposed to the "synthetic" HRTs, as these are terms a doctor will definitely understand and there can be no confusion.
PS ..... Sorry Michelle. I hope I haven't confused you even more, but I think it is important that people do understand that if the term bioidentical is to be used at all it should be used with a lot of caution and a lot of explanation.