Hormone therapy

It has been more than four years since the release of a major study linking hormone- replacement therapy with increased risk of heart disease, breast cancer and a host of other bad things.

And still, women who are going through menopause have no easy answers when it comes to easing their sometimes-debilitating symptoms.

An increasingly popular choice is so-called “bioidentical” hormones, which have made headlines in recent weeks following the release of a controversial book by former sitcom star Suzanne Somers.

Bioidenticals are derived from plants and are chemically identical to those hormones already produced by the body. Most bioidentical formulations are custom-made by compound pharmacies that specialize in such drugs.

“It feels so good not to feel anything,” says Molly Destefano, a 60-year-old Spokane woman who has taken bioidenticals for about five years. “I don’t have the hot flashes. I don’t have the aches and pains … It feels so good to just feel normal.”

While women like Destefano swear by bioidenticals, many in the medical community are not convinced, saying that they aren’t regulated by the government and haven’t been proven safe and effective.

Those who use bioidentical hormones believe they are safer than synthetic hormones – such as Premarin and Prempro – because they replicate a woman’s own hormones and they can be given in controlled doses. But there have been no large-scale studies of the safety or effectiveness of bioidenticals and, last month, the American Medical Association called for stricter regulation of the compounds.

Also, The North American Menopause Society does not recommend bioidentical therapy, expressing concerns that the drugs are not government-approved.

“Women generally are confused and frightened and scared,” says Dr. Steven Brisbois, an obstetrician-gynecologist with Spokane’s Northwest OB-GYN. “The implication is (bioidenticals) are better and safer, but the real question is, ‘Where’s the evidence that these hormones are going to be better or safer?’ The answer is, there isn’t.”

But Dr. Cheryle Hart, a Spokane doctor who regularly prescribes bioidenticals and takes them herself, says the hormones have fewer risks than synthetic ones because they can be given in smaller doses. Before prescribing bioidenticals, Hart has her patients undergo a blood test to determine which, and how much, hormone they need.

Even Hart, a proponent of bioidenticals, admits that it’s tough for women to decide how best to treat menopausal symptoms.

“It’s totally confusing and frustrating for everyone,” she says. “Unfortunately, Suzanne Somers is the only person you’ve got to listen to and she’s crazy. I do agree with the critics on her second book. She’s the guru and she doesn’t know anything.”

Somers’ latest book, “Ageless,” claims that bioidenticals can reverse the aging process.

Cathy Hudek would not go that far in her support for bioidenticals. But she has seen the huge change they’ve had on the women who take them.

Hudek is a pharmacist and co-owner of Riverpoint Pharmacy, which is located in the lower level of the Spokane Intercollegiate Research and Technology Institute

Riverpoint Pharmacy makes bioidentical hormone compounds.

“We’re trying to mimic ovarian function or copy Mother Nature,” Hudek says.

A box of tissue sits on the table in Hudek’s conference room.

“We have Kleenex in here because they’re just crying,” she says of the women who come in who are suffering from night sweats, poor sleep, depression and severe headaches.

Riverpoint uses purified, FDA-approved hormones that are then mixed into topical creams or drops that go under the tongue, Hudek says.

Hudek, though, doesn’t make any guarantees that bioidenticals are any safer than the synthetic variety.

“We don’t have those kinds of studies,” she says. “You just don’t know. But we know we’re replacing the very same things the body was making.”

Destefano says she relies on logic and common sense to reassure her that the bioidentical hormones she takes are safer than synthetic ones.

“It makes more sense to me to put something in my body that exactly matches what my body was making before,” she says.

Brisbois, though, says that formulated bioidentical hormones really aren’t any different than the synthetic drugs, and that they carry the same risks and benefits. Women should not be fooled into thinking they’re taking something that’s more “natural” and therefore more safe, he says.

“My personal view is that women have a right to know the real facts and have a right to know the options and the advantages and disadvantages to make an informed decision,” Brisbois says. “And they’re not really getting that right now from the medical community in general.”