The History of BHRT
The Origins of Bio-Identical Hormone Replacement Therapy (BHRT)
The history of BHRT goes back thousands of years. The first recorded use occurred in Ancient China. Older female nobility would take dried young women’s urine to counteract problems associated with menopause. The idea behind this was that young women’s urine contains the metabolic waste products of estrogen, progesterone, and testosterone. In fact, the use of young women’s urine to help older women with problems of aging can be found throughout history.
Research and development of synthetic and equine (horse) hormones began in the late 1930’s. It was even the basis for most scientific references to modern hormone replacement therapy (HRT). The current medical practice (based on this research) is to prescribe hormones that aren’t identical to the ones found in the human body. Bio-identical hormones originally had to be administered by a painful, intramuscular shot. This was only way to avoid the stomach and digestive system which would break down the hormones too much.
Why Did Pharmaceutical Companies Choose Synthetics over Bio-Identicals?
Even though bio-identical hormones were known to be effective and were available as early as the 1930s, pharmaceutical companies were unable to patent these compounds. This meant it was difficult to monetize them and they instead focused on improving these synthetic versions.
Synthetic oral forms of estrogen derived from horse urine were the first non-bio-identical hormones to be developed. Billions of marketing dollars helped make estrogen-only replacement therapy (ERT) popular up until the mid-1970s. At this time, researchers found a connection between ERT and endometrial cancer. This of course caused physicians to stop prescribing ERT until scientists noticed that endometrial cancer did not occur nearly as often in women whose ovaries produced a proper balance of estrogen and progesterone. This caused researchers to develop a synthetic non-human form of progesterone, called progestin. This was developed by the 1980s to balance the non-bio-identical estrogens that was being used in popular HRT preparations.
To add to the confusion between synthetic and bio-identical hormone therapy, the term “progesterone” was used interchangeably with the term “progestin” in medical, nursing and pharmacological studies. This meant that providers often assumed them to be same thing even though their effects on the human body were very different.
The “Micronization” of Hormones
In the late 1980s, the micronization of bio-identical steroids meant that progesterone could now be taken orally. Estradiol, estriol and testosterone could also be administered via transdermal routes (patches).
Micronized ’human’ progesterone eventually became available in Europe in the late 1980s and was approved by the FDA in 1998. It has been available from U.S. compounding pharmacists for years. The active component is bio-identical to endogenous (naturally produced) progesterone. Micronization of BHRT allows it to be released slowly into the body and readily absorbed by several routes without painful injections. Unfortunately, professional health providers rarely learn about this type of therapy in medical, nursing or pharmacy schools. This means they must invest extra time and money into learning about these techniques on their own. Oftentimes, this is only after their patients specifically ask for it.
Despite clinical studies that show the benefits of HRT, many women don’t take any form of HRT and because of this, experience a slowly diminishing quality of life due to peri-menopausal symptoms. To complicate matters, female baby boomers are entering menopause at an ever increasing rate and many won’t experience total remission of their symptoms with conventional, synthetic equine HRT options. By using non-bio-identical hormones, women are trading their peri-menopausal symptoms for unwanted side effects in addition to incomplete symptom relief.
The history of BHRT shows that it is a safe and effective form of hormone optimization. If you think you may need Bio-identical hormone therapy, find out by taking a simple test! Men click here and women click here. To schedule a FREE consultation with a certified BioTE provider, visit Integrative Health & Rehabilitation.