Hormone Replacement Therapy Q&A Webcast Transcript
Dr. Northrup: Okay. Thanks, Linda. Now we received many e-mails today from people who wanted me to explain the difference between bioidentical and synthetic hormones. This is so confusing to people, so let me run it—run it up the flag pole for you again. "Bioidentical" to me is not a marketing term, despite what you might have heard. It simply refers to a molecule that matches exactly what's found in the female human body, so that that molecule folds the way your own body's hormone would fold so that it fits on an estrogen receptor exactly right. The synthetic hormones—now by the way, I don't care where it's made. All hormones, pretty much, are made in a couple of labs, sold in bulk to the pharmaceutical industry, some go to compounding pharmacies, some go to regular pharmaceutical people and all of them are then packaged in different ways. The natural bioidentical hormones cannot be patented, which is why they haven't been available till recently. What has been patented in conventional pharmacies are the delivery systems. So we have all the patches are bioidentical. There's a lot of progesterone vaginal gels that are bioidentical. Then we've got capsules that are bioidentical progesterone. So these are all available in conventional pharmacies, and their molecular structure is just exactly like what your own body makes. So that's what "bioidentical" means. It is a biochemical term to me. And I understand that it is controversial. But remember, at your corner pharmacy, you can get bioidentical hormones—progesterone, estrogen and even testosterone. And your doctor needs to work with you to put those together in a way that's individualized for you. Now, on the show today, you saw that Suzanne Somers was on a different kind from a compounding pharmacy where they put the estrogen in one package and the progesterone in another because she uses them at two different times—estrogen every day of the week, progesterone the last two weeks of every month—but there are other compounding pharmacies that put the estrogen and the progesterone and plus or minus testosterone all in the same cream so all you have to do is do the little click and—(indicating)—rub it in and you get all three together. The point is, you can get what you want in any pharmacy. But in my opinion, the healthiest ones to take are those that match your own body's hormones. And I know that this is controversial because most of the studies have been done with hormones that do not match exactly what your body makes. The most important one being medroxyprogesterone acetate, which is a generic term relating to a synthetic progestin that is not anything like your body's natural progesterone. And that has many PMS-like side effects. So hopefully we've run it through again, and also in my book The Wisdom of Menopause there's a lot there that you can—that you can learn. Chapter 5 and throughout the book I talk about this. Okay. Now we have Nancy on the phone from Eagle Point, Oregon.
Nancy: Hello, Dr. Northrup.
Dr. Northrup: Hi.
Nancy: Hi. I've been on bioidentical hormones in pill form for about six years. I actually was never tested, but it was generalized, and I'm fortunate I was on bioidenticals because actually I brought your book in with me and your Women's Bodies, Women's Wisdom and had a lot of questions. So the one thing I really have a question about is it doesn't seem to be a panacea. A lot of women, including Suzanne Somers, have mentioned, you know, your sex drive comes back, your weight and everything else. So I'm kind of concerned relationship-wise about the sex drive. And my doctors have never tested for testosterone either, and I was wondering if that would be a good thing to look into, if that would be of help or maybe if I'm just taking the wrong amounts of what I am taking right now.
Dr. Northrup: I think the testosterone is a very good thing to look into. There has been quite a bit of ongoing research with it. And you want to have your doctor order what's called a free testosterone. So that measures—
Dr. Northrup: Free. F-r-e-e.
Dr. Northrup: And that's the part that is used by your body. The bound testosterone is not biologically active. So have your doctor order a free testosterone. And that may be all you'll need. But let me also tell you that the sex thing is fascinating. You have to use it or you lose it, and you can train your body to experience more and more and more pleasure. It's almost like biofeedback. And so you can increase your sex drive by paying attention to it. Reading romance novels, erotic novels. Watching movies that turn you on. Actually just making this something that you've decided to do so that you bring the pelvis and the heart together. And this is a whole other discussion. But I do love the fact that you brought up that the hormones aren't the whole answer. For a lot of women, they're not. I didn't want it to look on today's show like, "Okay, you just get the hormones right and everything else takes care of itself." Not always true. But in your case, absolutely get that free testosterone tested.
Nancy: I'll do that.
Dr. Northrup: All right. Thanks.
Nancy: Thank you very much.
Dr. Northrup: Thank you, Nancy. Now on Skype from her home office in Frisco, Texas, is Pam. Pam, what's going on?
Pam: Hi, doctor.
Dr. Northrup: Hi.
Pam: I am having severe problems with vaginal dryness and even more so than that, loss of elasticity. So I'm wondering if it's realistic that hormones will help me get back to normal, and would you recommend the full compliment of testing that we've heard about here recently?
Dr. Northrup: Is vaginal dryness and loss of elasticity your only symptom?
Pam: Pretty much. I have some hot flashes that come and go, but they're more of a nuisance than anything.
Dr. Northrup: Okay. Now the beauty of vaginal tissue is that it's rife with estrogen receptors. And so a little vaginal estrogen will restore that area more quickly than you can ever believe. And the nice thing is you can use just a small amount. So there are estrogen creams, estradiol, estriol, e-s-t-r-i-o-l is available from compounding pharmacies. That sticks to the cytoplasm receptors in the vaginal tissue better than the others and has minuscule systemic absorption. However, you can get any kind of estrogen cream with a prescription from your doctor, and you begin using a small amount once or twice a day for a week. Then you cut down to every other day for a week. And most women, once the vaginal tissue is restored, they'll be able to use a small amount twice a week and maintain that area, improved elasticity, improved moisture, from then on, with no worries whatsoever. This is one of the easiest things to treat that we have in gynecology. So you are in luck.
Pam: Hallelujah. I appreciate it.
Dr. Northrup: Yeah, just give it a couple weeks, and you'll be right back in the saddle, as it were. All right? Okay, thanks.
Pam: Thank you so much. I appreciate it.