Press
Release
Bioidentical
Hormone Replacement Therapy
in the Anti-Aging Clinical
Setting
An Official Position Statement
from the American Academy
of Anti-Aging Medicine
(A4M)
August
14, 2006
CHICAGO
Hormone
replacement therapy (HRT)
is the replacement of
physiological levels of
hormones that decline
as a result of a specific
disease state. The American
Academy of Anti-Aging
Medicine (A4M; www.worldhealth.net),
an international medical
society of 18,500 physicians
and scientists from 87
countries, is composed
of physician members who
are responsible for the
daily medical care of
millions of patients worldwide.
It is the position of
the A4M that the use of
hormones in aging patients
to replenish these levels
to a youthful physiologic
state, when conducted
by qualified physicians
trained in the practice
of treating age-related
hormonal declines, constitutes
a legitimate and important
life-enhancing, life-extending
medical application.
The
debate and discussion
over the safety of hormone
replacement therapy continues
to remain a focal issue
in anti-aging medicine.
In 2002 in the United
States, the National Heart,
Lung, and Blood Institute
(NHLBI), a government
agency, stopped the large-scale,
multi-center trial of
combined estrogen and
progestin therapy, administered
as part of the group's
Women's Health Initiative
(WHI) study of healthy
menopausal women. The
researchers terminated
this study element because
they found an increased
risk of invasive breast
cancer and coronary heart
disease that outweighed
the benefits from the
hormone replacement therapy.
However, NHLBI failed
to disclose that their
researchers did not use
bioidentical hormones
in the treatment. Bioidentical
hormones have the same
chemical structure as
hormones that are made
in the human body. The
term "bioidentical"
indicates that the chemical
structure of the replacement
hormone is identical to
that of the hormone naturally
found in the human body.
In order for a replacement
hormone to fully replicate
the function of hormones
which were originally
naturally produced and
present in the human body,
the chemical structure
must exactly match the
original. Thus, bioidentical
replacement therapy (BHRT)
is a method by which replaced
hormones follow normal
metabolic pathways so
that the essential active
metabolites are formed
in response to the treatment.
The molecular differences
between bioidentical and
non-bioidentical may prove
to be the defining aspect
in terms of hormone replacement
therapy safety, and failure
to make this differentiation
and thereby alarm the
public could be construed
as misleading. Furthermore,
natural - rather than
synthetic - forms of hormones
are associated with greater
bio-availability, that
is they are taken up by
the body more readily
and utilized more effectively.
Regrettably,
a number of articles recently
appearing in various newspapers
and magazines have falsely
suggested that BHRT is
unsafe and ineffective.
Experienced
anti-aging physicians
have been prescribing
BHRT for more than 20
years. For women, benefits
may include:
[Reed
KD. Natural hormone replacement
therapy: what it is and
what consumers really
want. International Journal
of Pharmaceutical Compounding.
2001;5(5):332-335; Drusko
J. Natural isomolecular
hormone replacement: an
evidence-based medicine
approach. International
Journal of Pharmaceutical
Compounding. 2000;4(6):414-442;
Boothby L, et al. Bioindentical
hormone therapy: a review.
Menopause. 2004;11(3):356-367.]
Laboratory
testing is essential to
the safe and scientific
application of anti-aging
hormone replacement therapy.
Just as it is substandard
care for a physician to
blindly administer insulin
to a diabetic patient
without regular monitoring
and reliable laboratory
analysis, so to would
it be for any physician
to administer hormone
replacement therapy without
appropriate monitoring
and laboratory analysis.
Safe
optimization of essential
hormone levels in the
deficient and symptomatic
patient is the goal of
anti-aging endocrinology.
This requires careful
monitoring of bio-available
hormone levels. This also
requires establishment
of baseline laboratory
data and regular analysis
on at least a semi-annual
basis in order to achieve
the safest and most effective
hormonal balance at the
lowest possible dose.
The
goal of BHRT is to optimize
function and prevent morbidity
with aging, and to enhance
quality of life. With
proper modification, adjustment,
and titration by an experienced
anti-aging physician,
the benefits of BHRT far
outweigh the risks. Anti-aging
physicians remain steadfastly
at the helm advancing
bioidentical hormone replacement
therapy, thereby providing
crucial research data
ultimately to negate the
controversy and confirm
the safety and efficacy
of BHRT. |
