Guest Post by Jerilynn Prior, Centre for Menstrual Cycle and Ovulation Research
As a clinician scientist with expertise in hormones and women’s health, I sit in Canada and look at the hype and dis-sing going on about “bio-identicals” in the USA and shake my head. If we don’t want estrogen that is not FDA approved to be used to treat hot flushes, the simple answer is to regulate appropriately. The perpetual debate about bio-identical hormones has now hit USA Today with a headline: “Bioidenticals: Estrogen without FDA approval for menopause?”
In Canada, all hormonal preparations require a prescription. Full stop. And the pharmacists who compound estriol or progesterone do so with my prescription for a specific dose and clear purpose. Those compounding pharmacists are also regulated the same way as pharmacists who dispense FDA/Health Canada approved medications. End of story.
What bothers me is that I believe there is an intrinsic advantage to hormones that are molecularly the same as our bodies produce. They are certainly better, a priori than those that are natural for horses or are “similar-but-different.” When oral micronized progesterone (molecularly identical, Prometrium®) is prescribed with estradiol (there are multiple FDA-approved brands of molecularly identical estrogen), there is no increased breast cancer risk.[1] On the other hand, medroxyprogesterone (a similar synthetic derivative of progesterone) with estradiol increases the risk for breast cancer by 79%.[1] That’s called a nasty surprise.
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