Menopause Therapy Sparks Controversy

Opinion Split Over Safety Of Synthetic Hormones, Bioidenticals

(CBS)  Fifty-two-year old Glennis runs her house with brisk efficiency, but there was a time when her days were spent in a mind-numbing fog.

"I found myself very irritable, very tearful, everything would make me cry," Glennis explains.

Yes, it was menopause, CBS Evening News anchor Katie Couric reports.

"I was deteriorating into this old, nasty lady," she says, laughing. "I'd feel like I was outside my body looking at myself and my behavior and saying, 'Eww, do you have to be that way?'"

Glennis started taking synthetic hormones, but stopped when the study four years ago warned of the risks. Some experts believe the study was misinterpreted and that low levels of hormones taken over a short period of time are safe.

But many skeptical women turned to something called bioidenticals. These products, derived from soy and yam extracts, are structurally identical to those hormones found in a woman's body, but they are not approved by the FDA.

Dr. Erika Schwartz, author of four books about menopause, is an advocate for bioidenticals, prescribing them to others and herself.

"I have seen people get their sex drive back. I've seen women get rid of their hot flashes, their night sweats, re-capturing their ability to sleep," Dr. Schwartz says.

But critics say there's virtually no difference between bioidenticals and their synthetic counterparts. And now, doctors are concerned that a new bestseller by former actress Suzanne Somers is creating more hype and more confusion.

"These people are claiming that these are natural, that they don't increase the risk of breast cancer, That's absolute nonsense," says Dr. Wulf Utian, executive director of the North American Menopause Society. "They carry exactly the same risks and exactly the same potential benefits as the commercial products."

Critics also say the compounding pharmacies mixing the bioidenticals aren't regulated enough.

"If they're getting something that's mixed in the backroom of a pharmacy, then they're not certain what they're getting," Dr. Utian says.

But the issue, says Dr. Schwartz, isn't about safety. It's about dollars and cents. Since bioidenticals are found in nature and can't be patented, Schwartz says that drug companies have no financial incentive to study them.

"I have no doubt that it's about profit," Dr. Schwartz says, adding that she wants a long-term study on these plant-derived hormones. For now, these women say the relief they're getting from bioidenticals today is worth whatever they may face in the future.

"I'm more worried about the risks if I don't take this," Glennis says.

"It's really just about maybe the second half of your life and being able to get through that feeling as good as you possibly can," says Stacy Pear, another patient.

[njgirl25]

Please...I would try any natural remedy BEFORE I'd consider drugs approved by the FDA. How many "approved" drugs have caused countless other illnesses and DEATH?

I have been using soy based products and herbs for the past 2 yrs and feel wonderful. Prior to that I experienced nearly all of the symptoms of menopause. Today, I have NO hot flashes, rarely feel irritable and have energy and passion for life. The only problem that still plagues me is sleep interruption on occasion. I can deal with that, and NO I will not take Lunesta or Ambien...the side effects are worse than losing a little sleep!!

The drug companies are not interested in any remedy that doesn't equal a profit. Enough said!

[unidough]

I am very interested in this Bioidenticals.
How do I get a hold of it.

[pmid77]

The claim by Dr. Wolf Utian that natural bioidentical progesterone has the same risk and benefits as a synthetic progestin is nonsense.

Natural progesterone normally taken as a skin cream as it is largely destroyed in the digestion system if taken orally.

Progestins such as premarin are taken orally as they are not identical to natural progesterone, but have been modified to be slightly different from progesterone so they can pass through the digestion system without damage. They are therefore a substance which is not natural and, like transfats, are foreign to the human body. It really makes no sense to say that two different substances, one natural and one foreign to the body, will have the same risks and benefits.

[nnye1941]

I have been on Bio-identical hormones for over 5 yrs and am 65 yrs old and was on synthetic hormones since I was 19 and up having a hysterectomy because of endometriosis and the treatment of birth control pills made the problem worse and if I had taken Progesterone (not Progestin) I wouldn't have had the need for a hysterectomy. After 45 yrs of misery I am now a happy, healthy hormonally balanced female who wouldn't trade her bio-identical hormones for all the money in the world.

[lnichols0411]

Thank you for bringing to light the fact that women of menopause have options. Traditional physicians rarely present alternative medical solutions. I turned to alternative bio-identical hormones whem my family physician told me that he had never seen menopause as the cause of death on a death cerificate. I realized that he was too lazy to learn about new approaches and only relied on what "big drug company reps" told him over the lunch or on the golf course.
Any chemist will tell you that the molecular makeup of bio-identical compounds are very different that Premarin (pregnant mare urine). Pregnant mares have 17 hormones in their urine. Women have 3 estrogen hormones in their body.
Progestin is synthetic. Progesterone is bio-identical and has proven to be a cancer protector.
There are many reputable compounding pharmacies around the US. They pay QA companies to monitor their compounds to insure that they are of the highest and consistent quality.
Within 6 weeks of starting my bio-identical biest, progesterone and testosterone, I was symptom free. My brain fog had cleared, I was sleeping all night without medication and my husband was the happiest of all. I actually suggested that we have ***!
My father recently died of Alzheimer's. It is clinically proven that women who do not have estrogen in their brains are at 50% greater risk of developing Alzheimer's Disease.Lou Anne Nichols

[memerider]

Let the buyer beware on drugs whether they are synthetic or "natural." They are drugs, and one has to take responsbility for becoming as knowledgable as possible when taking any foreign substance into one's body. Drugs may come from a plant or a chem lab and work or not and have side effects or not.

The science isn't even close to having any final data on any menopause drug--herbal, natural or what have you. If it seems to help, even if it's just placebo effect, and if you are willing to accept responsibility, then follow your own good judgment.

We can toss testimonials and limited scientific findings back and forth all day and it won't change anything.

[grandma68763]

After 25 years on hormone replacement therapy (after a total hysterectomy at age 24) I am now allergic to any and all drug company hormone products. BioIdentical hormone replacement therapy has given me new life without the horrible side effects and menopause symptoms I continued to suffer on the drug company products. I did not realize menopause could feel good until BioIdenticals.

[DebWells]

It really IS about the money! Millions of American women are now VOTING with their own hard earned dollars and we AREN'T buying the dangerous, synthetic HRT's that we are getting from our DR.s anymore.

The comment about the bio-identicals being made in the back room of some pharmacy is nonsense. The same could be said of all of the OTHER meds that our mainstream Dr.s prescribe for us. I've heard other Dr.s say this just before they prescribe yet another med to be made by the same phamacy's they put down for make bio-identicals. With as many women turning to bio-identicals (progesterone), of course the Med Industry and the pharmaceuticals are feeling it in their bank accounts.

I tell you, we women who are going through any phase of menopause, have husbands, children and now grandchildren,we KNOW how we feel and we are no longer going to buy into the 5 minutes worth of info we are given from our Dr.s during our all too short appts. with them.

Our libido's are back, we no longer have night sweats, hot flashes, insomnia, restless legs, our fibromyalgia is improving if not going away, no more rage and our minds are clear as a bell! We KNOW how we feel and if you think that the Million Man March on the nations capitol was impressive, if the pharmaceutical and medical industry's succeed in removing bio-identicals from the market place, just watch! A million hormonal WOMAN march in DC, will really be worth watching!

Leave us alone, we may have been born at night but not LAST night!

[jodi818]

Bio-identicals have changed my life as well. I was diagnosed with a fairly large fibroid. I have not have children yet, (I'm 35) and the dr. wanted to do a mini C section to remove the fibroid. I said no after learning about bio-identicals. I can now attest, that I can actually feel that the fibroid is gone! I will have tests this spring to confirm this. My mood swings have evened out and my *** drive is better.

To Unidough: go to the link provided by this website about Dr. Erika. She sells it. Your natural food store may as well. Also go to Arbonne.com and they have a cream that they sell. I am a consultant for this company, but search for a consultant close to you.

[bdevine8]

I have been taking black cohosh and chasteberry for about 8 years now, adding the progesterone cream from yams maybe 2 years ago. I feel great, never have any 'symptoms'. Synthetic hormone replacment therapy pills are made from horse urine!! Let some stupid guy take horse urine pills before they expect us to take that!!
Pharmeceutical companies and the medical community that they train should realize that the American public knows that there is something truly amiss in healthcare - and that bad medicine - and the disgraceful attempt to cover it up will never be acceptable. Their time is becoming shorter and shorter, unless they get back to making people healed wholly.

[ppelton]

The menopause story really amazed me. Women were willing to take the risk with so-called natural cures making naive assumptions that they would be safer than clinically tested synthetic hormones. I am surprised that someone concerned about taking a drug approved by the FDA would have no qualms about taking a "drug" approved and tested by no one. The interviewer (an M.D.) complained that pharmaceutical companies were reluctant to pay for long-term studies of a substance for which they cannot return a profit. This is not surprising. However, if a company offered to do such an expensive, long-term, well-controlled trial to explore the safety and efficacy of these concoctions and they proved negative would it make a difference? Would the naysayers believe it anyway? Why don't the generic companies and the "natural product" distributers pay for these trials? After all, they are also making a profit on us poor menopausal women (yes I am nearly at that stage, wondering myself how I will deal with it)? The placebo effect can be very powerful and who knows what is really going on with these so-called "natural cures."

How about a little exercise, a good diet, less stress, and a positive attitude? If that doesn't work and the hot flashes are unbearable, I am going to bet my health on short-term therapy with low-dose synthetic hormones. At least, I will know the risks and benefits (and I will know what I am actually being given).

[allie3006]

can we really trust the words of a Medical Doctor that is featured in the National Enquirer?? I was very disappointed when I saw her column in a rag paper that does not print the truth. So how can we believe her????

[mrwhitey3]

Ah yes, there was Katie out there shilling for big pharma tonight with a hatchet job by asking a hypothetical negative question "If you treated 100 women with these hormones and they all died of cancer 10 years from now would it be worth it?"

First, how many people did she have to interview to find one stupid enough to fall for the defend a negative hypothetical question trick?

Second, does she connect this type of "journalism" with her current popularity rating below a rerun of a sitcom?

Dump Katie! America needs a real anchor that delivers actual real news worse than ever. Until then, I get my news at whatreallyhappened.com and I see what the shills are selling on mainstream media like drudge and CBS. Love the chance to fight back though!

[babedoll1]

I was very excited to learn of the compounded hormones available 3 years ago when I read Suzanne Sommers' book and I tried for a year to use them. The first compounding pharmacist that I finally located managed to always short me on the amount that I needed. He also was always forgetting to mail it to me on time so that I would be able to use it the correct number of days in a row. I finally located another one who was much more accomodating, but after trying for a year and driving a long distance to keep seeing the doctor trained in this, I gave up because she just couldn't figure out the right combination that I needed. I was suffering with hot flashes and itching day and night. At this point, I wanted to kick Suzanne Sommers' ***! I feel that this is for those fortunate few who have more time and money to devote to this search, not to mention better physicians and pharmacists than we have access to in this rural agricultural area. I finally went back on the patch.

[annefrancis-2009]

I am concerned that Ms. Couric would cast a negative cloud on bioidentical hormones if they have not been proven to cause cancer as the synthetic hormones have been documented to do.
As a woman of menopausal age, she should be more mindful of playing to the pharmaceutical companies' corner as they no doubt are threatened by increased sales and interest in natural hormone therapies. Women are not dumb! They are listening and taking control of their health options. Even untested, they will try the natural options and find relief of menopausal hot flashes. The proof is in the pudding.
I would have appreciated this story more if she had found a bioidentical company who IS doing controlled tests or offered information to people will to serve as volunteers for bioidentical testing. Don't fear monger this important issue! Thanks. Anne Francis.

[trueprogress]

With all these hormonal and other problems, we need more research and care before we take some over the counter drug which has not been tested. You would not give to your children or your dog, but you take it yourself. It shows just how awful the symptoms are, and how desparate we are in this youth oriented society, to be getting older. For me, the wrinkles are a sign of wisdom. For others, getting older is a shock which can ruin an otherwise great life and family. Lets see Cattie with her wrinkles and all, why does the show seem so fake ?
Women have too high expectations for not getting olders. IT shows a sign of personal growth.

[slcat1106]

Bioidentical progesterone is worth researching for yourself. You will find that progesterone is the hormone that pregnant women have in their bodies at extremely high levels to help with the pregnancy. That tells you right there that it should be safe. Synthetic progesterone is made from pregnant mare urine and horses do not have the same hormone make up as humans. Remember, just because the FDA approves something does not mean it is safe and just because it has not been approved does not mean it is unsafe.

Again, research this for yourself. There is plenty of info out there. Many, many people are getting lifechanging benefits from Bioidentical Hormones. They can be purchased through a compounding pharmacist or health food stores or companies like Arbonne.

[lww11]

I am 59 years old and had a complete hysterectomy 12 years ago and spent 12 years in hell. I went from being a mild mannered, easy going person to being a grouchy irritated witch most of the time. I went from having a very satisfying *** life to no drive at all. For 12 years I never slept over 2-3 hours without waking up. I gained 50 pounds without changing anything about my diet or exercise. I started going to a new doctor this summer who gets the connection between aging and hormones and she put me on bioidentical gel hormones and for the first time in 12 years I slept all night. It's amazing how much better your brain works when you get uninterrupted sleep.
Don't tell me they don't work better than synthetic drugs. My insurance won't cover the hormones but I'll pay for them anyway but it's sad that people who can't afford them won't get them because of drug companies and insurance companies. I know the difference now and I won't go back to a one for all pill that doesn't work for me.

[lww11]

I am 59 years old and had a complete hysterectomy 12 years ago and spent 12 years in hell. I went from being a mild mannered, easy going person to being a grouchy irritated witch most of the time. I went from having a very satisfying *** life to no drive at all. For 12 years I never slept over 2-3 hours without waking up. I gained 50 pounds without changing anything about my diet or exercise. I started going to a new doctor this summer who gets the connection between aging and hormones and she put me on bioidentical gel hormones and for the first time in 12 years I slept all night. It's amazing how much better your brain works when you get uninterrupted sleep.
Don't tell me they don't work better than synthetic drugs. My insurance won't cover the hormones but I'll pay for them anyway but it's sad that people who can't afford them won't get them because of drug companies and insurance companies. I know the difference now and I won't go back to a one for all pill that doesn't work for me.

[lww11]

I am 59 years old and had a complete hysterectomy 12 years ago and spent 12 years in hell. I went from being a mild mannered, easy going person to being a grouchy irritated witch most of the time. I went from having a very satisfying *** life to no drive at all. For 12 years I never slept over 2-3 hours without waking up. I gained 50 pounds without changing anything about my diet or exercise. I started going to a new doctor this summer who gets the connection between aging and hormones and she put me on bioidentical gel hormones and for the first time in 12 years I slept all night. It's amazing how much better your brain works when you get uninterrupted sleep.
Don't tell me they don't work better than synthetic drugs. My insurance won't cover the hormones but I'll pay for them anyway but it's sad that people who can't afford them won't get them because of drug companies and insurance companies. I know the difference now and I won't go back to a one for all pill that doesn't work for me.

[bhrtman]

I just wanted to add my perspective. As a compounding pharmacist specializing in BHRT, I want to thank all of the women who have given positive testimonies regarding this therapy. The reason I got into BHRT was a personal issue that was resolved amazingly through BHRT. There is no better way than patient testimony to spread the word on this treatment option. I always tell patients to use common sense, and also to "follow the dollar". It's amazing there are certain drug companies that want us to stop making BHRT for patients because they say they are concerned about patient safety. I encourage all users of compounded medications to visit www.savemymedicine.org to learn more about current issues in pharmacy compounding. On a personal note, there is no greater feeling than getting a phone call from a patient saying "you saved my life and my marriage". Wow.....I sleep very well at night.
Regards,
Glenn

[robinm9]

Katie: I've always respected you as a journalist--until now. Why did you NOT report that in the interview you did with the president of the North American Menopause Society that this organization receives funding from Wyeth - the same pharmaceutical company which manufactures the synthetic hormone Premarin (PREgnant MARE uriINe - yes that's where the name comes from!). Katie - whether you intentionally left out this information or neglected to research it, you let all of your viewers down. In addition, why didn't you get someone from Wyeth on your show and ask THEM if they feel badly about all the cancer and other health problems their product has ALREADY caused? I doubt they do because they are still selling their product despite studies that show it's dangerous. Not only that, they have filed a consumer complaint with the FDA to stop the manufacture of bioidentical hormones! I have a suggestion, Katie, do a story on whether anyone at the FDA has received gifts, money, or trips from anyone in the pharmaceutical industry. I'd be very interested in an expose on that issue. Oh wait, aren't the pharmaceutical companies big advertisers for our network tv stations? Guess a story like that won't happen anytime soon. So much for objective reporting in America! Sign me disgusted and disappointed!

[fgarcia571]

Dear Katie:

My doctor recommended a complete hysterectomy at the age of 46 due to endometriosis. Needless to say the after effects of this operation were terrible. I went into instant menopause and I have a heart condition so I could not take the hormones that doctors were prescribing.

I was recommended bioidentical hormones. These hormones have saved my life -- I am currently 50 and I don't know what I will do if they stop making them. My gyn, endocrinologist and cardiologist check me every six months and prescribes my hormones accordingly. Please read "the Wisdom of Menopause" by Dr. Christianne Northrup, "What doctors don't tell you about menopause" by Dr. John Lee. These doctors tell you that doctors and pharmaceutical companies are losing money and are pushing for legislation. I know you are a superb advocate for women's rights and have always risen to the occasion of presenting the facts on any subject. I speak for the thousands of women in this country that need safer and better medicines to deal with menopause, pms and other women hormonal imbalances. God bless you.

[indiana127]

I have been on BHRT for five years now. It was the best decision I ever made for my health. I have plenty of energy, sleep well, *** drive is excellent, my mind works well, and I'm not an irritated, ****** menopausal woman. I recommend them to any woman with hormonal problems, menopausal or not.

BTW, there are studies on bio-identical hormones. Just go to www.salivatest.com and read, read, read!

I know what I'm talking about, because I work for a compounding pharmacy and wouldn't encourage women to look into BHRT if I weren't convinced of it myself. All of our patients are monitored by taking saliva tests at periodic intervels. How many women on synthetic hormones are ever monitored by blood or saliva tests by their doctors? Virtually none! Talk about unsafe. With Premarin, every woman was supposed to fall into four different dosage categories, while bio-identical hormone replacement therapy is tailored just for your body chemistry.

These media reports are barely scratching the surface regarding the amazing benefits of bio-identical hormones. While Wyeth and other pharmaceutical companies have been busy killing women for the past fifty years by their patented drugs, bio-identicals are now giving women their lives back. And Dr. Susan Love's caution to take them only for 3-5 years is pure bunk, right from the mouths of the pharmaceutical companies (the quote she was echoing refers to their new line of milder HRT, mostly still synthetics).

[drishman-2009]

Where does Dr. Utian get his information? Bioidentical estradiol is most definately FDA approved. It comes in commercial preparations in pills, patches (Vivelle Dot) as well as compounded creams. Bioidentical progesterone is commercially available Prometrium or can be compounded. One arm of the more recent PEPI trial used Premarin combined with bioidentical progesterone as opposed to medroxyprogesterone (found in PremPro) and there was no increase in breast cancer. In addition, it has been noted in several studies that oral estrogens increase CRP which is a cardiovascular risk factor and probably accouts for the minute increase in strokes noted in the WHI. Transdermal estrogens(patches and creams) do not increase CRP. Besides, do you want to take estrogen derived from horse urine which has over 30 different estrogens most of which are not even found in the human body? Or, wouldyou prefer to take what occurs naturally in your body? Another question, who funds NAMS?

[drishman-2009]

Where does Dr. Utian get his information? Bioidentical estradiol is most definately FDA approved. It comes in commercial preparations in pills, patches (Vivelle Dot) as well as compounded creams. Bioidentical progesterone is commercially available Prometrium or can be compounded. One arm of the more recent PEPI trial used Premarin combined with bioidentical progesterone as opposed to medroxyprogesterone (found in PremPro) and there was no increase in breast cancer. In addition, it has been noted in several studies that oral estrogens increase CRP which is a cardiovascular risk factor and probably accouts for the minute increase in strokes noted in the WHI. Transdermal estrogens(patches and creams) do not increase CRP. Besides, do you want to take estrogen derived from horse urine which has over 30 different estrogens most of which are not even found in the human body? Or, wouldyou prefer to take what occurs naturally in your body? Another question, who funds NAMS?

[hym8nts]

As a compounding pharmacist, I am deeply offended by the picture painted by Dr. Utian. My husband and I are pharmacists who own a compounding-only pharmacy and have installed one of the most advanced cleanroom facilities to not only ensure the safety of the patient and those who make the medications, but also the quality of the environment in which all the compounding takes place. We underwent extensive training and are highly regulated by the USP *notably 795 and 797 * which clearly defines the legal parameters in which non-sterile and sterile products are prepared, stored, and dispensed. In addition to the USP, we are regulated by state and federal laws, individual state Boards of Pharmacy and agencies responsible for medical quality assurance. We are still, at the end of the day, very highly trained PROFESSIONALS. Everything we make is from the finest raw ingredients available and is legally held to a much smaller margin of error than the larger manufacturers. I wonder how many of the big drug companies lose sleep at night knowing that "what we do" is still centered around patient care and not dictated by shares of stock. Money and Power corrupt. Patient Care suffers. We take this very seriously and will continue to fight for our rights to provide quality patient care. Fear and Ignorance should never be allowable tactics used to determine therapeutic outcomes. Heather Wilson Rutkowski, RPh. (Professional Compounding Services in Destin, FL)

[brianprather]

It is very interesting that NAMS would be opposed to Bio-Identicals, since the majority of their financial contributions comes from Wyeth (maker of Premarin) and the drug industry in general. "They carry exactly the same risks and exactly the same potential benefits as the commercial products." Dr. Utian should know that hormones with differing chemical structures will react differently, and carry different safety profiles. Not enough studies have been performed on Bio-Identicals to guarantee their safety. Equally, no studies have been done to show that Bio-Identicals are more dangerous than their synthetic counterparts. Therefore, Dr. Utian%u2019s comparison of synthetic hormones to Bio-Identical Hormones is not only unscientific, but also irresponsible, inflammatory & unsubstantiated. Equally irresponsible was the hypothetical question posed by Ms. Couric. She somehow infers that Doctors who prescribing Bio-Identicals are putting their patients at risk. Premarin & other synthetic hormones have been shown in scientific tests to be dangerous & carcinogenic, yet they are still widely used today. Apparently that is perfectly fine.

Gather the facts & make your own educated decision. And if you decide that you want to have the option to pursue Bio-Identicals, go to www.savemymedicine.org to preserve access to Bio-Identical Hormones & other compounded medications.

[brianprather]

Anyone interested in pursuing BHRT (Bio-Identicals) should visit www.savemymedicine.org. This website is dedicated to preserving patient access to Bio-Identical Hormones, as well as other compounded medications. There are forces (Drug Companies, Pharma, Insurance Companies, etc.) who are trying desperately to block women%u2019s access to these hormones. Why? Corporate greed. Bio-Identicals are cutting into the profit margins of the Drug Companies, who provide kickbacks to the insurance companies that cover their synthetic hormones. www.savemymedicine.org. Let your voice be heard. Protect your access to Bio-Identical Hormones.