09 Oct Traditional Herbs or bio-identical hormones: Which is Better?
Thanks for asking this important question. My position on this particular issue is the same as it has always been. Use the modality that works for you. And that could be traditional herbs or bioidentical hormones! Though different, both are good choices.
Believe it or not, there are women who go through perimenopause and menopause without needing any support. One day their periods just stop. They do not experience the very common symptoms of sleep problems, hot flashes, and mood shifts. But for those who do—the majority—relief is often found using traditional women’s herbs such as maca, Pueraria mirifica, black cohosh, or vitex.
Traditional women’s herbs are phytohormones. And they have what are known as adaptogenic, moisturizing, and tonifying effects. These effects are what results in relief of many menopausal symptoms. When an herb is adaptogenic (or an adaptogen) the affect it has differs, depending on your hormone levels.
Phytoestrogens act as natural SERMS (selective estrogen receptor modulators), helping the body adapt to its current hormone levels. For example, if your own estrogen levels are too high (estrogen dominance), a phytoestrogen will exert a kind of modulating effect to stabilize the cell and protect it from overstimulation. If your estrogen levels are too low, the same phytoestrogen will have a tonifying and moisturizing effect.
Because of their adaptability, traditional herbs such as maca, Pueraria mirifica, and black cohosh—all phytoestrogens—are often a first choice for many women looking to boost estrogen levels naturally. Vitex is a good choice when trying to boost progesterone levels. But if herbs don’t provide enough relief, then I suggest a “dusting of hormones.” And that means the lowest dose of bioidentical hormones that works.
To give you some further understanding of the differences between herbs and bioidentical hormones, here’s a mini-lesson in hormone receptors—the places on the cell membrane where substances can attach and produce an effect. There are two types of estrogen receptors: alpha and beta.
The alpha estrogen receptor is the one that gets the most attention because that is the one that mammalian estrogen binds to—resulting in typical estrogenic effects on breast and genital tissue.
Phytoestrogens, on the other hand, bind to the beta estrogen receptor. Their three-dimensional structure is a different shape, so they do not interact with estrogen receptors the same way as bioidentical or synthetic hormones do—and therefore they don’t produce the same biologic effects.
Bioidentical hormones and synthetic hormones have a different three-dimensional structure. Bioidentical hormones, although created outside your body, have the identical molecular structure as the receptors in your body. This literally makes them a good fit. And this is one reason I recommend them.
Synthetic hormones, like Premarin and Provera, have a molecular structure that is different than bioidentical hormones. This may be why their safety has come into question so many times. I won’t go into more discussion here about the benefits of bioidentical hormones or the safety issues with synthetic hormones, because I’ve written so much on this subject.
I always suggest you start with the simple things first, like changing your diet and starting an exercise program. If you don’t get the relief you want, move on to another solution—one that is just right for you and your body. This may require experimenting, and for you to use different options at different times.
As an example, Lorraine (a patient of mine), started with traditional women’s herbs when she was in perimenopause. They helped for a while, but as she got closer to menopause (the time of her last period) Lorraine decided to try bioidentical hormone replacement for her menopausal symptoms. She was quite happy with the bioidenticals for a few years. But, as her body adjusted to her new normal, she found she no longer needed the bioidenticals and switched back to herbs.
If there’s one thing I’ve learned in my two decades of practice it’s this: There is no one-size-fits-all approach to optimal health for any given woman (This makes a great Tweet! Please share). But there is one resource you can always, always count on to give you the right answer. And THAT is your own inner wisdom. Your body knows what it needs. And so do you. When it comes to making any decision, gather information, go within, offer your question to your inner wisdom. And know that you will be given the right answer for you.
If you or someone you know needs help sorting their menopause options, feel free to drop me a line on the “contact us” page on this site. I treat patients locally at my Naturopathic practice in Vancouver, B.C. and worldwide via phone or Skype.
To your best health!
Dr Tasnim Adatya
Naturopathic Physician, Menopause Clinician, Acupuncturist, and Health Educator