Bio-identical steroid hormone replacement: selected observations from 23 years of clinical and laboratory practice.

Author: Wright JV.

Publication Year: 2005

Citation: Ann N Y Acad Sci. 2005;1057:506-24.

This review discusses the types of estrogens used in bioidentical hormone replacement, including their dosages and routes of administration. The author advocates the use of natural hormones because of the problems with using non-human identical synthetic hormones, highlighted largely by the Women’s Health Initiative trial.  However, bioidentical estrogens must be properly monitored to ensure appropriate dosing, just as is common for thyroid hormone replacement.  The metabolism of estradiol to estrone and estriol is discussed.  The author advocates the use of iodine supplements, which stimulate the metabolism of estradiol towards estriol.  The amount of circulating estriol relative to estradiol and estrone is important in breast cancer risk: the greater the relative amount of estriol, the lower the breast cancer risk.