Natural Hormones vs. Bio-identical Hormones

What is the definition?

I am frequently asked by my menopausal patients to place them on "natural hormones." Additionally, many pre-menopausal and newly menopausal patients come to me already taking non-prescription "natural hormones" obtained from their local drug store. I have been asking patients what they think "natural" means and I am amazed at the answers I get!

I asked my patients

Some patients tell me that natural means that the hormone comes directly from nature, unaltered in any way. Some say that natural means that the hormone came from plants. Some believe that natural means that the hormone taken is in the exact same form as what is naturally found in the body. Others have told me that natural means that the hormone is produced in an "organic" way (like organic produce). And some patients have no answer to this question at all. They just take the manufacturer's word that the product is natural without ever asking themselves what natural means!

I asked the experts

When attending medical conventions, I have asked this question to representatives of natural hormone products. They answer that natural really means that all of the initial ingredients were natural prior to any processing or chemical conversions. Sometimes I get new-age answers such as that natural means that the "natural energy" from the original ingredients is maintained by using "gentle" synthetic and purification techniques.

My own definition

After many confusing discussions, I have developed my own definition of what is meant by the term "natural." Basically, any hormone promoted by the pharmaceutical industry is by definition "not natural", and any hormone promoted by the vitamin/supplement or alternative health-care industry is (of course) "natural". I will give you some examples to support this definition.

Is Premarin Natural?

The estrogen hormone Premarin™ is isolated from the urine of pregnant horses. It is not chemically altered in any way – it is just purified and concentrated. This meets the definition of natural as coming from a natural source. Yet as a prescription drug, nearly all patients would declare Premarin not to be natural.

Another example is the estrogen hormone Estrace. This hormone is pure estradiol, the exact same molecule as found in the body. Yet, because it is a prescription drug, many patients still refuse to accept this product as natural. The same is true for Prometrium, a prescription version of pure progesterone (identical to that found in the body).

Not surprisingly, Progesterone cream from yams (Mexican yams) is very popular with patients. They rub it on the skin. It is available without a prescription. Nearly all users would defend this product as natural. The truth is that yams contain molecules which must be chemically converted before there can be any detectable estrogen or progesterone. So then, why is this type of hormone product considered natural? Because it is purchased non-prescription, and is touted by the vitamin/supplement industry as natural.

Please do not assume that my confusion as to the meaning of the term natural means I have a bias against natural hormones or against viable alternative treatments for menopausal women. I do not. At different times, I have placed patients on soymilk, soy extract (available in pills), herbs (such as remifemin, black cohosh, dong quai and others), vitamins, minerals and supplements, traditional prescription hormones as well as my own version of natural hormones.

Don't go by the Product's Name

Have you heard of Estroven? To me, this product is the greatest success story in marketing I have ever seen in the natural products industry. People just love the name of this product. They think that they are buying a non-prescription form of estrogen. They are not. Estroven is just another common non-prescription supplement (of black cohosh, soy extract, herbs and vitamins) used to help menopausal women. Oh, but the name is amazing and clever. Great marketing, Wall Street.

Bio-identical Hormone Therapy

This term has pretty much replaced the term natural hormones. Bio-identical also has different meanings:

1. Bio-identical hormones are identical chemicals to those found in the human body.

2. Bio-identical Therapy requires that the hormones have to be taken identical to mother nature. In other words, a post-menopausal woman would have to take cyclic hormones and have a period every month to meet this definition.

Option #1 is the predominant definition. Our medical practice believes very strongly in this approach. If hormone therapy is right for you, we will use bio-identical hormones.

I Object to False Advertising

Many people inherently trust hormone products that are "natural." If it's natural, it must be safe, and it must be good for them. In order to create a market for over-the-counter natural hormones, the "natural" products industry is taking advantage of people's natural fear of prescription drugs, their strong natural desire to be in charge of their own health without having to go to the doctor and their natural trust of natural products.

They are confusing and possibly endangering the public by attaching the word natural to every possible product without ever defining exactly what is meant by natural in the first place.

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