Bio-identical Hormone Therapy (BHT) was conceived three decades ago by US physician Dr Jonathan Wright as a natural alternative to HRT for peri-menopausal women. The combination of oestrogens, progesterone, testosterone, and DHEA (a natural steroid which increases speed and stamina) was soon found to give a secondary benefit – youthful wellbeing and vigour.
Bio-identical hormone therapy routinely includes key anti-aging hormones such as oestrogen, progesterone, testosterone and DHEA, which can be taken orally in tablet form, administered as a topical gel or even injected.
But it can also include a wide range of other things, depending on the patient’s ‘deficiencies’.
Wright himself publicized the link to increased libido, co-writing a best-selling book (with Lane Lenard, Ph.D.) entitled Stay Young and Sexy with Bio-Identical Hormones, all supported by 556 citations to the medical literature.
In fact, hard scientific evidence supporting BHT is slim but the sheer volume of demand for the therapy- an estimated one million women in the US have switched to BHT from conventional HRT – suggests that the American proponents of the treatment have won the PR war.
In the US, bio-identical hormone therapy already has a huge following and demand is increasing all over the US, but the hotspots are where you would expect; LA, Las Vegas and New York, with growing interest in Florida too.
The rationale behind the therapy is simple – perhaps deceptively so. Everyone relies on hormone levels to stay healthy and well, and ageing is acceleratedwhen certain hormone levels start to decline. In fact, according to Dr Frances Prenna Jones, an age-maintenance cosmetic doctor based in London’s Mayfair, hormones are in perfect balance at age 26. “Age maintenance is the number one issue that patients ask me about,” she says. “It’s about keeping what you have in your late twenties going forward into the future.”
Balancing hormone levels and ‘topping up’ key anti-aging hormones should help to keep the appearance of aging at bay, while also assisting with cardiovascular health, bone density and memory. “Natural bio-identical hormones are identical to the hormones found naturally in your blood, so they cause fewer side effects than the synthetic hormones found in conventional HRT,” explains Dr Prenna Jones, who refers many of her clients to bio-identical hormone guru Dr Neal Rouzier based in Palm Springs, known as The Hormone Doctor in the US.
So far, so logical. But, in fact, we are taking a lot on trust when we take BHT preparations, which come under the banner of complementary medicine and are created in compounding pharmacies not by drug companies.
This is early days and there are not only gaps in our knowledge but black holes. The evidence simply isn’t there to prove that bioidentical hormones mixed by pharmacists are safer than commercially prepared hormones, – a point reinforced by the US Food and Drug Administration. In fact, the process of compounding the hormones may even carry extra risks, because of the possibility of contamination and incorrect dosages.
Even the way that doctors decide on what BHT is right for you is controversial. Typically, patients undergo blood tests and/or saliva tests to determine any deficiencies, but the accuracy and efficacy of this process is unproven. And the claim that bio-identical hormones are natural? Many of the bio-identical hormones are indeed derived from natural plant sources – often yams and soya – but so are many types of HRT.
Unlike HRT, the ideal time to start BHT is staggeringly young – long before any age-related changes take place. “I see women in the late 20s and early 30s who already have symptoms of ageing, such as PMS, or breast tenderness, which are signs of progesterone decline,” explains LA based Dr Rashel Tahzib, a family practice physician with a ‘super’ specialism in anti-ageing. “People here in LA are very image conscious, and they want to emulate the Hollywood crowd, but they are also concerned about feeling good. They would rather avoid chronic disease by preventing ageing on a cellular level.”
Hormone readjustment is also credited for helping to maintain weight – a key focus for many of Dr Rashel’s clients.
In Europe, the biggest market for BHT is Germany – not really surprisingly given the nation’s keen interest in alternative medicine (most BHT patients in the UK will be taking remedies created for them by pharmacies in Germany). Parisians are also big fans, and London has a growing number of anti-ageing practitioners.
Most BHT patients pay between £3000-£4000 per year and the therapy can be continuous as the prevention of aging is a full-time commitment. And not everyone is suitable; doctors will exclude women who have a family history of breast cancer or deep vein thrombosis. Putting aside the demands of the image-conscious Hollywood elite to look fabulous as they sashay to the next Premiere, BHT should be the key to living well for as long as possible – an increasingly important goal when the post Baby Boomers will be expected to work into their 70s, without showing signs of flagging.
Supporters say that we may look forward to a future when legions of women will have their hormone levels checked as casually as they visit their dentist. But – sorry to say for all if us hoping to keep aging at bay indefinitely, BHT could prove to be another expensive dead end in the quest for the juice of youth. “The truth is that no one knows and there are no long-term clinical trials to prove it one way or the other,” says Dr Mike Bowen, consultant gynaecologist and obstetrician based in Harley Street, who prefers to prescribe conventional HRT because it has 50 years of gold-standard trials behind it. “The best we can say is that it probably won’t do much good but it won’t do much harm. Ultimately, history will tell.”