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Bioidentical hormones — Ask Dr Jean

Ask Dr Jean 6 May 2019
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When it comes to women's health, there is no such thing as a silly question. Do you have a question you want answered, but have been too afraid or embarrassed to bring it up with your GP? Or you forgot to ask while you were in the doctor's surgery? Now, you can 'Ask Dr Jean'.


This question has been answered by Jean Hailes endocrinologist (hormone specialist) Dr Sonia Davison (pictured).

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Question

Hi. Bioidentical hormones have been recommended for me to treat hot flushes, anxiety and depression. Is there a blood test that I can do that could show what I am lacking in and what I am needing? Many thanks, Jill.

Answer

Without knowing any further details I am assuming you are either perimenopausal or postmenopausal and have bothersome symptoms. Blood tests are not useful in this situation if you are of typical age (40s to 50s) and have typical symptoms that women have around menopause, mainly because the hormone levels fluctuate considerably during perimenopause, and the oestrogen levels just remain low after menopause.

What will be useful is for you to see a health practitioner who has expertise in managing perimenopause and menopause. They can guide you as to the best evidence-based treatment for your symptoms and also consider other factors like your general health, your bone health and your cardiovascular risks.

Bioidentical hormone therapy is often custom-compounded treatment that has not been tested for safety and there are concerns that women may be at risk due to this lack of safety and effectiveness testing that other types of prescribed hormone therapy products must undergo. In particular, the progestogens in these products do not guarantee womb lining protection and the Medical Journal of Australia previously had a report of some Australian women who had womb lining cancer after having bioidentical hormone treatment.

It is possible, however, to have 'body-identical' hormone therapy, which has been rigorously tested and is identical to the hormones previously produced by your ovaries. This is prescribed treatment that is manufactured by pharmaceutical companies under strict conditions, and the safety profile (and risks) have been well established. I recommend looking at the Australasian Menopause Society (AMS) website, under the Find an AMS Doctor page, to seek a menopause expert GP in your area who can guide you. Our website (and the AMS website) have more excellent information about bioidentical and other hormone therapy and menopause/perimenopause management in general.