(310) 979-3434
Dr. Rashel, Integrative Medicine

Natural (Bio-Identical) vs. Synthetic HRT

Natural (Bio-Identical) vs. Synthetic HRT

Based on current medical literature it is clearly demonstrated that natural hormones are superior to their synthetic counterparts.  Natural, bio-identical hormones are very different from their synthetic versions often having completely opposite physical and cellular effects.  It is therefore critical that women especially, be given the information that these natural hormones do not have the negative side-effects of the synthetic hormones and in no way pertain to the conclusions reached by the Women’s Health Initiative (WHI) study.  Natural hormones are a safe and a more conservative approach to hormone replacement therapy and do not carry the risks associated with Premarin and Provera.

Some of the side effects associated with synthetic hormones such as Premarin, Provera, (oral estrogens) and any synthetic Progestin (the two components in Birth Control Pills) are the following:

Increased risk of stroke and Heart attack

Increased risk of certain Cancers

Negate positive effects of the other hormones in the body



Weight Gain


‘I’ve heard Hormones are dangerous for women’-WHI study confusion

There is a great deal of confusion about the meaning of the recent study known as the Women’s Health Initiative (WHI) which was studying the effects of the most prescribed drug combination  Hormone Replacement therapy for menopausal women Premarin (conjugated equine estrogens) and Provera (medroxyprogesterone acetate).  This study had to be stopped because use of the studied drugs increased the risk of breast cancer, heart attacks, blood clots, and stroke.   This study surprised many physicians whereas other doctors had been discouraging patients from synthetic hormones and encouraging natural prescription hormones which have been shown to be beneficial and not have the risks associated with synthetic hormones.  This study also however resulted in the confusion among some of the public that ‘hormones are bad’ unfortunately resulting in some patients not benefiting from the benefits of natural hormone therapy.

Progesterone is naturally produced by a woman, and can also be derived from the Yam but because the drug companies cannot patent this natural hormone, they must alter its molecular structure so they can then patent it in order to make it financially worthwhile to market and sell.   When this is done Progesterone is changed into progestin used in Provera and Birth Control pills.  This alteration of Progesterone’s molecular structure results in some opposite effects of that of natural Progesterone.  One illustration of this is that progesterone is secreted in high amounts in women during pregnancy to promote fetal growth but progestins during pregnancy will kill the fetus.   Provera (Brand synthetic Progestin) was shown to protect the uterus from cancer from unopposed estrogen and this is how it was approved by the FDA.  It was not known at the time however, that it would not protect the breast from cancer like natural progesterone does.   The alteration of natural progesterone’s molecular structure also changed it to a compound that constricts coronary arteries and other vessels significantly increasing the risk of heart attack and stroke whereas natural progesterone has a vasodilator effect that decreases the risk of heart attack and stroke.

Premarin, the most popular brand synthetic drug for estrogen replacement therapy is derived from pregnant horse’s urine and contains mostly estrone and a number of equine (horse) estrogens that are not natural to humans.  These foreign estrogens are highly inflammatory  and carcinogenic when bound to human estrogen receptors.   A combination of the natural estrogens has been shown to protect against breast cancer and result in a reduction in breast cancer risk.  When this is added to natural progesterone’s powerful breast protective effects, one would expect a significant reduction in breast cancer in women on natural hormone replacement than in women on no therapy.   Also when Premarin is given orally it passes through the liver and significantly increases clotting factors and the risk for stroke and heart attack.  This results in multiplied heart attack risk when Provera is added.  When estrogens are given transdermally in patch or cream form this problem is avoided.  Synthetic progestins are toxic regardless of the form prescribed.

It is critical to understand that synthetic hormones are not equivalent to bio-identical (natural) hormones and the side effects seen with synthetic hormones are not seen with natural hormones.  It is also important to understand that the route of administration of hormones can negatively impact the body, as seen with the oral administration of estrogen not with transdermal administration.  It is also important to understand that estrogen should never be taken without progesterone regardless of whether the woman has a uterus or not.  Unopposed estrogen can cause many health risks including cancer and should always be used along with progesterone.   There are progesterone receptors in the brain, breast, as well as in the uterus, therefore it is critical to take progesterone along with estrogen even if the uterus has been removed.  Conventional medicine often disregards this fact and patients can be at greater risk for cancers, brain edema, anxiety, insomnia and heart disease when taking estrogen alone.

Customized natural hormone therapy is the only way that hormones can be replaced safely.   Hormone replacement should be considered only after thorough assessment of all your body’s hormones and their interaction.   Your hormone response is as unique as your fingerprints and one size does not fit all.

For more information about natural bio-identical hormone replacement therapy contact us at (310) 979-3434 or complete our New Patient Form.