BioIdentical Hormone Replacement Therapy (BHRT)
A 32 year old female patient came in to my clinic one day complaining of fatigue and just feeling off. She was very tired and knew something was wrong yet nobody could figure it out. She had seen several different physicians and they all told her that her “labs were normal” and their solution for her was that she was going to have to learn to live with it. Needless to say she was very frustrated.
I asked her when she started feeling bad and she told me “November of 2012.” So I had to ask what happened in November of 2012 and she had no idea. She couldn’t identify any reason or trigger for this. There had been no apparent changes. So I went on to ask the other questions I often ask to patients like this. I got around to her menstrual cycle and this was clearly a problem as she hadn’t had one in a couple of years. I asked her why and she said “Oh, I have this thing implanted in my arm.” It was an Implanon device which secretes Etonorgestrel, a progestin. I asked her when she got it and she said “October of 2012.” I replied “I think we found our cause here.”
We decided to remove the device right then which we did. I ordered my baseline lab panels to ensure no other issues and asked her to follow up with me in 2 weeks to review the labs.
She came back in 2 weeks nearly in tears. She felt 80% better for the first time in over 2 years. Her Fiancee was actually mad. He asked why they had been to so many different doctors and they couldn’t figure it out and didn’t try to fix her issues. At the same time he was very grateful that she was feeling better.
The Etonorgestrel is a synthetic hormone but it does have some effects similar to progesterone. It works a little differently and it is metabolized a little differently. Progestins do not reproduce the same effects in the human body as progesterone.
Side effects of these progestins include:
- Increased appetite
- Weight gain
- Fluid retention
- Irritability
- Depression
- Headache
- Decreased energy
- Bloating
- Breast tenderness
- Decreased sexual interest
- Acne
- Hair loss
- Nausea
- Insomnia
- Interferes with the body’s own progesterone production
- Doesn’t help balance estrogen
- Remains in the body longer
- Can cause spasm of coronary arteries
- Stops estrogen’s protective effects on the heart
- May increase symptoms of progesterone loss
- Increases LDL
- Decreased HDL
- Only protects the uterus from cancer
- Counteracts many of the positive effects on estrogen on serotonin
BioIdentical Hormones refers to hormones that have the same (identical) structure as the hormones in the human body.
