Ask Barbie: Risks for Blood Clots and Oral-vs–Transdermal Estrogen

Ask Barbie: What Are Bio-identical Hormones?

…and why you MUST know this!

Introduction

Welcome to Ask Barbie, where I answer all your burning questions about hormones, menopause, and gynecology.
Today’s Ask Barbie question is about sex hormones. More specifically, it’s about bio-identical sex hormones.

The question is: What Are Bio-identical Hormones?

Definition

As usual, I’ll start with a definition. But in this case, I’m going to define what bio-identical does mean and what bio-identical does not mean.

First you need to know that there are two different terms that people use interchangeably for these hormones.

They are:

  1. Bio-identical
  2. Body identical.

They mean exactly the same thing. So, throughout this article, I will use bio-identical to cover both terms.

The term bio-identical or body identical merely means that the molecular structure of the hormone is identical to the molecular structure of that same hormone as produced by your own body.

That is all it means. It is only about molecular structure.

But there are many things that bio-identical does not mean.

It does not mean that it is:

  • Better
  • Safer
  • or more effective

And the most surprising thing of all is that the term bio-identical does not mean that it is “natural.” I’ll tell you more about this later. It’s a huge area of misinformation.

Marketing and Misinformation

So, the term bio-identical is really only a biochemical term. It refers only to the biochemical molecular structure of the sex hormone.

But, because of misinformation, it has become a buzzword and a marketing word. People misinterpret the meaning of bio-identical to mean all sorts of other things that it doesn’t mean.

Of course, marketers use this word to entice you to buy their products. And that is why I told you that bio-identical does NOT mean that the sex hormone is better, safer, more effective,or “natural.”

These claims are completely unfounded and illogical. But they work for marketers. And most people fall for them.

Pharmaceutical versus Compounded

The next distinction that is important for understanding bio-identical hormones is to know that both pharmaceutical companies and compounding pharmacies make bio-identical hormones.

Many people have the misconception that compounded hormones are bio-identical, while pharmaceutical hormones are not. This is not correct.

Once again, the word “bio-identical” means only that the molecular structure is identical to that same molecule made by your body. And both pharmaceutical and compounding companies make molecules with the same molecular structure as that same molecule made by your body.

“Natural” versus “Synthetic”

And that brings us to the biggest misconception of all.

The most successful marketing ploy is to imply that bio-identical hormones are “natural,” while non-bio identical/non-body identical hormones are “synthetic.”

This is not correct.

The definition of “natural” is a product that you utilize in its natural form … as found in nature.

The definition of “synthetic” is a product that is modified from its natural form as found in nature. “Synthetic” can also refer to a product that results from combining any ingredients to create the product.

So the only things that are natural are things that we utilize as they already exist in nature. When you pick a piece of fruit from a tree and eat it as is, it’s natural. But when you combine that same piece of fruit with any other food, the very act of combining them makes it synthetic. The fruit is still natural. But the end-product as combined with another food is synthetic. This is true even if all the other ingredients in the final product are natural.

When you cook, you are synthesizing. Any time you combine ingredients, you meet the definition of “synthetic.” The actual ingredients don’t matter a bit. The act of combining them constitutes synthesis.

As you can see, the words natural and synthetic are not mutually exclusive. It is possible to combine multiple natural substances together. Doing so would result in a product that is both natural and synthetic. It is natural because it contains only items that are exactly as they were found in nature. But it is synthetic because the act of combining them modified how they are found in nature.

So this understanding of the true meanings of the words “natural” and “synthetic” is very important for understanding the answer to our ‘Ask Barbie’ question.

Both bio-identical and non-bio-identical/non-body identical hormones are synthetic.

Now I know this is shocking, so let me explain:

There is only one way to get truly natural sex hormones that have the same molecular structure as the molecules made by your body. The only way it is possible to get natural, bio-identical estrogen or progesterone that is identical to human estrogen or progesterone is to manually squeeze human ovaries and collect the estrogen and progesterone that drips out of them.

Nobody has ever done that; nobody is doing that now; and nobody ever will.

Not only is it unethical; it’s also impossible.

So there is no such thing as a truly natural bio-identical sex hormone product.

The closest thing we have to a “natural” bio-identical sex hormone product is the estrogen called Premarin.

Premarin is pregnant mare urine:

  • Pre = pregnant
  • Mar = mare
  • Ine = urine

And it isn’t natural, either. Scientists take the pregnant mare urine to a lab and convert it into pill or patch form. That makes it synthetic.

The only way we could take pregnant mare urine in its natural form is if we drank the actual urine of a pregnant mare. And nobody does that.

And pregnant mare urine contains bio-identical hormones that are identical to that of a horse, not a human. It just so happens that several of the sex hormones that are bio-identical to a horse are also identical to those of humans.

The only way to get bio-identical human testosterone is to manually squeeze human testicles and collect the testosterone that drips out of them. Once again: nobody has ever done that; nobody is doing that now; and nobody ever will.

So, by dissecting these terms into their true meanings, you can see that marketers extrapolate the meanings of these words markedly. But that misinforms you to believe that there is something special about anything that carries the label “bio-identical.” And that is not the case. So, this leads to several misconceptions.

Better versus Worse

The most common misconception is that bio-identical hormones are better than non-bioidentical/non-body identical hormones.

This is incorrect for several reasons. They include:

  • There is nothing that is better for all women.
  • All that matters is what’s best for you, personally.
  • While your brain may think that bio-identical hormones are“better,” your body may disagree.

All that matters is that you use what works the best for you, personally. Nobody knows what your body prefers. You have to find it. And if you listen to your body, you will always nail it, because your own body will not lie. But marketers and other people will.

Effective versus Ineffective

The second misconception is that, because the molecular structure of a bio-identical hormone is identical to that of the same hormone made by your own body … that makes it more effective.

That is not correct.

Your body may or may not utilize bio-identical hormones more effectively than non-bio-identical hormones. This is a purely individual matter. Some women find that their bodies prefer bio-identical hormones. Other women find that their bodies prefer non-bio-identical hormones.

Safe versus Unsafe

The next misconception is that bio-identical hormones are safe, but non-bio-identical hormones are unsafe.

And this is a misconception because the very definition of the word “safe” is vague and differs from person to person.

Safety pertains to our individual risk factors. And our individual risk factors are what dictate our risks for diseases. Whether or not any hormone is safe for you, personally, depends on your individual risks.

Sources of Bioidentical Hormones

So nowadays, many people are talking about bio-identical hormones. Not only that; many people are taking them.

So how do we get these so-called “bio-identical” hormones?

If we can’t get them by squeezing human ovaries or squeezing human testicles, how is it that we have bio-identical sex hormone products flooding both the pharmaceutical and compounding markets?

Well, here’s how we get bio-identical sex hormones:

Scientists collect plants that contain estrogen, progesterone, or testosterone. So right there you can see that the source of these hormones is vegetable rather than animal. Humans are animals. We do not belong to the plant world. And yet, the very source of most products labeled bio-identical originate from plants.

In the lab, scientists put the plants that contain sex hormones through several steps of chemical reactions. These chemical reactions are very complicated. They serve to:

break down the plant into its individual ingredients,
separate the original ingredients,
isolate the ingredients of interest,
then use enzymes to change the molecular structure of the particular ingredient several times,
add any other ingredients necessary for the “bio-identical” molecule,
and, after multiple chemical processes, the resulting molecular structure is identical to the molecular structure of that same hormone as produced by your own body.

If you’ve ever taken biochemistry and carried out biochemical experiments, you were doing some of the same things scientists do in pharmaceutical and compounding labs in order to create bio-identical hormones.

It is a long process with a lot of heating, drying, oxidizing, hydrating, etc. etc. etc.

There is absolutely nothing “natural” about it.

The original source was completely foreign to your body. And the end-product is completely synthetic.

Human Sex Hormones

Now we’re going to delve into a little bit of biochemistry.

All human sex hormones are steroids. They all have the same basic steroid molecular structure. It looks like this:

Human Sex Hormones

So, all estrogen, all progesterone, and all testosterone has that same basic steroid molecular structure.
They differ only by what dangles from this basic structure. And the various things that can dangle from the structure designate whether the molecule is:

  • estrogen
  • progesterone
  • testosterone

Estrogen

Now we focus specifically on bio-identical estrogen.

Your body makes three different kinds of bio-identical estrogen:

  • Estrone in your fat cells,
  • Estradiol in your ovaries,
  • Estriol in your placenta during pregnancy.

As you can see, these three kinds of estrogen come from completely different organs. Likewise, they serve completely different purposes.

If you were to draw their individual molecular structures, they would look like this:

Estrogen

Notice that they are all similar, with the exception of what you see in red. The red dangling parts are the only things that distinguish one from the other, and if you add to that a non-bio identical / non-body identical synthetic estradiol, it looks like the last one in this row:

Non- bio-identical synthetic estradiol

As you can see, most of it is the same. The only thing that’s different is one of the dangling items. I’m showing you these structures so that you can see that the actual differences between the different kinds of bio-identical estrogens versus synthetic estrogen are not that great. But people tend to assign more differences to them than there actually are.

Progesterone

Here’s what the molecule of bio-identical progesterone looks like:

Progesterone

Notice that it looks a lot like estrogen, with different dangling structures.

And here’s the molecular structure of a progestin that is a synthetic form of progesterone:

Progestin - a synthetic form of progesterone.

Testosterone

Testosterone

Finally, we have testosterone. There are two forms of testosterone:

  • Testosterone
  • De-hydro-epi-androsterone (or DHEA)

Here’s the basic molecular structure of testosterone:

Testosterone

And here’s the basic molecular structure of DHEA:

DHEA

Once again, notice that they differ only in terms of what dangles off of the basic steroid molecule.

And, here’s the molecular structure of a synthetic testosterone:

Synthetic Testosterone

Calcium Analogy

One way to understand how bio-identical hormones differ from non-bio-identical hormones is to compare them to calcium.

Calcium is the bio-identical mineral that has the chemical structure identical to the calcium your own body creates.

But if you go to a vitamin and mineral shop to buy calcium, you’ll find all sorts of different kinds of calcium:

  • Calcium carbonate
  • Calcium citrate
  • Calcium phosphate

They’re all still calcium. And your body utilizes them as calcium. But in the case of calcium, they are combined with something else to make them a salt. The salt form is what you would consider the synthetic, non-bio-identical form of the mineral.

But guess what? The very reason they are produced as salts is because your body uses them better as salts than it uses the calcium all by itself. The salt form improves absorption, digestion, and kidney filtration.

You’re unlikely to find calcium in isolation. And that’s because your body can’t utilize it in isolation unless your body makes it itself.

So synthetic molecules are not inferior. In most cases, the very reason the synthetic molecule became available in the first place was because it enables your body to utilize the molecule more efficiently.

The Answer: What are Bio-identical Hormones?

I hope this helps you understand the meaning of bio-identical / body identical hormones. They have a molecular structure that is identical to that of the molecule your own body made. But that does not dictate whether or not your body prefers it over a non-bio-identical hormone. 

The key to success is to let your own body decide. I always tell women that we all have to find what works for us. The only way to find what works for us is to do our own personal individual experiments with bio-identical and non-bio-identical hormones to see which work best for us.

And because women are not robots, there is nothing that will be best for all women.

So stay away from marketing terms like better/worse, right/wrong, effective/ineffective, safe/unsafe; natural/synthetic.

Just use whatever works best for you.

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