Bio-Identical Hormone Therapies

What Are Bio-Identical Hormones?

Bio-Identical Hormones are precise duplicates of the hormones produced by the female ovary, particularly, estrogen and progesterone. Bio-Identical Estrogen and Progesterone are different from conjugated equine estrogens and medroxyprogesterone, which have slightly different chemical structures.

How can Bio-Identical Hormones Support Fertility & Reproductive Health?

Progesterone therapy can be utilized in the luteal phase of the cycle to help support secretory changes in the endometrium, and therefore support implantation. Sufficient levels of progesterone are necessary to allow for implantation of an embryo to occur and to support early pregnancy. In Women with luteal phase defects where lower amounts of progesterone are produced, supplementing with additional progesterone can help create a favourable environment for conception and maintenance of pregnancy. In the setting of IVF and IUI when gonadotropin hormone treatments are used, progesterone therapy has been shown to help increase clinical pregnancy rates [1, 2, 3].

Hormone therapies can also be utilized when there are reproductive disorders or hormonal imbalances present. Hormone replacement therapies may be used for dysfunctional uterine bleeding, spotting, irregular cycles, endometriosis, PCOS, or menopausal symptoms (i.e. vaginal dryness, hot flushes, mood disorders, joint pain).

When are bio-identical hormone creams recommended?

The creams are applied topically to provide transdermal absorption of the bio-identical hormone. The transdermal route is ideal when trying to achieve an increased level of hormone in the blood and trying to increase the delivery of the hormone to multiple organ systems. 

When are Vaginal Suppositories used?

Vaginal suppositories are ideal when trying to deliver the hormones directly to the reproductive tract. It allows for greater concentration of the hormone in the uterus and reproductive tract when compared to the skin cream and transdermal approach. The suppositories are best used when the bio-identical hormone specifically needs to reach the reproductive organs (i.e. supporting implantation and secretory changes of the endometrium, treating vaginal dryness, luteal phase defects). 

Where are Bio-Identical Hormones available?

Doctors of Naturopathic Medicine that have successfully completed the Ontario Prescribing and Therapeutics Course and respective Examinations are able to prescribe Bio-Identical Hormone Therapies. 

Naturopathic Doctors are licensed Primary Health Care Providers in Ontario and are trained to utilize a combination of techniques to help fertility patients. Their 7-8 year Post-secondary education includes, but is not limited to, extensive training in Chinese Medicine and Acupuncture as well as Botanical Medicine, Clinical Nutrition (Including Prescribing of Pharmaceutical strength nutritional supplements), Pharmacology, Healthy Diet & Lifestyle, Clinical Diagnosis and Treatment, and Medical Sciences. This allows them to offer a comprehensive treatment protocol that includes more than Acupuncture alone. 

Frequently Asked Questions

References:

1. Progesterone supplementation during the luteal phase and in early pregnancy in the treatment of infertility: an educational bulletin. (2008). Fertility and Sterility, 89(4), 789-792.

2. Hill, M. J., Whitcomb, B. W., Lewis, T. D., Wu, M., Terry, N., Decherney, A. H., . . . Propst, A. M. (2013). Progesterone luteal support after ovulation induction and intrauterine insemination: a systematic review and meta-analysis. Fertility and Sterility, 100(5).

3.Shapiro, D., Boostanfar, R., Silverberg, K., & Yanushpolsky, E. H. (2014). Examining the evidence: progesterone supplementation during fresh and frozen embryo transfer. Reproductive BioMedicine Online, 29.

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