Why I Prescribe Bioidentical Hormones: Dr. Randolph Explains

Over the years, I have received many questions about bioidentical hormone replacement therapy (BHRT). What is it? Is it safe? Why do it? I love talking to people about BHRT, because I know that it is life-changing, healing, natural medicine!

What is it? Is it safe? BHRT is a safe and effective treatment, when prescribed by a knowledgeable physician or clinician. It replaces deficient (or balances excess) sex hormones (estrogen, progesterone, testosterone) in both women and men. Hormones are applied topically in a cream that is rubbed into the skin, or sometimes through other “delivery” methods, (such as oral capsules, sublingual tablets, topical gels, or under-the-skin pellets), and often administered in varying doses throughout the month. Bioidentical hormones are NOT synthetic. They are derived from a botanical source found in wild yam and soy, and then synthesized in a lab to be identical to your naturally produced hormones. Bioidentical hormones have the exact molecular structure as the hormones made by your body. They are safe because they bind to hormone receptor sites in the exact same way that your own hormones do, so they do not trigger side effects. Which bioidentical hormones you need, and how much, will depend on your individual symptoms, hormone health history, and the results of your bloodwork or saliva test.

It is important to note that some patients have come to me expressing a general fear of any hormone replacement therapy. Sometimes this fear has been prompted by their former physicians, but mostly it is fed by misleading information in the media. The largest and most-cited study was the Women’s Health Initiative (WHI), a 15-year research study initiated by the National Institutes of Health (NIH) to address major health issues causing mortality in post-menopausal women. All of the women in the study were given conventional synthetic hormone replacement therapy (HRT). The study found that women who had been given estrogen were more likely to have heart disease risk factors such as high blood pressure, high cholesterol, diabetes, and obesity compared to those on combined estrogen-plus-progestin (synthetic progesterone). The problem with that study was: researchers DID NOT use bioidentical estrogen and bioidentical progesterone. They used synthetic estrogen and synthetic progesterone, which DO NOT have the same chemical structure as the hormones your body makes. The term that describes how hormones fit into receptor sites (like a key fits into a lock) is called “relative binding affinity,” or RBA. Bioidentical progesterone, for example, has an RBA of 100%, while synthetic progestins have an RBA of only 78%. Synthetic hormones are taken by mouth and must be processed through the liver, which can be quite harmful. In addition, synthetic hormones were given in the same daily dose during the WHI study.

Think about it: Synthetic products ARE NOT the same as the hormones your body produces naturally! And women’s bodies DO NOT naturally produce the same amounts of hormones every day of the month! WHI was abruptly ended (early) in 2002 due to the high prevalence of cancer and other diseases. Unfortunately, recommendations from the medical establishment following the study were: “hormone replacement therapy is bad, and women should not use this treatment unless absolutely necessary and then only for a limited time.” Women were taken off synthetic hormones, but never offered anything else. Conventional medicine has long relied on the pharmaceutical industry to provide answers for health problems, instead of exploring preventative care, nutrition, and natural (non-patented) treatments — many of which have now been proven to reverse and prevent disease.

My path to BHRT began in the early 1990s. After years of observing the effects of synthetic treatments routinely recommended to patients by the medical establishment, I started to question the safety and efficacy of traditional hormone replacement therapy (HRT). My patients were not feeling better! Patients came to me describing unwanted side effects, some very troublesome, like low libido and weight gain, and others of greater health significance, like fibrocystic breasts and low thyroid disorders. In fact, many patients were getting worse on these treatments. My background as a compounding pharmacist fueled my search for alternatives. My experience with pharmacognosy (plant-based medicine), combined with my understanding of hormones, led me to discover ample medical research on the option of “bioidentical” hormone replacement therapy. I read every medical journal article and research paper I could find on the subject. I contacted the leading BHRT medical professionals, including the late John R. Lee, who became a mentor to me. I learned everything that I could about BHRT. And in the mid-1990s, I started compounding bioidentical hormones on my own every weekend, to offer to my patients. Within weeks (sometimes days), patients came back to the office reporting symptomatic relief of hot flashes, fatigue, low sex drive — with no side effects. Some patients told me I had saved their marriages and changed their lives! It was incredible. BHRT wasn’t just treating their symptoms — it was resolving my patients’ underlying hormone problems. I was actually making my patients healthier!

Over time, one of the many encouraging outcomes I saw was an incredibly low incidence of breast cancer among my patients. Bolstered by these results (and many others), I opened my first on-site pharmacy alongside my medical practice in 1998. At the time, many of my physician peers thought I had gone off the deep end. The irony is — after the WHI study was ended early due to increased risk of heart disease, breast cancer, stroke, and blood clots, and after additional studies in prominent medical journals showed similar findings with synthetic hormones — some of those same doctors who dismissed my search for alternatives started to come around! (Others simply stayed in the dark.)

The truth is, conventional medicine, with its heavy reliance on synthetic pharmaceuticals, has failed to provide accurate information for patients who truly need natural hormone replacement therapy. Fortunately, those of us who have taken the time and put in the effort to understand alternatives can demonstrate without a doubt that biodientical hormone replacement therapy (BHRT) is the only and best approach that safely addresses symptoms of hormone imbalance and improves long-term health. From an ethical and medical standpoint, it is the only choice — and that’s why I prescribe BHRT.