The bioidentical hormone therapy industry has been getting a bad rap lately in the US, and this press release is an example of why. Among other things, the writer confuses estrogen and progesterone, in one paragraph saying their product is a “safe and scientifically-proven, all-natural estrogen delivery cream[]”, and in the next describing it as a “natural progesterone cream” (emphasis is mine). Moreover, the press release springboards from another estrogen-positive press release that claims that estrogen may be the cure for female depression, citing an ob/gyn author of a book, and promoting a soon-to-be-launched web page.

So, in one breath the product is an estrogen delivery cream that will help with low estrogen, but in the next breath (on the linked product page) it is argued that it will help with estrogen that is too high (which is more accurate). The product website emphasizes that  it is “without dangerous pharmaceuticals”:

This remarkable product contains NO risky synthetic estrogens or progestins. [Product] Cream is similar to the progesterone your body naturally produces, so there are no worries about dangerous interactions or nasty side effects.

It’s been said that there are no side effects, there are just effects. It is odd to marry this claim that their product won’t have nasty side effects (because it is like the progesterone in your body) with the claim that progesterone cream will balance out the nasty effects of your own high estrogen levels.

Progesterone cream may well be better tolerated, but just because it’s natural, doesn’t make it so.

And, interestingly, despite being anti-big Pharma, the article adopts the pharmaceutical industry’s language of menopause as “estrogen deficiency” that has been so helpful to those who would market “hormone replacement therapy” as a cure for all female ageing. As is still common, it is assumed that perimenopause (the transition leading up to the last period) is a time of dropping estrogen. There’s also the assumption that the challenging issues of midlife are necessarily hormonal (rather than multi-faceted, including not only biological changes, but also cultural views of ageing, social context, socioeconomic issues, divorce-related poverty, even spiritual and psychological development).

It’s unfortunate that bioidentical has come to be associated with fuzzy thinking and poorly supported claims, because there are good, solid, well-researched arguments in favour of using naturally occurring molecules for therapy, particularly for hot flushes and night sweats. We’re analyzing data from the first randomized placebo-controlled trial of oral micronized progesterone for hot flushes and night sweats in early menopause, and we should have some data later this year to report.

It’s also worth noting that other countries do it differently – Canadians can buy progesterone cream such as this, but they do it with a prescription, at a specified dose, and for a particular issue. And people who try to sell it over the counter in a health store are prosecuted.

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