The backlash from the 2005 Women's Health Initiative (WHI) report exposing HRT as being a possible cause for heart attacks, blood clots, cancer and strokes won't quiet down anytime soon.

Actually it's amazing that it took this massive government program to change the standard of care because there has been a mountain of evidence indicting synthetic HRT for a long time now. A lot of women now want to know what the alternatives are to HRT and that has instigated a lot of discussion about bio-identical hormones.

What's the difference between Bio-identical and Synthetic Hormones?

Synthetic hormones are created by drug companies so they can maintain a patent for drugs such as PremPro, Provera and Premarin. Known side effects include not sleeping, lack of sex drive and lack of energy. In the past, hormone replacement therapy has been most doctors' only answer to women's menopausal symptoms.

Bio-identical hormones are manufactured to have the same molecular structure as the hormones made by your own body. They are synthesized in a lab from a natural source such as soybeans in the case of estrogen and testosterone, or wild Mexican yam in the case of progesterone.

Their appeal is that the body can more easily metabolize them, minimizing negative side effects, and in fact, women have reported feeling increased levels of energy, a healthier libido, improved weight loss and better memory from their use.

While synthetic hormones are available in oral form, bio-identical hormones can be taken by mouth, through a Transdermal patch, in a cream, lotion, in drops you put under your tongue, or as a vaginal ring. They bypass the digestive tract and liver which has the advantage of providing a more consistent hormonal level.

Numerous European medical studies suggest that bio-identical hormones are safer than synthetic; however no long-term studies have been conducted as yet. Keep in mind that the WHI studies ublished all concern synthetic HRT, specifically Premarin (a drug derived from horse urine), PremPro and Provera and did not include any information on bio-identical hormone replacement therapy.

Also, women in the WHI studies were primarily on HRT after menopause, which is most often therapeutically not necessary, and many of the women had had hysterectomies. The most common use for any kind of HRT is for per-menopausal symptoms -- when a woman first begins to experience body fluctuations.

Most integrative doctors have discovered the most successful approach to dealing with a woman's menopausal symptoms is to begin with laboratory tests called a "hormone panel." Saliva testing is also available but not known to be as effective as serum testing. The doctor can then prescribe a precise dosage of bio-identical estrogens, testosterone, progesterone or DHEA that can be made specifically for your body at a compounding pharmacy. To find a doctor and/or compounding pharmacy near you, visit http://www.everythingmenopause.com

Some women report experiencing no symptoms at all during peri-menopause and many find they can rebalance their hormones without the use of any drugs. Often relief is found through an approach that combines medical-grade nutritional supplements, over-the-counter bio-identical progesterone, and dietary and lifestyle changes. The importance of exercise can't be overlooked or emphasized too much. The older you get, the more your body needs to move aerobically, and a weight-bearing workout also becomes more important.

For women switching from Premarin or PremPro to a natural form of estrogen, there should be a transition period because the estrogen receptors have been primed by the synthetic molecule and won't immediately accept other forms. It's probably not a good idea to stop cold turkey either, but better to gradually discontinue taking HRT so that the symptoms such as hot flashes or vaginal dryness, don't occur. Make sure to consult your doctor if you decide to go this route.