Spanish doctors are afraid of hormonal drugs, the new anti-aging trend

In certain age groups, pellets or bioidentical hormone implants are a common topic of conversation over coffee or after-dinner conversations. This occurs more often in women, but also in men. There is debate about whether they are better than hormones prescribed by gynecologists because they are “natural” hormones; whether they renew energy; whether they increase libido; whether they rejuvenate…

There are more and more gynecological clinics and aesthetic medicine centers that offer this type of hormone therapy to treat symptoms related to menopause, andropause and aging in general, ranging from fatigue to sexual dysfunction, weight gain and osteoporosis.

They propose inserting a cylinder (pellet) under the skin that releases precise duplicates of hormones such as estradiol, estriol, estrone, progesterone, testosterone and others to replace those no longer produced by the ovaries and testes due to age. They say it corrects physical and emotional highs and lows, increases energy levels, mental clarity and sexual desire, improves sleep quality and reduces body fat.

Given this cover letter, it is no wonder that bioidentical hormone treatments are rapidly gaining popularity and more and more people, especially women, are asking their gynecologists about them, which has raised alarm among many professionals and medical societies.

“These hormones are sold as anti-aging therapy and are confusing the population. The same women who reject conventional hormonal treatment for menopause (which is regulated by health authorities, approved by European and American drug regulators and has undergone clinical trials to prove its effectiveness, safety and side effects) consider it appropriate to use it and others Hormones in combinations and dosages that are not only unregulated, but also lack any scientific confirmation. The effects of these hormones, their side effects and their interactions with other medications are unknown,” warns Pluvio Coronado, president of the Spanish Association for Menopause Research (AEEM).

Naturally, testosterone boosts your mood! but we don’t know what adverse effects it has when mixed and put into a pellet.”

Pluvio CoronadoPresident of the Spanish Association for the Study of Menopause

And expresses particular concern about the inclusion of testosterone in these implants. “Of course it is a hormone that improves mood, increases libido and increases well-being! However, we do not know what adverse effects it may have when placed in a pellet or mixed with progesterone and estradiol, and we do know that testosterone increases virilization in women, enlarges the clitoris, can cause hair loss, and can increase body hair. .”

Beatriu Roca Comella, president of the Menopause Department of the Catalan Society of Obstetrics and Gynecology, is also concerned about “the lack of studies demonstrating the effectiveness and safety of these compound hormonal preparations,” especially those containing testosterone. She points out that these products are not subject to any official drug authority.

And make it clear that just as it can be assessed whether the use of testosterone gel supplements may be beneficial for some patients, the use of pellets is not recommended due to a lack of information and regulations.

Still, Roca and other gynecologists know that some of the patients they see use it. “They tell you that it has changed their lives and they have regained enthusiasm and vitality, but the truth is that they also suffer from bleeding that is difficult to control,” explains another of the specialists consulted.

In this sense, it has been a while since the AEEM (Spanish Association of Endocrinology and Nutrition) produced a recommendation document warning doctors that patients’ preferences or desires should not be a justification for prescribing these bioidentical hormone implants, “which could cause security problems”. due to overdose, underdose or lack of quality or sterility”, as they are individually formulated and are not subject to control.

We demand that the sale of something that is potentially harmful to women should not be allowed.”

Pluvio CoronadoPresident of the Spanish Association for the Study of Menopause

However, despite this recommendation, there are still professionals who offer these therapies. Therefore, the President of the Association took advantage of his intervention in the Senate Health Commission to talk about menopause and express to parliamentarians his concern about the medium-term impact of these therapies on the health and quality of life of Spanish women. He called on the government to “address the use of unregulated hormone therapies” and promote regulated hormone therapy as a safe alternative to improve quality of life during menopause.

“We are calling for regulation and a ban on the sale of something that is potentially harmful to women, because there is no prospectus, no monitoring of its effects, nor standard doses of what is introduced into the body,” emphasizes Coronado in a conversation with La Vanguardia.

Both he and other gynecologists consulted emphasize that the benefits promised by these hormones are achieved with conventional treatments, in which regulated hormones are used under the supervision of health authorities and whose dosages and side effects are known. “The problem is that these other implants are marketed with the prefix ‘organic’ (which sounds healthier) and as anti-aging treatments, which is a strong marketing argument,” emphasizes the president of the Spanish Menopause Society (AEEM).

Ramón Vila-Rovira, founder and medical director of the Vila Rovira Institute, one of the centers that offers bioidentical hormone therapies with pellets in Barcelona, ​​does not share this view. “It is easy to act against something that is progressing; They say that these hormones have no scientific confirmation, but they are not studied either, and the reality is that they have been used in the United States for 30 years, so there is clinical confirmation backed by experience: they provide “restores energy, relieves hot flashes…” he explains.

Bioidentical hormone pellets are validated by 30 years of experience with their use in the United States.”

Ramon Vila-RoviraPlastic surgeon, director of the Vila-Rovira Institute

And attributes the rejection of many gynecologists to the fact that “they are not sold in pharmacies and big commercial brands cannot make money because they are manufactured as an extemporaneous formula in one of the two approved laboratories.”

Ana Torres, the gynecologist who leads these therapies at the Vila Rovira Institute, agrees that today “there is a sufficient sample of people using hormone pellets to conduct a proper study on the benefits for patients.” that the demand for this therapy continues to increase among people in their 50s, particularly among women, but also among men.

With conventional treatment, you receive the same pill whether you are 45 or 60 years old; We calculate the dose based on the person’s weight, race, age or type of physical activity.”

Ana TorresGynecologist, Vila-Rovira Institute

Torres points out that she does not prescribe bioidentical hormones without first conducting a gynecological examination and follow-up to ensure that they are not contraindicated, just as is the case with traditional hormones.

“We don’t use rare hormones, just testosterone and estradiol. The difference is that with traditional hormone treatment, you get a pill at 45 that works the same as it did at 60, regardless of whether you weigh 60 kilos or 90 kilos. For pellets, we carry out an analysis to calculate which hormones the person needs depending on their weight, race, age and the sport they practice, we then adjust the dose of the personalized formula to meet those associated with menopause and the “To reduce symptoms associated with aging without causing side effects,” she explains.

A treatment that costs over a thousand euros per year

Hormone beads, which are identical to those of the body at the molecular level, are marketed as a personalized treatment tailored to the individual needs of each patient, be it sexual dysfunction, osteoporosis or energy deficiency. Dr. Vila-Rovira argues that the problem with these therapies is not their safety — they are performed by plastic surgeons and gynecologists, he says — but their cost. Women have to have hormone implants inserted three times a year, with the cost per session being around 350 euros. For men, the insertions are carried out twice a year and each cost around 600 euros. In addition, it is necessary to regularly monitor hormone levels in order to adjust the dosage, prevent side effects and maintain the desired effect over a longer period of time.