From the Guidelines
Bioidentical hormones, such as estrogen (E2) and progesterone (P4), are typically eliminated from the body within 24-48 hours after discontinuation, with the liver playing a primary role in their metabolism and excretion occurring through urine and feces 1. The elimination process of these hormones can vary depending on the type of hormone and administration method. For instance, estradiol has a half-life of 13-20 hours and is usually cleared within 2-3 days, while progesterone has a shorter half-life of 5-20 minutes with complete elimination occurring within 24 hours 1. Some key factors that can affect the elimination of bioidentical hormones include:
- Liver function
- Kidney function
- Age
- Body composition
- Concurrent medications It is essential to consider these factors when discontinuing bioidentical hormones, as they can impact the rate of elimination and the return of menopausal symptoms. For accurate hormone level testing after discontinuation, it is recommended to wait at least 48-72 hours for most delivery methods, but 3-6 months for pellet implants 1. In terms of specific elimination times, topical preparations (creams, gels) may have slightly longer elimination times due to skin absorption, while implanted pellets take the longest to eliminate, with hormones detectable for 3-6 months after insertion. Women discontinuing bioidentical hormones should expect a gradual return of menopausal symptoms within days to weeks as hormone levels decline. It is crucial to note that the use of bioidentical hormones, including custom compounded products, is not recommended due to the lack of data supporting their safety and effectiveness compared to standard hormones 1.
From the Research
Elimination Process of Bioidentical Hormones
The elimination process of bioidentical hormones, such as estrogen (E2) and progesterone (P4), in women is not directly addressed in the provided studies. However, we can look at the general information available on the metabolism and elimination of these hormones:
- Estrogen (E2) is metabolized in the liver and eliminated through the urine and feces 2.
- Progesterone (P4) is also metabolized in the liver and eliminated through the urine and feces 2.
Factors Affecting Elimination
Several factors can affect the elimination of bioidentical hormones, including:
- Dose and route of administration: The dose and route of administration of bioidentical hormones can affect their elimination. For example, transdermal administration may result in slower elimination compared to oral administration 3.
- Individual variability: Individual variability in liver function, kidney function, and other factors can affect the elimination of bioidentical hormones 2.
- Age and health status: Age and health status can also affect the elimination of bioidentical hormones. For example, older women or women with liver or kidney disease may have impaired elimination of these hormones 3.
Key Points
Key points to consider regarding the elimination of bioidentical hormones include:
- Bioidentical hormones are metabolized and eliminated by the liver and kidneys.
- The dose and route of administration can affect elimination.
- Individual variability, age, and health status can also affect elimination.
- There is limited information available on the long-term safety and efficacy of bioidentical hormones, including their elimination 4, 5.