'I was becoming bloated and puffy and my energy was non-existent,' she says.Disheartening for any woman, but for Ivana it was serious; she runs a Pilates and body conditioning studio for athletes and for people needing rehabilitation after injury - and looking well and fit is essential to her livelihood. After what had happened to me when I went on the Pill - nausea, headaches and a vanishing sex drive - there was no way I was going to start taking extra oestrogen in this form.' That was ten years ago and now Ivana is a remarkably sleek and fit 55-year-old.It sounds like a subtle difference, but, in fact, this is supposedly what makes bio-identicals safer and more effective.Ten years ago, bio-identical hormones were offered only by a few specialised clinics around the world, as everyone believed conventional HRT to be safe and effective.A recent study in the UK concluded that middle-aged women are more sexually satisfied than their male counterparts.As a marriage and family therapist who is often asked about sexuality, I was intrigued by this finding and decided to do some research of my own.
'Bio-identicals were pushed out of the picture by the more profitable versions produced by the drug companies,' says Schwartz. Last February, a major review of more than 200 studies on bioidenticals in the Postgraduate Medical Journal concluded that they were more effective and had greater health benefits than regular HRT.
Many experts later said the study was irrelevant to most women.
'It involved women over 60 who had been oestrogen- deficient for ten years so they were more at risk to both cancer and heart disease than a woman taking HRT at the beginning of the menopause in her early 50s,' explains Dr Sarah Jarvis, a spokesperson for the Royal College of GPs.
It's not the source that is the key, but how the chemicals are tweaked in the lab.
Although bio-identicals seem very new, they have been around since the Twenties and Thirties, explains Dr Erika Schwartz of the Bio-identical Hormones Initiative in New York, an organisation that trains doctors in their use.