What actually is Bio-identical hormone replacement therapy (B-hrt)?
Due to technological advances, hormones can be extracted from natural sources are be able to be administered in exact concentrations. Once the extraction occurs, mostly from soybeans or yams, the process of standardization produces a pure stable source of hormones. These hormones are exactly the same as those produced in the human body.
Are they natural or synthesized?
Years ago that mattered when chemicals derived in labs were used for hormone replacement. Now they are extracted from natural sources and synthesized to provide exact concentrations for administration.
What are the hormones I should focus on when I am considering replacement therapy?
The main hormone of menopause is progesterone. Progesterone is produced by the corpus luteum, the residual part of the ovulatory follicle in the ovary. Progesterone is the precursor of many essential hormones, especially testosterone. DHEA is mostly produced by the adrenal gland, a small gland above the kidney. DHEA also is a precursor to many sex hormones. Adrenal fatigue can present with very low levels of DHEA. Testosterone is a very important hormone for both men and women, however in varying amounts. Even though this is a crucial hormone, therapies that rely only on this therapy fail to provide the benefits of a balanced replacement program. Estrogen which is helpful in small amounts is a minor contributor to a balanced hormone replacement regimen.
How are these hormones administered?
After years of research, it was determined that bio-identical hormones do best if absorbed without first going through the portal vein to the liver. It is there that is transformed and cleared which will cause variable results. Consistent modes of absorption occur wither through the skin, vagina or rectum, or the oral cavity. Here in the United States the preferred method is oral or skin. Unfortunately, the skin route is also unpredictable and levels are inadequate for our purposes. Testosterone can be given by injection which is the best form of guaranteed absorption.
What are the indications for B-hrt?
Most of our patients come to us with symptoms that affect the quality of life. that includes insomnia, hot flashes, mood changes, dry vagina and low libido. All of these symptoms are easily treated. What makes our therapy more significant is the elimination of fractures associated with osteoporosis and the reduction of the incidence of breast cancer. Over the last 22 years, we have had zero uterine endometrial cancers while on the treatment.
What is the reasons to get laboratory evaluations for B-hrt?
We have developed a panel of laboratory tests to evaluate a person's individual needs when the patient starts the program. Most of our patients do not require any additional tests unless a problem arises. We do not require “routine” tests on an interval to adjust hormone levels. We use the patient's history and physical findings to make minor adjustments. After tens of thousands of patients, this is superior and more efficient than relying on interval labs.
What are the potential side-effects of taking B-hrt?
With our experienced staff, we have had no major complications. We adjust the patient hormone profile to mimic levels that we researched to exist in a healthy woman ages 35-40. This optimization of levels is the key to our patient’s success.
How long should I be taking these hormones?
We always say until you are ninety years old. In our hands, there is no medical reason to stop. Just because a person ages does not mean that the indications for therapy changes. Of course, there might have to be some minor changes due to change in lifestyle, weight, and activity. we do monitor closely the bone scans to evaluate the potential risks from osteoporosis.