Bioidentical Hormones Therapy

There are synthetic hormones – i.e. Premarin & Provera – and then there are “natural” or bio-identical hormones. Bio-identical means that they are chemically identical to what your body produces. This is in contrast to the synthetic hormones which usually come from pregnant horse urine.

Bioidentical hormones are processed hormones designed to mimic the hormones made by your body’s glands. Taking bioidentical hormones can help people who experience symptoms of low or unbalanced hormones. This is often the case for people experiencing symptoms of perimenopause or menopause.

There are many reasons for maintaining the sex hormones at youthful levels. Dealing with symptoms of menopause is one of them: hot flashes, night sweats, weight gain, mood swings, irritability, fatigue, insomnia, and weight gain (just to name a few). There is a common misconception that women go “through” menopause. As if menopause is only the time in which they experience hot flashes, night sweats, etc. Many women believe that once these symptoms stop they are “through” and don’t need to worry about any thing else. In fact, once you are in menopause you are never done with it. Your body will never go back to producing the estrogen, progesterone & testosterone that it once did when younger. If you want to age gracefully with as little signs of aging as possible you will need to have your hormones balanced and at youthful levels. This is really the cornerstone of any “anti-aging” program.

The term “synthetic” is typically used to describe hormones that aren’t bioidentical. One example is Premarin (conjugated estrogens), a synthetic hormone product that was first approved to treat menopause symptoms in 1942. It contains a mixture of estrogens from the urine of pregnant horses.

Synthetic hormones were put under the spotlight in 2002, when the initial results of the Women’s Health Initiative (WHI) were released. This was the largest women’s health prevention study ever conducted. The findings showed that hormone therapy in postmenopausal women could raise the risk of breast cancer, blood clots, heart disease, and other conditions.

Since then, bioidentical hormones — specifically compounded products — have been promoted as a safer alternative.

The main benefit of Bioidentical Hormones Therapy is the relief you get from menopause symptoms that can interfere with your life. Hot flashes are more than a nuisance. They can really interfere with your quality of life and make a good night’s sleep impossible.

Bioidentical Hormones Therapy can also help relieve vaginal dryness, pain, and itching so you can resume intimate relations with your partner. Other benefits, studies show, may include, reduced risk of heart disease, dementia, and osteoporosis.

Other benefits include:

• Increased bone density
• Increased muscle mass
• Decreased fatty tissue
• Brain/memory protective
• Heart protective
• Improves arterial elasticity
• Lowers blood sugar
• Restores sleep
• Improves collagen in skin – reduces wrinkles
• Decreases inflammation: less joint pain
• Reverses incontinence
• Increases overall energy
• Increases libido

Bioidentical Hormones Therapy is worth considering if you’re experiencing menopausal symptoms that interfere with your daily life. Dr. Ward will determine whether you’re a good candidate for Bioidentical Hormones Therapy after a thorough examination, medical history, and consultation regarding your expectations and goals. Both men and women, usually 40 years and older can benefit from Bioidentical Hormones Therapy.

Below is a list of the different ways that bioidentical hormones can be replaced. Keep in mind that we do NOT want to take estrogen or testosterone in a pill form. This will lead to:

• liver inflammation
• weight gain
• high blood pressure
• high cholesterol & triglycerides
• gallstones

Here are the different ways of using bio-identical hormones:

1. Creams –
   • Advantages: you can control the amount of hormones going into your body on a daily basis and it is non-invasive
   • Disadvantages: some people have absorption issues; it may rub off on someone close to you; it takes longer to get you balanced; hormone levels have to be tested a different way (dried urine test) as they don’t show up in the blood when doing this transdermal route. Because of this extra step in testing it generally takes women longer to get balanced. You also have to remember to put it on twice daily – this can be challenging for someone suffering from brain fog. I don’t recommend creams for men. Because they need a much higher dose than women the cream that they would use is much more likely to rub off onto someone else or just have absorption issues.
2. Injections –
   • Advantages: you control the amount of hormone going into you
   • Disadvantages: you have to stick yourself with a needle and you need to remember to do it. Traditionally injections have been done once per week. This is less than ideal as it causes your hormone levels to go up and down like a roller coaster. I recommend doing a “micro-dose” injection every day or every other day.
3. Troches (like a mint that dissolves between gum & cheek)
   • Advantage: non-invasive
   • Disadvantage: you are going to swallow some of the hormone this way causing all the negative side effects listed above. I don’t ever prescribe these.
4. Pellets (looks like a grain of rice that gets inserted under the skin in the flank or bikini area)
   • Advantages: this is by far and away my most favored delivery method for hormones:
     • takes less than 5 minutes to place
     • you don’t have to remember to do anything
     • lasts 3 months for women and 4 months for men
     • we can easily and accurately follow the blood levels of hormones
     • this is the fastest way to feel better
   • Disadvantages: once the pellets are placed they can not be taken out – they just dissolve over time. That being said, I have never seen a “bad reaction” from pellets. That is because we are not putting in a foreign drug into the body but something that it naturally produces (just not enough of).

With all the above treatments women are also prescribed oral progesterone. This is the one hormone that is safe to take by mouth.

You can prepare for your appointment with Dr. Ward by:

• Tracking your symptoms: List your symptoms, how often and when they occur, as well as their severity
• Listing your medications: Include any prescriptions and over-the-counter medications, as well as supplements, dosage and how often you take them
• Preparing questions: Write down questions before your appointment with Dr. Ward

Dr. Ward will draw a complete and very detailed hormone panel prior to treatment to assess your options and to help you make the most informed decision possible.

This depends on which treatment you elect to replace hormones.

After the pellets are inserted you usually don’t feel much of anything for about 1-2 weeks.  Then the benefits start kicking in.  Male patients may feel the benefits sooner from pellets due to the fact that they have a much bigger dose than women.

Many people and a lot of older doctors as well have a negative view of hormone therapy. “I thought they caused cancer?” is a common question. This stems mainly from a large trial that was done in the 1990’s. It was called the Women’s Health Initiative Study. They put hundreds of thousands of women all across the US on Premarin & Provera. They had to stop the study before it was done because women were dying of stroke, heart disease, and breast cancer. This is when most traditionally trained doctors said – “ok – we will no longer prescribe hormones”. They never made the distinction between synthetic and bio-identical. Why? Why are bio-identical hormones not “standard of care” or mainstream? Big Pharma can not patent bio-identical hormones and thus can not make billions off of them. Long ago the Supreme Court ruled that companies can not patent something that occurs in nature (i.e. water).

More common side effects can include:

• Increased facial hair
• Acne
• Scalp hair loss

These side effects are generally minimal to non-existent as we do not overdose hormones.

This is a great treatment to accompany anything which aims to reduce inflammation, improve mood & sleep, improve skin, increase muscle mass, and decrease fat.