Bio-Identical Hormone FAQs

Bio-Identical Hormone Replacement Therapy: FAQs

What are Bio-Identical Hormones?

Bio-Identical hormones have the same chemical structures as the hormones secreted by your body in your ovaries, adrenal glands, or testes.

Where do Bio-Identical Hormones come from?

Bio-Identical Hormones come from the yam plant or soybean plant.

Which Bio-Identical Hormones are used most frequently?

Estradiol, testosterone, pregnenolone, estriol, DHEA and sometimes progesterone.

Does a perimenopausal woman take the same dose as a postmenopausal woman?

Not usually. Most commonly you start in early menopause with a low dose, and gradually increase to a higher dose in menopause. With time you taper down the dose again.

What is the best route of administration, e.g. Sublingual, gel, capsule, cream, pellet, tablet or patch?

Everyone is different. So what is best for one may not be best for another. Sometimes you need to try 2 or 3 different delivery systems until you find what works best for you. Depending on the area of the body, topicals are used; absorption can vary from 1% to as high as 20%.

How long is a treatment and how often should they be repeated?

One session takes less than 1 hour. The treatments are done approximately once a week for each treatment area. A series of 4 treatments is usually recommended depending on the size of the treated area.

When is the best time of day to take my hormones?

Ideally, the best way is to take one half of the daily dose every 12 hours for oral, sublingual and topical doses. However, testosterone sublingual for libido is best taken 2 hours before bedtime. Estrogen for night sweats is best taken with your evening meal. DHEA is best taken after breakfast. Progesterone is best to take at bedtime.

Will my symptoms be relieved more, the same, or less with Bio-Identical Hormones compared to synthetic hormones?

Because we at Medical Aesthetics of New England, PC dose your Bio-Identical Hormones individually, we can usually achieve better symptom relief than using the limited number of choices found in synthetic hormones.

Will Bio-Identical Hormones help Osteoporosis?

Yes, when dosed properly Bio-Identical Hormones can help to treat Osteoporosis.

Will my insurance pay for Bio-Identical Hormones?

Some insurance companies may provide coverage for Bio-Identical Hormones. While we don’t accept insurance payment at Medical Aesthetics of New England, PC, we will provide you with a receipt and information so you can submit a request for reimbursement to your insurance company.

Do men need hormone therapy?

Andropause is a natural decline of testosterone levels in men beginning in their late 20's. Most men maintain adequate levels of testosterone into their mid 40's to mid 50's, some into their late 70's to early 80's. At Medical Aesthetics of New England, PC, we test men when they begin to show signs of testosterone deficiency. Even men in their 30's can be testosterone deficient and show signs of bone loss, fatigue, depression, erectile dysfunction, difficulty sleeping and mental decline.

Do Bio-Identical Hormones have the same danger of breast cancer as other forms of hormone replacement therapy?

Bio-Identical Hormones act differently in the body than do synthetic hormones. Age and family history are very significant risk factors that play into the decision of whether to use Bio-Identical Hormones. In some studies, Bio-Identical Hormones do not carry with them the same risk of breast cancer as high doses of oral estrogens that do not maintain the correct estrogen ratio or hormone metabolites. Nor do they increase the risk of breast cancer like the synthetic, chemical progestins used in the Women's Health Initiative Trial. The age of the woman when BHRT is used is an important factor. Side effects and health concerns increase as the time from menopause increases. BHRT should not be used indefinitely as some kind of fountain of youth.

European medical studies suggest that bio-identical hormones may be safer than synthetic versions. But we must be cautious here, because they have not been well studied, especially for long-term use. And in any case, we recommend that women never think of any drug as completely safe. Also, the WHI studies on the effectiveness and health risks of HRT were based on synthetic/equine-based hormones, and the average age of the women at enrollment was 63. The details did make a difference in their risk. The North American Menopause Society (NAMS) and the Endocrine Society state that: "BHRT may be safer, but that study hasn't been done yet."

Can You Take Bio-Identical Hormones Indefinitely?

Hormone therapy has been linked to increased risk of breast cancer, especially as women get 10-15 years past menopause, so most health experts recommend that women take the lowest dose for the shortest time, if they need it.

Are there side effects to Bio-Identical estrogen?

When a patient first starts on Bio-Identical Hormone therapy there may be mild, temporary breast tenderness, which usually resolves on its own. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain, which should also resolve on its own.

How are hormones monitored during therapy?

Hormone levels will be drawn and evaluated before therapy is started. Levels will be reevaluated during hormone therapy. After the first year of therapy, hormones levels may be followed less frequently. Men must notify their primary care physician and obtain a digital rectal exam each year. Women are advised to continue their monthly self-breast exam and obtain a mammogram and/or pap smear as advised by their gynecologist or primary care physician.

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