Bioidentical Hormone Replacement Therapy FAQ

Bioidentical hormones require a physician’s prescription. After a thorough consultation and laboratory testing, your physician will prescribe a unique combination of hormones to optimize your hormone levels and address your individual needs. The prescriptions are then filled by a compounding pharmacy, where a pharmacist will custom-compound your unique bioidentical hormone treatment. Bioidentical hormones are compounded using a yam or soy base to make a hormone that is structurally identical to those naturally produced in your body.

Depending on your age, dosing, medical history and compliance, your bioidentical hormones will be prescribed using a variety of dosing options. These may include creams, gels, oral medications, lozenges, injectables, or implantable pellets. Your doctor will help explain the different types of hormone delivery and determine which is best for just you.

Yes, the minimally invasive 15 minute procedure to implant the pellets is carried out through a 3-5 millimeter incision and there is very little trauma to the tissue while implanting the pellets.  Most patients state that the area of placement is mildly sore for several days following implantation.This small inconvenience from the implantation is quickly forgotten during the 4-6 months that the testosterone is active. Patients enjoy the benefit of guaranteed compliance and the steady optimal testosterone levels.

Yes, a variety of research shows that bioidentical hormones have little in common with the side effects of synthetic hormones. Today, bioidentical hormone replacement therapy is an increasingly popular alternative to traditional (synthetic) hormone replacement therapy.  That is partly the result of findings from the U.S. government-sponsored Women’s Health Initiative study in 2002. The study showed that traditional, synthetic hormone therapy increases a women’s risk of breast cancer, heart attack, blood clots and stroke. This is not the case for bioidentical hormones.

In terms of bioidentical hormones, there is a large body of evidence that supports the safety of natural bioidentical hormones and their association with lowering a patient’s baseline risks for breast cancer, cardiovascular disease and osteoporosis. Other research has found that bioidentical hormones have favorable action on blood vessels and decreasing the risk of dementia.

Finally, studies of both bioidentical estrogens and progesterone show that they are not associated with an increased risk of blood clots.

No. Several newspapers in early 2014 cited a flawed study that was retrospective, poorly designed, and implied negative cardiovascular effects from testosterone treatment. This could not be further from the truth. There are numerous studies documenting the beneficial cardiovascular effects from testosterone optimization. Read our blog for a more detailed review.

To determine your initial levels, we perform a very comprehensive blood test that is designed to highlight the inactive and active forms of hormones in your body. This testing is much more involved than your traditional  primary care annual blood testing. After beginning the therapy, we will retest your hormone levels to ensure safe and optimal levels are obtained to maximize the benefits of treatment.  Testing will continue at defined intervals to assure levels remain optimized.

No. There have been numerous studies documenting no increased risk of prostate cancer with testosterone therapy. A well-known Harvard urologist, Dr. Abraham Morgentaler, has devoted a large piece of his career to studying this issue. In fact, he is currently studying the effects of testosterone on patients who have been diagnosed with prostate cancer. Men typically do not get prostate cancer when they’re in their 20s and 30s when their testosterone levels are at their highest. It’s almost always contracted later in life when testosterone levels have significantly declined. For an in-depth read on this topic, Dr. Brandt recommends reading, Testosterone for Life by Dr. Abraham Morgentaler.

Effects of BHRT are both short term and long term. Natural hormone therapy helps men and women reduce the risks of many of the diseases associated with aging, including cancer, heart disease, osteoporosis, stroke and senility.

No. Studies have demonstrated the beneficial effects of bioidentical estrogen and progesterone. There is an approximately 30% decreased risk of breast cancer in women that begin treatment with bioidentical estrogen and progesterone at menopause and remain on the treatment long term.

We recommend reading Dr. Neal Rouzier’s book “How to Achieve Healthy Aging” Dr Neal Rouzier is a renowned researcher that provided training to Dr Scott Brandt, founder and medical director of ThriveMD. We also recommend reading our blog, namely the posts in the BHRT category.