You use the term “bioidentical hormones”.  What does this mean and how is it different than traditional hormone therapy?  

Bioidentical means that the hormone is exactly the same, in both structure and function, to the hormones made in the body.  The hormone has to stimulate the receptor on the cell in order to get the effect of the hormone.  A bioidentical hormone fits into the receptor exactly the same as the body’s own hormones.  The cell will not be able to tell the difference between a hormone made by a compounding pharmacy and by the ovaries/testes.  This explains, in part, the safety and ideal response of hormones when suing topically applied bioidentical hormones, properly balanced and dosed.


What is the most common type of hormone deficiency? 

All hormones decline as we age.  The most notable are the reproductive (sex) hormones, estrogen, progesterone and testosterone.  There is quite a bit of scientific literature attesting to the many health benefits of proper hormone restoration n men and women and showing the dangers of non-bioidentical hormones, especially the progestins found in birth control pills and conventional post menopausal hormones.



What does hormone deficiency feel like or look like? 

Most men and women describe many similar symptoms of hormone deficiency.  Women note, most commonly, hot flashes, night sweats, vaginal dryness, emotionality, anxiety, depression, poor libido, sleep issues, fatigue, orgasmic difficulty, urinary symptoms, dry and wrinkled skin and anhedonia (loss of enjoyment of life’s pleasures).  Men will describe many of these same symptoms including urinary difficulty (enlarged prostate) and erectile dysfunction.  Most people will report a noticeable change in appearance, advanced aging, etc.



How is BHRT treatment different than regular hormone replacement? 

Topical applied bioidentical hormones are the preferred route of administration allowing the use of smaller doses that are delivered directly to the tissue bypassing liver metabolism.  There is evidence that oral estrogen may result in some loss of benefits and even may negate some of the positive benefits of estrogen on the blood vessels.  Dosing and balance is critical for safe and effective hormone replacement.  Topically applied hormones are most accurately measured in the saliva.  Serum levels do not accurately reflect the dose of hormones.  Blood testing for topically applied hormones often results in overdosing.  Overdosing can result in unwanted side effects and increased risk as well overstimulation of hormone receptors resulting in a reduced response to hormones and return of symptoms which leads to an increase in hormone dose which perpetuates this problem.



Who can benefit from BHRT treatment? What are the benefits? 

All patients are a candidate for proper hormone restoration.  In fact, I consider all patients candidates for hormone replacement unless proven to have a contraindication to hormone restoration.  There is literature supporting the benefits of hormone restoration on preventing cardiovascular disease, protecting the breast and uterus from cancer, preventing osteoporosis and bone loss, regulating cholesterol and blood sugar.  In men, all causes of death are associated with testosterone deficiency including prostate cancer.  I must emphasize that this means “proper” hormone restoration using the correct hormones at the correct doses and in the correct balance.  This requires a thorough understanding of hormones and hormone restoration.