Bioidentical Hormones

NASHVILLE HORMONE & INTEGRATIVE MEDICINE

Bioidentical hormones

What are bioidentical hormones?

Bioidentical hormones are hormones that are identical in structure and function to the hormones made naturally by the ovaries and testes (estrogen, progesterone, and testosterone). Hormone levels decline with age, and despite popular belief, it’s not age that causes hormonal decline but the opposite: hormonal decline causes aging. By maintaining youthful hormonal levels, patients can reduce the risk of developing disease of aging and improve their quality of life. Bioidentical hormones are natural, topical hormones derived from plants, not from chemicals or animals.

Are bioidentical hormones safe?

Bioidentical hormones are very safe unlike conventional hormones taken orally, which are associated with many health hazards. Medical literature indicates that bioidentical hormone replacement therapy (BHRT) is not only safe, but can actually reduce risks of developing disease including cancer.

BHRT is administered topically in a cream form that’s applied to the skin. The cream is made by a compounding pharmacist who has special knowledge and training in this area of study. A simple saliva test is used to monitor the tissue levels of bioidentical hormones when administered topically.

Who is a good candidate for bioidentical hormones?

Women experiencing symptoms of menopause (hot flashes, night sweats, anxiety, irritability) and men experiencing symptoms of andropause or male menopause (fatigue, weakness, depression, and sexual problems) may find relief through the use of bioidentical hormones.

What kind of doctor is qualified to treat patients with BHRT?

Proper hormone balancing requires knowledge and a special expertise which can only be obtained from advanced training. Patients should take special care to choose a doctor who is Fellowship trained and board-certified in anti-aging, functional, and regenerative medicine. Established experience in the field is critical. Dr. Monaco at Nashville Hormone & Integrative Medicine Center meets all of these criteria and has been practicing in regenerative medicine for over 20 years.

What diseases may be prevented by bioidentical hormone replacement therapy?

BHRT can reduce the patient’s risk of developing disease of age, including high blood pressure, high cholesterol, diabetes, heart disease, Alzheimer’s disease, cancer, and more. In addition, BHRT can help patients feel younger, increasing sex drive and stamina and reducing the symptoms of menopause or andropause (male menopause).

Menopause

NASHVILLE HORMONE & INTEGRATIVE MEDICINE

Menopause

When is the best time to seek treatment at Nashville Hormone & Integrative Medicine?

Many patients wait until they begin experiencing the symptoms of menopause, but having hormone levels checked before the onset of hormonal decline is important in establishing a baseline. Knowing the baseline allows the patient and Dr. Monaco to closely monitor hormone levels and intervene at the right time.

Having hormone levels checked early can also help patients identify perimenopause early; it occurs gradually over many years and may not be apparent immediately following onset.

What are the symptoms of perimenopause?

Perimenopause is the time period before menopause (one year after the last menstrual period), which can last 1 – 10 years. The symptoms of perimenopause include:

  • Hot flashes
  • Mood swings; irritability
  • Night sweats
  • Pain during intercourse
  • Vaginal dryness
  • Anxiety

How long does it take to notice a change?

When symptoms are resolved depends on the length of time it takes to achieve true hormone balance. Women in the throes of perimenopause generally notice an improvement in night sweats and hot flashes in just a few days, while it may take a few months to notice cognitive and memory benefits.

Does BHRT cause weight gain?

A decline in natural hormone production causes weight gain. As a matter of fact, many women over age 35 find that regardless of their diet and exercise regimen, they struggle to manage their weight. By balancing hormone levels, the patient allows her body to work the way it did when she was younger, improving her metabolism and ability to maintain a healthy weight, during both perimenopause and post menopause.

Does BHRT work without any lifestyle change?

BHRT is most effective when combined with a healthy diet, exercise routine, and stress management in place to address the health and well-being of the whole patient. Each of these is an important part of postmenopause health and wellness.

Does BHRT require a prescription?

In some cases, bioidentical hormones can be purchased without a prescription, but the strength is approximately 1/10th of the same prescription-grade hormone. In order to receive maximum benefit, patients must work closely with a regenerative medicine doctor who can prescribe full-strength bioidentical hormones and monitor their efficacy in the body.

Testosterone Deficiency

NASHVILLE HORMONE & INTEGRATIVE MEDICINE

Testosterone Deficiency

What are the symptoms of low testosterone?

Patients suffering from declining testosterone levels may experience:

  • Lack of desire for intimacy
  • Inability to achieve erection for men
  • Decreased semen production for men
  • Hair loss
  • A decrease in energy levels
  • Lost muscle mass
  • Increased body fat
  • Decreased bone mass
  • Problems with mood and mental capacity

Scheduling an appointment is an important first step.

When should men see a doctor?

Because the goal is to maintain hormone levels most men have at ages 21-49, men can see a doctor in anticipation of the decline to ensure they’re able to treat it proactively. This allows the doctor to get a baseline and potentially detect decline in hormone levels before they cause noticeable symptoms.

Why is it important to see a doctor?

It’s critical that patients undergo comprehensive medical testing before embarking on a hormone modulation program. First, a baseline blood PSA must be taken to rule out existing prostate cancer. Then free and total testosterone and estradiol tests are required to ensure that too much testosterone isn’t being converted into estrogen. Follow-up testing for estrogen, testosterone, and PSA are needed to rule out prostate cancer and fine-tune the program. A qualified and experienced integrative medicine doctor can use the results of these tests to design a program tailored to each patient’s unique situation.

What can cause high testosterone levels?

There are 5 basic reasons free testosterone levels may be low:

  • Too much testosterone is being converted to estrogen through the activity of aromatase, and/or the liver is failing to remove excess estrogen, possibly because of heavy alcohol intake.
  • Too much free testosterone is being bound by SHBG. This would be especially apparent if a man’s total testosterone level is in the high normal range but his free testosterone level is low.
  • Not enough LH (which controls the production of testosterone) is being secreted by the pituitary gland, resulting in low total testosterone.
  • Not enough testosterone is being produced by the testes, which causes low testosterone and high LH.
  • DHEA level is abnormally low

How is low testosterone treated?

Treatment depends on the underlying cause of the hormonal imbalance and typically includes supplements, bioidentical hormones, and lifestyle changes like weight loss or exercise. Dr. Monaco ensures every patient receives a treatment plan customized to his unique lab results and goals.

Libido

NASHVILLE HORMONE & INTEGRATIVE MEDICINE

Libido

What are the symptoms of insufficient testosterone levels in men and women?

The symptoms are much the same for both men and women:

A decrease in sex drive

Weak orgasm

Lack of energy

A decrease in strength, endurance

Lost height

Reduced enjoyment of life

Feeling sad or irritable

Declining sports ability

Falling asleep after dinner

Decreased work performance

//// Seeking treatment as soon as these signs and symptoms are detected can ensure early diagnosis and intervention. ////

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Why is testosterone so important?

Testosterone plays a key role in health and wellness for men and women…

Offers mental clarity

Maintains muscle mass

Protects bone density with age

Increases energy

Provides cardiovascular protection

Regulates libido

Decreases fatigue

Protects the brain

While sex drive is often the most noticeable or undesirable side effect, driving patients to see a regenerative medicine doctor, the risks of low testosterone extend beyond libido to include cardiovascular, brain, and bone risks as well.

How is declining libido treated?

The first step in treatment is a comprehensive patient screening, including patient interview, review of signs and symptoms, medical history, physical examination, and blood tests. Once this is complete, Dr. Monaco can determine the underlying cause of the decline in libido. In some cases, the cause isn’t insufficient testosterone so much as it’s an overproduction of a competing hormone. Once the cause is known, a custom treatment plan is created with the goal of improving the patient’s libido and overall health and wellness.

Treatment may include dietary or lifestyle changes, the addition of natural supplements, or bioidentical hormone replacement therapy. In most cases, ongoing monitoring of hormone levels is important in ensuring the condition is well managed and maintained.

How can sexual problems impact a patient’s life?

Sexual problems can dramatically impact a patient’s life. Declining testosterone levels can put a strain on intimate relationships, cause feelings of embarrassment and inadequacy, and deeply impact self-confidence. Dr. Monaco understands the deep impact hormone insufficiency can have on a patient’s life, as well as how difficult it can feel to share these intimate details with a doctor. He provides compassionate and empathetic treatment to patients suffering from problems with intimacy with one goal: to improve the patient’s quality of life in a safe and effective way.

Adrenal Fatigue

NASHVILLE HORMONE & INTEGRATIVE MEDICINE

Adrenal Fatigue

Adrenal Fatigue

What is adrenal fatigue?

Adrenal fatigue is a term used to describe the state a person is in when their adrenal glands decrease hormone production in response to a stressful lifestyle.

What are the signs and symptoms of adrenal fatigue?

Those experiencing adrenal fatigue may struggle just to get out of bed in the morning, suffering from chronic fatigue, feel tired after waking in the morning, or have trouble thinking with clarity or completing tasks. Adrenal fatigue can make it difficult to fully function.

Why is it important to schedule an appointment?

There are 2 important reasons to see a doctor as soon as possible:

  • These symptoms can indicate a serious underlying condition like arthritis, anemia, heart failure, or diabetes and adequate screening is crucial
  • The sooner adrenal fatigue is detected the sooner the therapy will improve how the patient feels

What treatment is available for adrenal fatigue?

Treatment depends on the severity of the problem. When adrenal fatigue is caught early, in stages 1 or 2, dietary changes and herbal supplements can sometimes naturally balance hormone levels and increase adrenal gland production. However, patients who are in stage 3-4 adrenal fatigue typically require bioidentical hormone replacement therapy.

What kind of doctor treats adrenal fatigue?

Most traditional doctors will not treat adrenal fatigue; they’ll test for underlying conditions and if none are detected, they’ll prescribe medication to improve sleep or wakefulness. While these solutions may help temporarily, they don’t address the real problem: decreased hormone production of the adrenal glands.

A regenerative or integrative medicine doctor understands the dramatic impact adrenal fatigue can have on the patient’s life and knows how to screen for and treat the decline. Finding a doctor who is Fellowship trained and board-certified in regenerative medicine, like Dr. Monaco at Nashville Hormone & Integrative Medicine, is imperative in ensuring treatment is both safe and effective. An integrative medicine doctor will not rule out underlying causes but screen for those as well before making a determination.

Why is DHEA important?

DHEA is the most common steroid hormone in the body. It’s produced mainly by the adrenal glands, and to a lesser extent, elsewhere in the body. DHEA can be metabolized into other sex hormones including testosterone and estrogens and up to 150 individual metabolites. Because it’s metabolized into other hormones, DHEA may allow the body to choose which hormone is needed, then synthesize that hormone from the available DHEA.

Thyroid Health

NASHVILLE HORMONE & INTEGRATIVE MEDICINE

Thyroid Health

What is the thyroid?

The thyroid gland is a butterfly-shaped organ located at the front of the neck. Its main function is to produce thyroid hormones, which control the body’s metabolic rate. The thyroid gland uses iodine to produce thyroid hormones. Two primary hormones produced by the thyroid are T3 and T4.

What happens when thyroid hormones are imbalanced?

The thyroid directly impacts metabolism. An excess of thyroid hormones (hyperthyroidism) overstimulates the body, resulting in a slew of undesirable symptoms, including racing heart, anxiousness, and weight loss, while hypothyroidism, or a lack of thyroid hormone, can cause symptoms like fatigue/sluggishness, heart failure, mood problems or depression, and weight gain. Hyperthyroidism is rare, while hypothyroidism is common.

Low levels of thyroid hormone may result in a host of medical problems ranging from weight gain, poor energy, cardiac insufficiency, high blood pressure, high cholesterol, impaired glucose metabolism, depression and psychiatric disorders, musculoskeletal pain, infertility and reproductive disorders, pregnancy complications, and in severe cases, death. Thyroid regulation is critical.

What are the signs and symptoms of thyroid disease?

The signs of thyroid disease depend on the type of thyroid disease (hypothyroidism or hyperthyroidism). Symptoms of hypothyroidism include:

Fatigue, sluggishness, weakness

Constipation

Sensitivity to cold

Weight gain

Hair loss; thinning hair

Depression

Stiff, swollen joints

Irregular menstrual cycles

High cholesterol

Puffy face

Dry Skin

Signs and symptoms of hyperthyroidism include:

Weight loss

Rapid heart rate

Heart palpitations

Anxiety

Trembling hands

Sweating

Irregular periods

Sensitivity to heat

Hair that is brittle and fine

Trouble sleeping

Muscle weakness

Frequent bowel movements

Because thyroid disease can affect many systems of the body, it’s important that patients seek medical attention and thyroid regulation as soon as they suspect something is wrong.

How does bioidentical hormone replacement therapy improve the symptoms of thyroid disease?

The most common treatment for low thyroid hormone levels consists of thyroid hormone drug replacement therapy. The primary purpose of thyroid hormone drug replacement therapy is to alleviate symptoms. Most commonly, clinicians give a drug only containing T4 expecting the body to convert the T4 to the active hormone T3. This conversion requires many nutrients and is inhibited by stress. Clinical trials report patients feel better when a combination of T3 and T4 are given. Additionally, iodine, zinc, selenium, Vitamin C, copper, and Vitamin E may be deficient and could result in incomplete relief of symptoms as well.

Regenerative medicine doctors focus on the health and well-being of the whole patient, combining natural and comprehensive hormone therapy with diet and exercise to ensure the best possible outcome for the patient.

Stress

NASHVILLE HORMONE & INTEGRATIVE MEDICINE

Stress Relief

 

How does stress impact the body?

Patients who are under a high level of stress (have experienced a death in the family, are caring for a loved one, or have a highly stressful job, for example) often find that their stressful lifestyle is accompanied by extreme and debilitating fatigue and sometimes even depression-like symptoms. This is because when under stress, key hormone production in the adrenal glands declines, starving the body of the hormones it needs to function at its best.

What role do bioidentical hormones play in stress management?

Hormones play a critical role in every aspect of health and well-being; they have the power to regulate temperature, mood, metabolism, heart rate and more, and the power to both increase and decrease risk of serious disease. When the body is under stress (or naturally due to age), hormone production decreases, wreaking havoc on the patient and inhibiting their ability to enjoy life. Bioidentical hormone replacement therapy, also known as BHRT, is a natural, safe, and effective way to balance hormone levels throughout the body.

What kind of doctor addresses hormone imbalance in the body?

A regenerative medicine doctor is trained and experienced in screening for hormonal imbalances, identifying the safest solution, and monitoring the patient for progress and setbacks throughout the treatment period. Qualified regenerative medicine doctors are Fellowship trained, board certified, and experienced with a positive track record.

What treatment is available for stress-related hormonal imbalances?

Stress-related hormonal imbalance is typically the result of adrenal fatigue. In this case, treatment can range from simple nutritional changes to supplements or bioidentical hormone replacement therapy. Most patients require a combination of dietary changes and supplements, or in severe cases, dietary changes, supplements, and BHRT.

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How long does it take to feel better?

The recovery time depends solely on the severity of the renal insufficiency and the patient’s compliance with the treatment regimen. Unfortunately, many patients start their journey with traditional doctors and don’t find the cause of their fatigue until they see a regenerative medicine doctor, often weeks or months later. In these cases, it can take longer to balance hormones and produce the desired improvement. Most patients start to feel better a few weeks after treatment and are fully recovered within a few months.

Sculpsure Body Contouring

SculpSure® is the world’s first FDA-cleared laser treatment for non-invasive lipolysis of the abdomen, flanks, back, thighs and submental area.

What is SculpSure?
  • Good question! SculpSure™ is the very first FDA cleared, non-invasive laser platform for permanent fat reduction.
  • SculpSure™ works by heating up the fat cells above a threshold temperature to which they are no longer viable. The body then clears away the damaged fat cells on its own.
  • SculpSure™ utilizes cooling plates to keep the skin cool and comfortable while the heat is concentrated and delivered right into the fat.
  • As SculpSure™ is completely non-invasive, there is no downtime, and no need for any type of anesthesia
What are the benefits of SculpSure?
  • Treatment in just 25 minutes
  • Non-surgical & non-invasive
  • No anesthesia
  • No needles
  • No downtime
  • No pain
  • Over 95% patient satisfaction rate
  • Clinically proven results
  • Safe for all skin types
What are the biggest advantages of SculpSure?
  • Super-Fast treatment time
  • Easily tolerated
  • Cost effective
  • Completely non-invasive
  • Permanent results without surgery
  • No-vacuum or “stick of butter” as with CoolSculpting™
  • Versatile applicators allow for treating many areas.
  • Thermal spread creates treatment areas slightly larger than applicator size, and also helps blend treatment to adjacent areas.
WHAT IS THE DIFFERENCE BETWEEN SCULPSURE™ AND COOLSCULPTING™?
  • First off, it is worth mentioning that the results from both Sculpsure™ and CoolSculpting™ are about the same. You can expect a 20-25% improvement in the treated area with either procedure. On average it takes 4 sculpsure applicators or 4 coolsculpting applicators to treat an abdomen, so it is fairly easy to compare technologies.
  • TIME DIFFERENCE: Whereas CoolSculpting™ takes on average 1 hour per applicator, to treat an abdomen with 4 applicators it would take 4 hours. With SculpSure™ the same area with 4 abdominal applicators can run in just 25 minutes. Similarly, treating the love handles with CoolSculpting can take 4 hours if using 2 cool-curve applicators on each side, whereas with SculpSure both love handle can be treated simultaneously in just 25 minutes.
  • PRICE DIFFERENCE: Since the SculpSure™ system is so much more time efficient, the cost per applicator is much less. We charge just $350 per applicator for SculpSure™, whereas with CoolSculpting each applicator typically costs $600 and up!
  • COMFORT: With SculpSure™ there is no suction or end of procedure massage – the two most uncomfortable parts of the CoolSculpting™ procedure.
  • TIME TO RESULTS: Results come a little sooner with SculpSure™ than with CoolSculpting™ (6wks-3mo vs 2-4mo).
  • SIDE EFFECTS: Periodic pains and numbness up to weeks-months has been reported with CoolSculpting™ whereas there has been no reported side effects from SculpSure™. In addition bruising is not uncommon from CoolSculpting™’s suction applicators.
Prep

When discussing the procedure with your licensed practitioner, you should communicate which areas of your body you’re interested in treating. The practitioner will tell you how many sessions you might need to reach your goals. Based on licensing rules in your state, the licensed practitioner may be a:

  • doctor
  • physician’s assistant
  • nurse practitioner
  • nurse
  • aesthetician

The first SculpSure consultation often takes place right before the treatment, but sometimes you will have to schedule a separate appointment.

Be prepared to discuss your medical history and what medications you’re currently on. To minimize the chance of bruising, you might be told to avoid blood thinners and painkillers such as Ibuprofen or aspirin a few days before you plan to have a SculpSure treatment done.

We are the premier location for non-invasive laser body sculpting.

JUST 25 MIN.

In just 25 minutes, we can treat an entire abdomen, or both love handles!  This is a fraction of the time it takes with CoolSculpting.

PAINLESS

Most patients describe a mild warm sensation during the treatment.  Permanent results come in 8-12 weeks as your body clears the fat from the treated areas.

FDA CLEARED

SculpSure is FDA cleared with proven results and high patient satisfaction.  Since it is completely non-invasive there is absolutely no downtime.

 

 

The pricing for treatments at the SculpSure Center of  is based on the number of applicators.

  • Each SculpSure™ applicator is regularly priced at $350, with package rates available.
  • The average abdomen takes 4 applicators (one area), which can be run in one single 25 minute cycle.
  • The flanks (love handles) also take on average 4 applicators (2 on each side).  Similarly all 4 of these applicators can be run in one single 25 minute cycle.
What is SculpSure™?
SculpSure™ vs. CoolSculpting™?
  • First off, it is worth mentioning that the results from both Sculpsure™ and CoolSculpting™ are about the same. You can expect a 20-25% improvement in the treated area with either procedure. On average it takes 4 sculpsure applicators or 4 coolsculpting applicators to treat an abdomen, so it is fairly easy to compare technologies.
  • TIME DIFFERENCE: Whereas CoolSculpting™ takes on average 1 hour per applicator, to treat an abdomen with 4 applicators it would take 4 hours. With SculpSure™ the same area with 4 abdominal applicators can run in just 25 minutes. Similarly, treating the love handles with CoolSculpting can take 4 hours if using 2 cool-curve applicators on each side, whereas with SculpSure both love handle can be treated simultaneously in just 25 minutes.
  • PRICE DIFFERENCE: Since the SculpSure™ system is so much more time efficient, the cost per applicator is much less. We charge just $350 per applicator for SculpSure™, whereas with CoolSculpting each applicator typically costs $600 and up!
  • COMFORT: With SculpSure™ there is no suction or end of procedure massage – the two most uncomfortable parts of the CoolSculpting™ procedure.
  • TIME TO RESULTS: Results come a little sooner with SculpSure™ than with CoolSculpting™ (6wks-3mo vs 2-4mo).
  • SIDE EFFECTS: Periodic pains and numbness up to weeks-months has been reported with CoolSculpting™ whereas there has been no reported side effects from SculpSure™. In addition bruising is not uncommon from CoolSculpting™’s suction applicators.
  • Super-Fast treatment time
  • Easily tolerated
  • Cost effective
  • Completely non-invasive
  • Permanent results without surgery
  • No-vacuum or “stick of butter” as with CoolSculpting™
  • Versatile applicators allow for treating many areas.
  • Thermal spread creates treatment areas slightly larger than applicator size, and also helps blend treatment to adjacent areas.