Everything You Need to Know About Bioidentical Hormone Replacement Therapy

*This post was originally written for posting on the Madsen Medical Direct Care website.

When a patient of a certain age comes into the office with symptoms like brain fog and inability to focus, low sex drive, low energy, hair loss, weight gain, and mood swings (to name a few), we often explore hormone levels to see if bioidentical hormone replacement therapy would be beneficial for the patient. 

Hormone replacement therapy is a tool that physicians and providers use to optimize hormone levels, including testosterone, progesterone, estrogen, and thyroid. It is administered through pills, pellets, injections, creams, gels, patches, or troches.

The term "bioidentical hormones" means the hormones used in the product are chemically identical to those your body produces. Bioidentical hormones provide the same action and effect, are metabolized into the same downstream metabolites, have the same binding affinity, and are expected to restore normal physiology like natural hormones. 

Humans were created in such a way that hormones impact many essential bodily functions, including appetite, mood, sex drive, brain function, and even help with sleep. For a more comprehensive list of potential symptoms that occur with hormone imbalance, see here.

The art of hormone replacement requires the following from the provider and the patient:

1: Using traditional medicine with its ability to come up with a differential diagnosis. This means a list of possible conditions that share the same symptoms that you described to your healthcare provider. This list is not your final diagnosis but a theory about what could be causing your symptoms.

2: Gathering an extensive patient history, which may take 30-60 minutes to identify the array of nonspecific symptoms. 

3: Obtain appropriate laboratory tests.

Considering these variables, your provider can sit down with you and develop a plan for optimal health and longevity. As with most health issues, it is worth noting that certain lifestyle choices, such as processed foods and refined sugar, lack of physical activity, and prolonged stress, will all impact hormone function in the body.

What can patients expect on BHRT?

In our experience, both men and women with proper hormone replacement will have improvement in symptoms within 3 to 4 weeks. One of the most rewarding experiences is to hear our patients talk about how drastically their lives have changed with the use of bioidentical hormone replacement therapy.

Things to remember when using bioidentical hormone replacement therapy. 

1: Everyone who has symptoms of hormone deficiency does not necessarily have hormone deficiency. Often, other medical conditions present nearly identically to hormone deficiency, such as sleep apnea, adrenal insufficiency, thyroid problems, etc. These medical problems may be the culprit and need to be corrected. A solid understanding of traditional medicine is imperative.

2: Using hormone replacement without addressing diet, exercise, and stress is like trying to fly a kite without wind. A medical group that provides hormone replacement without incorporating specific instruction on diet, exercise, and stress management, in our opinion, is not providing holistic care and your results will be suboptimal.

Looking for a provider? Consider these three things.

1: Look for a medical practice with an in-house physician who is board-certified by one of the American Boards of Medical Specialties.

2: The medical provider should have credentialing in the use of bioidentical hormone replacement. Most traditional medical training programs do not offer this in-depth training on the use of bioidentical hormones and even traditional hormone replacement therapy. This specialty training should not come from a weekend conference but from a rigorous training program.

3: Medical providers should be trained in an integrated approach to medicine that incorporates a holistic view of the patient and the therapies available to treat symptoms. Remember that an individual's symptoms may or may not be connected to a hormone imbalance, so the medical provider must be trained to see the whole picture. For example, hot flashes can be a signal of estrogen deficiency, but they may also be a signal of sleep apnea, hyperthyroidism, tuberculosis, HIV, lymphoma, Lyme disease, carcinoid, or even malignancy.

Hormone optimization is an exciting option for optimal health and longevity. It's safe and effective when approached in a well-educated, holistic approach. If you'd like to find out if bioidentical hormone replacement therapy would be beneficial for you, please call our office at (740) 774-7444.