What is BHRT?
Bio-identical hormone replacement therapy, or BHRT, is a more natural way to replenish the hormones that your body already makes. Many things can cause imbalances, the most common of which is menopause. There are a variety of treatments: over-the-counter hormones available in low doses, bio-identical hormones derived from plants, and synthetic hormones. The synthetic agents (Prempro, Premarin, Provera, Estratest, Estinyl, etc) are molecular cousins of the natural agents—estrogen, progesterone, and testosterone. However, they are not identical to the structure or activity of the natural hormones they emulate. Hormones work like a key in a lock. Bio-identical hormones fit that lock perfectly. Synthetic hormones fit more like a skeleton key in some, but not all, hormone receptor (“lock”) sites. Side effects are more common with synthetic hormones because of poor lock and key fit and not all organs benefit from the protective effects that bio-identical hormones can offer.
BHRT For Women
Women have traditionally used synthetic estrogen therapy to treat menopausal symptoms and to help protect against osteoporosis. When your hormone levels are restored naturally, you will enjoy the same protective benefits that synthetic HRT offers without the troublesome side effects. These synthetic side effects include, but are not limited to, an increased risk of ovarian cancer, breast cancer, and cardiovascular disease.
There are three major types of estrogen: estrone, estradiol, and estriol.
Estrone is found in women after menopause. Its functions are basically the same as those of estradiol, but they also tend to be weaker.
Estradiol is present in women before menopause. It is not only important for sexual and reproductive health, but also for the rest of the body, especially organs and bones. Estradiol is also an antioxidant, which means that it also has a neuroprotective function. It has also been linked to reduction of coronary artery disease. Being one of the most important estrogens, it can improve psychological well-being and decrease the severity of hot flashes.
Estriol is another naturally occurring hormone for the female.
These estrogens can be combined in a number of ways. Bi-est is made from estradiol and estriol, whereas tri-est is a combination of all three.
Progesterone is made from pregnenolone, a derivative of cholesterol. In women, it is crucial to the menstrual cycle, preparing and maintaining the uterine lining. If there is no pregnancy, progesterone signals the lining to shed, causing menses. In menopause, when a period is no longer present, progesterone levels drop drastically. This would be fine, except that progesterone plays an important role for hormone balance. It also has mood-enhancing and anti-depressant effects. If a woman has a deficiency in progesterone, she may feel anxious, angry, and irritable.
This hormone helps with bones, ligaments, muscles, libido, energy, and relieving depression. Many people think that testosterone is purely a male hormone, but it is also beneficial to women in lower doses.
BHRT For Men
Many people do not realize that women are not the only ones to suffer because of a hormone imbalance. Later in life, testosterone levels in men may decrease, causing symptoms such as decreased sexual desire, osteoporosis, and changes in mood.
Frequently Asked Questions
The First Steps
How do I know if my hormones are imbalanced?
As people age, hormone levels rise and fall. Symptoms can vary from person-to-person, and there are specific differences in hormone imbalance symptoms between men and women. Females may be anxious, irritable, depressed, and have mood swings. There may be memory lapses, foggy thinking, headaches, bone loss, water retention, weight gain, low libido, hot flashes, night sweats, irregular periods, excess facial/body hair, polycystic ovaries, vaginal dryness, or infertility. For males, there may be abdominal fat, low libido, decreased mental clarity, decreased strength, decreased stamina, difficulty sleeping, erectile dysfunction, night sweats. Men may feel irritable, depressed, or burned out. While these symptoms alone cannot diagnose a hormone balance, they are helpful in evaluating whether or not to be tested.
How can my hormone levels be tested?
Talk to your doctor about obtaining a saliva test. By testing your saliva instead of blood, the amount of free hormones can be better evaluated. After the test results are obtained, your doctor will know which hormones need to be adjusted and by what quantities.
If I had a hysterectomy, do I still need progesterone?
Historically, progesterone was considered the “pregnancy hormone”, so many healthcare professionals felt it was not needed by a woman with no uterus. Now we know that progesterone plays many important roles in your body. Breast health, bone health, fluid balance, cognitive function, libido, and emotional stability all are influenced by progesterone. So, the absence of a uterus should not be the deciding factor when examining your need for progesterone.
Do women need testosterone?
Testosterone is predominantly a male hormone, but small amounts are necessary for women as well. If patients have Diabetes Mellitus and use insulin, this medicine may affect blood sugar and insulin requirements. Patients should check blood glucose levels closely and ask their physician before adjusting the dose of their insulin. Testosterone helps build bone, maintain muscle tone, increase energy, and maintain libido. When supplements are necessary, only very small amounts are used to prevent masculine effects.
Do I need a prescription?
Prescriptions are required for all compounds, BHRT or otherwise.
How can I talk to my doctor about BHRT?
The first step is to make an appointment. When you call, ask to schedule a “hormone consultation”. It may be helpful to make a list of questions to ask and bring the list with you. Women to Women is an excellent resource for preparing yourself with what to ask, when to ask, and how to do it.
Where can I learn more?
We have put on several BHRT seminars and can even work with your group to set up a seminar that fits into your schedule. Also, our pharmacists are highly knowledgeable on the topic; you can reach them by phone, email, or by dropping in to the store. For information outside of the store, we recommend you read Ageless by Suzanne Somers as well as Are Your Hormones Making You Sick? by Taylor MD Eldred.
What strengths are available?
Virtually any! Since these compounds are handmade and not mass-produced we are able to evaluate your hormone levels and dispense the exact amounts necessary.
How can hormones be dispensed?
There are many choices available, including capsules, topical creams and gels, suppositories and sublingual drops or lozenges. The oral treatments (trochees) can be made in a variety of flavors. Mint often masks the flavor the best, but we have recently started offering orange and raspberry to patients who request them. Creams are made with a combination of Moisturel lotion and cream, sure to leave your skin smooth.
The Cost of BHRT
Can my insurance pay for my BHRT?
Though this answer certainly varies with insurance carriers, BHRT compounds are not covered through most insurance plans. We can submit claims directly to your insurance company in store; however, sometimes additional paperwork needs to be filled out.