Bio-Identical Hormone Treatment

The human body contains more than 100 different hormones. However, say the word “hormone” and many people will only think about estrogen, testosterone, raging PMS or menopause. Hormones do it all; they are what make you a man or a woman. But they also put you to bed at night and wake you in the morning. They control your sex drive, calm down your anxieties and relieve depression. And they are responsible for the burning and storage of fat. Any attempts at weight loss without considering the effects of these chemical messengers will be in vain.

Balance - JG NP

Hormone imbalances can be a matter of excess or deficiency. Too much thyroid hormone, called hyperthyroidism, may give you a racing heart, panic attacks, and insomnia. Not enough thyroid hormone,called hypothyroidism, will cause weight gain, hair loss, and fatigue. Too much testosterone in a woman may cause acne, aggressiveness and a mustache like your Uncle Tony. Too little and say goodbye to libido and the ability to build muscle. Our bodies want just enough of these hormones to keep bodily functions running smoothly.

FAQ’s About Hormones

What is the difference between synthetic hormones and bio-identical hormones?

In our bodies, our hormones work on a lock and key mechanism. Our own hormones fit the lock exactly allowing the proper message in the amount needed by the body to get through. Bio-identical hormones, when carefully and appropriately compounded, also fit the lock almost like our own hormones, allowing them to mimic the actions of our own hormones and keep things in balance. Synthetic hormones do not usually fit the lock well and must “force” their way in. These hormones are often made from pregnant horse urine (thus the name “Premarin”) and because they don’t sit on the hormone receptor exactly as the body likes, they may block out other hormones from also reaching that receptor.

Can I get bio-identical hormones from a regular pharmacy, such as CVS, or do they need to be compounded?

Some bio-identical types of hormones have been released by the pharmaceutical companies. One example of this is Elestrin or

Divigel, which are bio-identical types of estradiol. They have an altered patented system owned by the pharmaceutical company.

Prometrium is another example of a bio-identical type of progesterone that is available at any pharmacy. The disadvantage of these hormones is they only come in 1 or 2 doses and can’t be changed if those doses do not work for you. Also the slow release progesterone form the compounded pharmacist is superior in aiding deep restful sleep all night. The major advantage is that compounded bio-identical hormones can come in whatever dose the patient needs because the pharmacy can “compound” that hormone into whatever is needed. The one size fits all method does not always work when addressing hormone imbalances.

I have heard that compounded bio-identical hormones are not FDA approved. Why is that?

In order for the FDA to approve a drug, they must test that drug in the proper dosage and combination. Because a compounded hormone can come in any dose that the physician determines is needed by the patient, it is not possible to test each of these doses. Bio-identical hormones that are not compounded and only come in one or two doses (like the Prometrium example above) are FDA approved. However, this does not mean they are safer than the compounded versions of these hormones.

How soon can I expect to feel better after I start my hormone therapy?

The amount of time needed to see a positive change in symptoms after starting therapy is different for everyone. Bio-identical hormones sit on the hormone receptor site for about 3 months. This means that it takes about 3 months for a change in hormones to saturate that receptor site. It is usually best to wait about 3 months before changing doses (up or down) because that is about how long it will take for the current dose to actually take effect.

Common complaints from our patients as to why they initiate hormone therapy include insomnia, hot flashes, loss of libido, night sweats, depression painful intercourse and irritability. While these symptoms definitely can arise from hormonal imbalance, diet, exercise, stress and other life factors can also play a huge part. In our hormone programs, we educate and empower you on lifestyle changes that can be made to enhance the effects of hormone therapy.  Patients that make these changes, as well as take their prescribed hormone regime, tend to feel better more quickly.

What kind of testing do you do to track my hormone levels?

In most cases saliva testing will be recommended. Your hormone levels fluctuate greatly throughout the course of your monthly cycle and this testing allows us to track these fluctuations. Even if you are no longer having monthly cycles, your hormones levels will vary daily and saliva allows us to get an average of the hormone levels over the course of a few days. Checking hormone levels in blood looks at your levels on that specific day and can be a place to start when evaluating hormones produced by your own body. However,to get a clearer picture of your tissue hormone levels we will also look at your saliva. Once you are on hormone therapy, those hormones only stay in the blood for a short time (in some cases, only a few minutes) before they are absorbed into the tissues, which may lead to overmedicating if levels are not tracked through salivary testing. Typically the hormones that we prefer blood testing for are thyroid and pregnenolone hormones.