Female HRT Therapy
Bioidentical hormones are different from those used in traditional hormone replacement therapy (HRT) in that they are identical chemically to those our body produces and are made from plant estrogens. The hormones used in traditional HRT are made from the urine of pregnant horses and other synthetic hormones. Female hormone imbalance greatly contributes to the morbidity of women in the United States. One of the reasons that so many symptoms are associated with female hormone imbalance is due to the vast interrelationship between sex hormone levels and other body systems. The benefits of estrogen, progesterone, and testosterone in both men and women include reduced risks of heart disease, dementia, and osteoporosis, among many others.
Progesterone balances out estrogen replacement therapy, but the clinical effects such as increased sleepiness are largely due to metabolites formed in the gut. This is a good option when postmenopausal women struggle with sleep, however, a different route of action may be better for premenopausal women. 100 mg to 200 mg has been shown to balance concurrent estrogen replacement.
Patches offer consistent hormone dosing over time and are highly effective at managing hot flashes. Even low doses typically increase bone mineral density (BMD).
proven to increase serum and urine levels as well as improve hot flashes and BMD. Transdermal E2 is attractive because it is easy to use and bypasses first pass metabolism, which can cause unwanted side effects. Estriol is often given in doses 1 to 4 times higher than estradiol.
Testosterone or Estradiol Pellet
pellets offer consisting hormone over time for testosterone and estradiol. Research is limited on of effects on hot flashes and bone mineral density. Because serum/urine E2 levels match or exceed those seen in patches, E2 pellets are likely to help with hot flashes and BMD.
Vaginal Estrogen or Testosterone
Low doses increase local tissue levels while higher dose higher doses also increase the systemic levels.
Placing the hormone in the top 1/3rd of the vagina significantly o increases urine levels and hormonal effects. Estriol is often given in doses 1 to 4 times higher than estradiol.
Transdermal testosterone can be used to correct low testosterone (low T) and improved sex drive and muscle mass.
Male Testosterone Replacement Therapy (TRT)
As men age, the amount of testosterone in the body gradually declines — typically about 1 percent a year after age 30 or 40. Testosterone replacement therapy can improve the signs and symptoms of low testosterone in these men.
My clients are best served by in-depth questioning and comprehensive diagnostic testing. Subsequently, the decision to use either injectables, nutraceuticals, and/or testosterone replacement therapy is made. Improved stamina, healthy, stronger muscles, leaner body mass, and less body fat increased libido and an overall improved feeling of health and well-being.
Testosterone pellets offer consistent hormone dosing over time. Hormone pellets are inserted below the surface of the skin and gradually release the desired hormone into the body. A simple in-office procedure is performed in our office every 5-6 months for placement.
The most frequently used testosterone injections are testosterone cypionate (8-day half-life) and testosterone enanthate (4-5 day half-life). Injections provide robust testosterone levels for 1-2 weeks typically. The injections are dispensed to you in monthly increments for weekly home administration. It is best, to begin with lower dosing and monitor the clinical and lab response before considering more aggressive treatments.
Testosterone creams and gels are the most popular TRT formulation but can be challenging to dose and monitor effectively. Doses between 50 and 150 mg are commonly used in studies to see improvements in muscle mass and other clinical parameters. Cream applications come in a variety of bases. The creams are applied daily, and the hormone is absorbed through the skin and interacts with the hormone receptors for desired results. Application is convenient, but patients must also be careful to avoid transference (to partners, children, or pets).