Bioidentical Hormone Replacement Therapy (BHRT) is a more natural approach to hormone balance. BHRT uses hormones that are chemically identical to the body’s natural hormones.

How it works

• Bioidentical hormone replacement therapy (BHRT) uses plant-derived hormones to mimic the body’s natural hormones. The goal is to balance hormone levels to help with symptoms like hot flashes, mood swings, and vaginal dryness.
• It can help with symptoms of aging, menopause, sexual dysfunction, osteoporosis, cardiac disease, and may help reduce the risk of Alzheimer’s disease.
• BHRT can be prescribed as oral supplementation, patches, transdermal creams or vaginal creams for more localized administration.

Benefits of BHRT

• BHRT is a gentler alternative to harsh medications and surgeries
• BHRT is better tolerated and has a favorable safety profile compared to synthetic hormones
• BHRT can improve sleep, energy levels, and sex drive

When to consider BHRT

• BHRT may be a good option if you’re experiencing symptoms of hormonal imbalance, such as: exhaustion, stress, foggy thinking, weight gain, and sleep disturbances among many others.

 

How do I know if I need BHRT?

We recommend women be evaluated with a full hormone panel starting anywhere from 35-40 years old. This is a time when hormonal fluctuations can occur and symptoms of imbalance often manifest.

In prescribing BHRT we start low and go slow. This helps the body adjust before increasing the dosage. It is important monitor any hormone replacement therapy by monitoring symptoms and using appropriate testing after supplementation. A lack of hormones can mean increased risk for heart disease, osteoporosis, and Alzheimer’s disease later in life, while abnormally high estrogen can cause inflammation and increased risk for certain cancers, like endometrial cancer. We can reduce this risk of endometrial cancer by making sure progesterone levels are sufficient. Though we do know from research that estrogen supplementation does not increase the risk for breast cancer.

Balance is the key and it is important to look at not just estrogens and progesterone, but to assess how insulin, thyroid, DHEA, FSH, LH, cortisol, pregnanolone, testosterone, and other hormone precursors are interacting for a full body understanding.

Hormone precursors are hormones that convert into other hormones. Without these precursors, we miss many of the benefits of the full hormone cascade working together for the body as a whole. Each precursor has unique benefits.

Progesterone helps ease anxiety and provide calm and deep, restful sleep. It is a neurosteroid and helps the nervous system function well. It is important to know that progestin is a synthetic form of progesterone and does not work the same as progesterone and comes with increased risks.

There are 3 types of estrogen. Estradiol is the most powerful of the estrogens and can help with many perimenopausal/menopausal symptoms. It is important for bone health, healthy cholesterol levels, brain, heart, skin health. It is prescribed with progesterone, because if given alone it can stimulate the growth of the uterus lining and increase the risk of endometrial cancer.

Estriol is a weak form of estrogen that can be used to help alleviate some menopausal symptoms while also not increasing the risk for breast cancer. Estriol is great vaginally to support these sensitive tissues and a healthy microbiome.

Dehydroepiandrosterone (DHEA) is made from cholesterol in the adrenal gland and can convert to testosterone and estrogen. These levels are highest at about 30 years old and decrease significantly as we age. Low levels of DHEA can contribute to low libido, reduced bone mineral density, heart disease, and osteoporosis, whereas sufficient levels are associated with brain health, immune function, energy, bone metabolism, blood sugar regulation and healthy libido.

Testosterone is made in the ovaries and the adrenal glands. When testosterone levels are low we see impacts in energy levels, mood, sex drive and cognitive function. It helps with bone, skin, and nail health as well as possible neuroprotective benefits.

Pregnenolone is made from cholesterol in the adrenal glands and the brain and is considered a neurosteroid. It is a precursor to progesterone and DHEA. It provides protection against nerve cell damage, neuroplasticity, growth of nervous tissue, helps regulate mood and memory and assists with weight loss, libido, and energy.