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Millions of women are suffering from symptoms of hormone imbalance. As women approach menopause, declining levels of certain hormones can cause significant symptoms. Signs of female hormone imbalance include menstrual irregularities, hot flashes, night sweats, weight gain, mood changes, low libido, fatigue, brain fog, vaginal dryness, and insomnia. In many cases, bioidientical hormone therapy can help.

What are bioidentical hormones?

The term “bioidentical hormone” refers to hormones created to be exact replicas of the hormones found naturally in the body. They are made from compounds found in plants (typically wild yams). They are then processed by highly trained compounding pharmacists into capsules, creams, and pellets to meet the needs of individual patients. Many people are under the misconception that bioidentical hormones are not approved by the FDA. Bioidentical hormones are FDA approved, but because of their customization for individual patients, FDA approval and regulation is limited.

Why not synthetic hormones?

Synthetic hormones are chemically similar to human hormones but are not identical. These hormones essentially act as toxins since their chemical makeup cannot be metabolized properly. This is why traditional hormone therapy using progestins and animal estrogens (Premarin, Prempro) is associated with so many adverse side effects and risk.

Do hormones cause cancer?

Many women are fearful of using hormones because of the well documented link between synthetic hormones and cancer. Synthetic hormones have been found to increase a woman’s chance of developing breast, ovarian, and uterine cancer. Bioidentical hormones on the other hand, do not increase risk; in fact, bioidentical hormones reduce the risk of breast cancer by correcting hormone imbalance.

How do I know if I need hormones?

If you have any of the symptoms listed above, you may benefit from hormone therapy. Simple blood tests can be done to determine your individual hormone levels. In some cases, saliva testing is also utilized to evaluate hormone levels.

What are my treatment options?

Most hormones are given in capsules, creams, or pellets which are placed under the skin. Some hormones are not recommended to take orally due their potential for causing harm to the liver. Hormones that are taken by mouth (thyroid, progesterone, DHEA) are taken on a daily basis either in the morning or evening. Topical hormones are used daily, six days per week. They need to be rubbed into the skin for 1-2 minutes to minimize the risk for transference.

Pellet therapy has been available in the US since the 1930s. It provides a steady state release of hormone which is nearly identical to the way hormones are naturally produced in the body. Pellets contain 3-4 months of hormone and are placed under the skin by a physician in a very minor procedure done right in the office which takes about 15 minutes. This route is the most physiologic, most convenient, and carries the least risk of transference.

Once pellets are placed, blood levels are checked to determine if you need more or less hormone. These adjustments are done with subsequent placements. Extrusion of pellets is rare, but reported. It is important to avoid vigorous activity for about three days while the small incision site heals.

It is common for a combination of options to be used for the treatment of hormone replacement or hormone imbalance. It is important that you continue to see your primary care physician for yearly health maintenance examinations.

Isn’t testosterone a male hormone?

Testosterone is an anabolic steroid found in high levels in men, but it also plays a very important role in women. Similarly to men, testosterone levels in women decline as we age. Testosterone is best known for its role in improving a woman’s libido, but it also improves energy, stamina, exercise tolerance, muscle mass/body composition, mood, brain fog, memory, bone strength, and overall sense of well-being. Testosterone in women is responsible for providing sensitivity of the nipples and clitoris associated with sexual pleasure.

What are the potential side effects?

Reaching optimal hormone levels can take several months and you may have symptoms of adjustment before you achieve the perfect balance. Potential side effects include changes in mood, sleep disruption, acne, breast tenderness, irritability, headaches, and soreness or itching at the application or insertion site. It might seem frustrating to continue to see the same symptoms we are trying to correct, but as your treatment continues and hormone levels improve, you will feel much better.

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