Bioidentical Hormone Replacement Therapy

For decades, bioidentical hormone replacement therapy  ( BHRT) has been prescribed for men and women who are experiencing untoward symptoms of perimenopause, menopause, and andropause (male menopause). A prescription is required for bioidentical HRT and a compounding pharmacist makes hormones which are identical to the hormones you were making in your 20s and 30s. No synthetic hormones are prescribed.

The hormones come in various delivery systems - creams, gels, pills, troches (lozenges), injections, and suppositories. Hormonal blood levels are obtained before and during treatment. All the research you see on television and read about is done utilizing synthetic hormones.  Integrative physicians do not give horse estrogen to human females.

 Synthetic Progesterone (Provera, Progestogens, Progestins) cause cornary constriction, bloating, depression, and weight gain........One must question why synthetic "Progesterone" was ever prescribed if this information is in the package insert .   Heart disease is the number one cause of death in women.  So one must question why are we hanging onto antiquated training which prescribes something which constricts  (tightens) the coronary (heart) arteries?  I will not prescribe synthetic Progesterone.

Menopausal and perimenopausal symptoms include but are NOT LIMITED to the following: hot flashes, night sweats, insomnia, headaches, poor memory, vaginal dryness, pain with sexual relations, loss of libido, difficulty reaching climax, difficulty losing weight, myalgias (muscle pain), fibromyalgia, hair loss, irritability, mood swings, and difficulty converting fat to muscle.   Note to husbands,  when I return your wife to you please stop send plants, unlike flowers they live. 

Being fortunate enough to be  trained by fourth generation European Endocrinologists has enabled me to reverse most, if not all, of the above symptoms. Of course, whole food nutrition helps any hormonal program work better.  Much better actually.  And fat cells contain Estrone, which inhibits my work. 

Our youngest menopausal patient is 31 years old.  And perimenopause can last as long as a decade.  Suzanne Somers'  very understandable  book called The Sexy Years tells her story of battling breast cancer, experiencing most of the menopausal symptoms heretofore listed, and finding a physician to prescribe Bioidentical HRT (BHRT).   The absolute must have book is Natural Hormone Balance by Uzzi Reiss, MD.   Dr. Reiss is an OB-GYN physician in Beverly Hills, California who has been treating women and men with BHRT for over 30 years.

When physicians or medical residents train with me regarding BHRT, they receive a question and answer test pulled from reading Dr. Reiss' book FIVE+ times.  Even with that training, please know this is an art, and every patient  is different.   This requires a full history and understanding of how each patient responds to treatment.  This takes time.

In 2007 we know that Estrogen affects over 300 tissue systems.  Estrogen helps maintain temperature regulation, appetite, hair, skin, bones, mood - and many other systems.  So prescribing Estrogen is not just for hot flashes and vaginal dryness.  Progesterone acts as a natural antidepressant, promotes diuresis, aids thyroid action, stabilizes blood sugar and appetite, maintains the lining of the uterus, normalizes blood clotting, normalizes zinc and copper levels, builds bone,  and promotes fat burning. Progesterone is needed even if you no longer have a uterus.  Both Estrogen and Progesterone assist in restoring libido.  As the French say, many problems are settled on the pillow.  Many marriages have been saved.

Please know, I understand you are confused.  You think gynecologists and endocrinologists (horomonal specialists) are the experts in hormones, which is understandable.  Gynecologists are very busy, they are surgeons.   Most physicians know what the drug reps tell them is new approved medication.   Endocrinologists, even great ones, are  experts in the thyroid and pancreas, and hormonal disease states which are highly complex.  For example,  Empty Sella Syndrome in the Anterior Pituitary Gland.  No physician actually learns BHRT in our conventional American medical training as of this writing. 

But that is changing.  Conferences are being held in the US with leading European and American physicians who have actually trained in this subspecialty.  When I lecture, there is always a question regarding why didn't my Mother and Grandmother need these hormones.  That was a very different environment, with a distinctly different food supply. 

Please know if we learned everything we need to know in our medical training, we would never emerge from the lecture hall.  Physicians must choose what they passionately embrace and continue studying and learning.  Among many other maladies,  I choose BHRT, and weight loss since there is an obesity epidemic.  This has required me to study with fervor, and attend many, many conferences both in the US and beyond.  This is not a fault of the present medical training.  Remember that at Brown Medical School graduation they said,  "50% of what we taught  you is wrong,  we just don't know which 50%. "  Updated by Roberta Foss-Morgan, DO, September 3, 2007