Bioidentical hormone replacement therapy (BHRT) has been prescribed for men and women for over 50 years. Patients seeking BHRT present with many complaints as they develop many untoward symptoms of hormonal decline. The symptoms slowly develop during perimenopause, menopause, and andropause (male menopause). 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. At first blush patients are surprised that hormonal replacement has been scientifically studied and prescribed for over 50 years in Europe.

The topic of BHRT is overwhelmingly confusing. Patients are confused, and rightly so, as they listen to the mercurial way hormone replacement is discussed in the media. Bottom line, the medical research obtained results using synthetic hormones and Integrative medicine does research using BHRT. Synthetic hormones such as Horse Testosterone and Estradiol are too strong and have a laundry list of unpleasant side effects. Horses are much bigger than human males and females.

Synthetic Progesterone (Provera, Progestogens, Progestins) cause coronary constriction, bloating, depression, and weight gain……..Most women are already experiencing weight gain and depression. So my thoughts are let’s help the patient and not cause harm. One must question why synthetic Progesterone was ever prescribed if the information in the package insert teaches us that heart disease and depression are two major side effects. Since heart disease is the number one cause of death I ponder why we are hanging onto antiquated training which prescribes synthetic Progestin.

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/partners – when I return your wife to you please send plants if you must. Flowers perish, plants have botanic longevity.

I have been fortunate enough to be trained by fourth generation European Endocrinologists. This training has enabled me to reverse most, if not all, of the above symptoms. Of course, whole food nutrition helps any hormonal program work better. When we synergistically marry BHRT with whole food nutrition your former state of robust health will emerge victoriously.
My youngest menopausal patient is 31 years old. And perimenopause can last as long as a decade.

May I suggest that you read The Hormone Soultion by Thierry Hertoghe, MD. This book is an easy read and you will understand that there are many hormones which decline with the passage of time. Low dose replenishment of HRT is done using physiologic (low doses), not pharmacologic (high doses).

When physicians or medical residents train with me to learn BHRT treatment, they receive a 27 page question and answer test. Even with that training, please know this is an art, and every patient is biochemically unique so your treatment program is different from someone else’s prescription. After a full history and understanding how you respond to treatment. and a physical exam – your program becomes clear. So prescribing your unique program takes time, and continues to change with time.

In 2010 we know that Estrogen affects over 300 tissue systems — helps maintain temperature regulation, appetite, hair, skin, bones, and mood – Estrogen is not just for hot flashes and vaginal dryness any more. In 2010 we learn that Estrogen affects 300 tissue systems. I take Estrogen for my brain, metabolism, skin, and bones……

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, 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 and men tell me “thank you for giving my wife back.

I understand you are confused and I realize that you think gynecologists and endocrinologists (horomonal specialists) are the experts in hormones. Gynecologists are very busy surgeons. Most physicians learn Endocrinology by listening to drug reps tell them about the latest FDA approved Synthetic hormone. what the drug reps tell them. Endocrinologists, even great ones, are experts in the thyroid and pancreas, and hormonal disease states which are highly complex such as Empty Sella Syndrome in the Anterior Pituitary Gland, thyroid cancer, and Insulinomas. Physicians do not learn how to prescribe BHRT in in our conventional American medical training.

The only way your doctor is going to know how to prescribe BHRT is if they attend conferences which are offered throughout the US and Europe. When I lecture, there is always a question regarding why didn’t my Mother and Grandmother need these hormones. They lived in a very different environment, with a distinctly different food supply.

If we learned everything we need to know in our medical training, we would never emerge from the lecture hall. At some point they have to emancipate us from endless lectures and countless hours in the hospital. Physicians choose what they are most passionate and choose to continue studying and learning. I choose to study BHRT and weight loss since there is an obesity epidemic. This has required me to study with fervor, and attend 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 — the problem is we don’t know which 50%.” So we continue to study, learn, unlearn many edicts of medical wisdom we learned, then relearn new medical wisdom. This requires a highly flexible brain with cerebral hemispheric synchonicity — meaning that we continue to change because our brains have neuronal plasticity. We protect patients with the edict to do no harm. We listen to patients. RFM update 05/03/10