Who is a candidate for BHRT?

Hormones begin to decline by age 30, and by age 40, health can be affected by these hormonal imbalances. Both men and women are candidates to receive BHRT.

BHRT for women:

Women may be eligible for hormone replacement in the form of testosterone, estradiol and/or progesterone. Testosterone in women is produced mainly in the adrenal glands and ovaries and plays a large role in women’s health. Some studies state that women begin to decline in testosterone in their 20s, and they can see a significant reduction in testosterone production by the mid 30s. By age 40, most women have lost approximately 50% of their testosterone production. Some studies support that testosterone can actually lower the risk of breast cancer.

Decreasing levels of estradiol are directly related to menopausal symptoms. Women typically complain of brain fog, difficulty maintaining tracks or thought, and difficulty with tasking. Research reveals that approximately 1 to 2.5 million women in the U.S. over age 40 are benefiting from the use of compounded bioidentical hormones.

For women, non-oral estradiol does not increase the risk of hypercoagulability. Women who have perimenopausal symptoms, personal or family history of heart disease, osteoporosis, Alzheimers, usually benefit from BHRT.

BHRT for men:

For men, hormonal decline can even begin as early as mid 20s, with men typically experiencing a 1% yearly decline in testosterone after age 40. Because laboratory findings are simply guidelines, many men when tested are told that their testosterone is within normal limits, when in fact they could benefit from BHRT. If you are a male experiencing signs and symptoms of andropause or “low-T,” we are happy to evaluate you and determine if you are a candidate.

What are the side effects or risks?

There are always risks and benefits to any procedure or medication, but BHRT via pellets yield minimal side effects. Again, the hormones in BHRT are molecularly identical to your body’s own hormones, and bio-identical estradiol and testosterone are FDA approved. Most commonly patients may experience breast tenderness and/or mild transient weight gain of 2-3 pounds that spontaneously subsides. The incision site for pellet placement is subcentimeter in size (less than half an inch). These sites heal well, making it difficult to even identify prior insertion sites; there is minimal risk of scarring or hyperpigmentation when placed correctly.

Why BHRT over other forms of HRT?

BHRT are naturally sourced, plant derived, and molecularly identical to your own hormones. Pellet form BHRT is convenient, as treatment is needed only every 3 to 4 months. The pellet releases hormone continuously, and gradually, which helps avoid the frequent highs and lows noted with other forms of HRT, including injections. Injections are less convenient, as they can be required as frequently as every 3-4 days, causing rapid and frequent symptom fluctuations. Non-bio-identical estrogens contain animal hormones, leading to the  production of metabolites that can contribute to hypertension.

Does BHRT really work?

Yes. Although most patients notice improvement in symptoms within 3 to 4 weeks, it could take up to 6 months, or at least 2 cycles, for those new to BHRT to notice significant change and full optimization. A patient’s age, weight, activity level, metabolism, and male/female can affect dosing and length of benefit from treatment. Pellets can be used long term and they can be discontinued at any time. Discontinuation will lead to your hormones resting back at a pre-procedure range; they will not slow the natural production of your endogenous hormone levels. 

How do I get started?

The initial step in BHRT is to schedule a consultation. At this visit we will thoroughly review your personal and family medical history, discuss goals of therapy, and draw initial full panel labs. Once your labs are resulted, they will be reviewed with your history to determine your eligibility. 

If you are deemed a candidate for BHRT, you will then be scheduled  for an appointment for the in office procedure. The procedure is a minor surgical procedure completed under local anesthetic with minimal discomfort. A small incision is placed in the skin and the pellets, which are smaller than a grain of rice, are inserted in the gluteal pocket just above the gluteal muscle. Heavy exercise and activity is discouraged for a few days post procedure to allow the pellets to properly seat. The site is dressed with steri strips and a small dressing.

Over the course of the next few months the hormone pellets will continuously and slowly release into your bloodstream. Peak levels are typically noted around 5-6 weeks. Patients may begin to notice a slow increase of symptoms around 3-4 months. At this time the process of lab analysis with history is used again to begin the next round of dosing. When starting BHRT, a minimum of 2 cycles is recommended in order to fully optimize results.