The term “bio-identical” refers to the molecular structure of hormones used for treatment. It means that these hormones are identical in structure to the body’s naturally produced hormones. For example, bio-identical estrogens that are derived from soy or yam sources are compounded in order to have the same molecular structure as human estrogen.

Therefore, the tissues of the body will recognize these molecules as their own. Synthetic hormones, on the other hand, will have parts of its structure that look similar to natural hormones but will have other molecules that make them different from the bio-dentical ones. Thus, the actions of synthetic hormones are unable to fully replicate those of bio-identical hormones and have different results and side effects. Bio-identical hormones are available by prescription only.

Fatigue

Poor Sleep Or Insomnia

Anxiety

Mood Changes

Weight Changes

Decreased Sex Drive And Libido

Hot Flashes And Vaginal Dryness In Women

Poor Erectile Function In Men

Loss Of Skin Elasticity

Poor Memory And Concentration

Decreased Muscle Mass And Strength

Weakness

Joint Pain

In both men and women, this may include symptoms like fatigue, poor sleep, “brain fog” or memory loss, poor concentration, decreased sense of well-being, irritability, anxiety, low libido, poor sex drive, weight gain, hot flashes, menstrual irregularities (in women), erectile dysfunction (in men), loss of muscle mass and anxiety, to name a few.

Medical research has shown that there is a gradual hormone decline in males with symptoms appearing mid-life, sometimes as early as age 30’s to 40’s. Towards the later decades in life, testosterone levels decrease further and lead to further worsening of symptoms or increased risk for degenerative diseases. Additional factors like being overweight/obese further worsens hormone deficiencies.

Hormone imbalance in men is not limited to testosterone alone but includes others like estrogen, pregnenolone, DHEA, melatonin and/or thyroid. Discuss your symptoms with a physician trained in the use of bio-identical hormones to get a complete evaluation and recommendation. If hormone imbalances are present, bio-identical hormone therapy is a crucial part of your treatment regimen.

Yes, hormone imbalances can happen at any period in our lifetime. It may be aggravated by chronic illness, certain medications, stress, nutritional deficiencies or presence of any toxins in our body. A thorough evaluation will provide better information regarding the status of your hormones and any therapies that may be appropriate for you.

We recommend a thorough evaluation with a physician who has expertise in the field of hormone therapy such as our providers at WFH. You should call our office to schedule your initial patient visit with our MD’s. If you have any lab work within the last 6 months, please inform our front desk when you call to book the appointment and make sure to send/bring copies to our office. We request that all female patients bring copies of their most recent PAP and/or mammogram if performed. You will be requested to fill out a comprehensive medical information packet that includes our office policies and questions regarding your medical history.

In order to facilitate the flow of your visit, it would be helpful to have this packet completed prior to your appointment time. You may even send this ahead of time in order for it to be scanned into your electronic medical records.

Our medical doctor will do a thorough review of your medical history, current medications, supplements and perform a physical examination at your first visit. Labs will then be requested as appropriate and an individualized plan will be made with you. This plan may include prescriptions, supplements/herbs, nutrition, detoxification and stress management.

The initial hormone evaluation can be done by blood (serum) testing, blood spot, saliva or urine testing. Most of the initial hormone lab evaluation that is done at WFH is by blood/ urine testing through a laboratory like Quest, LabCorp or Clinical Path Labs, which may be covered by most insurance plans. Additional specialized testing (like saliva, urine or other blood tests) may be requested if applicable. This will be discussed with you at your visit.

Insurance coverage will vary based on your plan so you should find out from your respective insurance company with regards to coverage of tests. If it is determined that you are hormone deficient, then bio-identical HRT will be recommended as part of your overall treatment plan.

A patient is typically seen on follow-up 4-6 weeks after their initial visit in order to do a thorough review of laboratory results and further recommendations made as needed. This visit is shorter in duration that the initial evaluation.

Subsequent visits will vary in frequency (every 2-4 months) depending on individual symptoms and progress. We usually monitor your lab work at least every 6 months, sooner if medically necessary when dose adjustments are made. We will continue to monitor you at least every 6 months and will provide the necessary prescriptions to last until your next visit.

Whole Family Healthcare will not take over the function of your primary care doctor. Any prescriptions that are provided by your primary care practice should be monitored and renewed by them if necessary.

We advise that you keep a primary care doctor so that you have access to care after-hours and on weekends. We do not maintain admitting privileges at any hospitals. For our female patients, we also do not currently perform internal exams and/or PAP smears.

There is no set time period but someone may already feel the effects of bio-identical HRT after 2-4 weeks, even if it may not be the optimal levels yet. We do not over-replace hormones, we strive to keep them in balance at the levels that your body needs in order to be optimal and have a good quality of life.

In general, hormone replacement therapy is safe but may have some side effects like: increased oiliness of skin, acne, decreased testicular size, decreased sperm count and fertility (especially in younger men), mild fluid retention, increase in red blood cell count, increase in estradiol production and breast tissue enlargement, cholesterol changes, or stimulation of prostate tissue and urinary symptoms.

It is important to get baseline evaluation of prostate health before starting testosterone therapy. Studies have shown that testosterone treatment doesn’t cause prostate cancer, but it may ‘unmask’ prostate abnormalities. So, monitoring prostate health is part of ongoing treatment plans.

Most doctors who prescribe hormones to women for its effects on the uterus (ie. for bleeding symptoms) are correct in its effects on the lining of the uterus—they are virtually indistinguishable. Non-bioidentical hormones will help control uterine bleeding. However, there is a lot of data available showing the difference in effects and advantage of using bioidentical hormones with regards to their other actions in the body: there is better overall symptom control, better physiologic effects and decreased risks of developing other medical conditions. Studies have demonstrated that women on progesterone report better sleep, less anxiety, less depression, less ‘brain fog’ and an improvement in sexual function compared to progestins.

In breast tissue, progesterone decreases breast cell growth and increases the breakdown of estrogens to less potent versions. These actions are not demonstrated by synthetic progestins. Large-scale trials have reported progesterone use as having a significant reduction in breast cancer risk compared with synthetic progestins. Studies on estriol (E3, a weaker bio-identical estrogen) show that it binds to the receptor that inhibits breast cancer cell development while GEE (Conjugated equine estrogen) binds to the receptor that promotes breast cell growth. Progesterones have also been shown to maintain and help the heart-protective effects of good estrogen.