1. Why does a woman need hormones during and after menopause?
To treat perimenopausal and menopausal symptoms. Hormones control virtually all functions of the body including our reproductive, immune and metabolic systems. Hormones can actually control our overall physical and mental health. As hormone levels decline, we suffer both physically and mentally. By restoring these hormones, we regain our youthful zeal, strengthen our bodies and renew our minds.
2. Why does a man need testosterone replacement?
As a man ages, his testosterone levels decline. Testosterone offers cardiovascular, bone and brain protection, helps maintain bone density and muscle mass, helps maintain mental clarity, increases energy, decreases fatigue and regulates libido.
3. What are the side effects associated with synthetic vs. bio-identical hormones?
The molecule of the biological-identical hormone is identical in structure to the hormone naturally found in the body. Synthetic hormones have a structure similar to but not exactly the same as a hormone produced by your body. Pharmaceutical companies cannot patent natural or bio-identical compounds. However, they can patent chemically different molecules that are highly profitable. These chemical differences mean that the synthetic hormone acts differently and produces substantially different effects. Bio-identical and synthetic hormones should not be considered the same or used interchangeably. They are entirely different. A multitude of studies have demonstrated many harmful effects of synthetic hormones but medical literature supports few if any harmful effect of natural hormones.
4. When will I see results?
Some patients see results within three to four days. Other patients see results within 10-14 days.
5. What is the best time to consider bio-identical hormone replacement therapy (BHRT)?
Most of our patients tell us they have lost their energy and feel tired all the time. Many say they have gained weight and can’t lose it. They just don’t seem to have that skip in their step or the zest for life. We listen to you describe your symptoms. We use laboratory results from blood studies (not saliva) to determine your hormone levels. Medical literature has shown blood studies to be more accurate to determine hormone levels than saliva studies.
Women: If you have depression, mood swings, fatigue, decreased libido, increased facial wrinkles, hot flashes, cold hands and feet, sagging skin and breasts, urogenital atrophy, loss of muscle tone or restless sleep, many of these symptoms directly correlate to decreased levels of estrogen, progesterone, testosterone and thyroid. If you have had a total hysterectomy (removal of your uterus and ovaries) or have gone through menopause, you should start BHRT as soon as possible. If you are approaching menopause and experiencing irregular cycles, you should have your hormone levels evaluated. See our Female Hormone Replacement Questionnaire.
Take our Hormone Well-Being test
Men: If you have fatigue, difficulty concentrating, decrease in muscular strength and tone, decreased libido or inability to maintain an erection, you should have your hormone levels checked. Many of these symptoms directly correlate to decreased levels of testosterone. See our Male Hormone Replacement Questionnaire.
Take our Hormone Well-Being test
6. Do I need to take these hormones forever?
No. If you decide to stop, your body will simply return to where it was before starting hormone therapy. Once menopause has started, your ovaries are no longer producing these hormones.
7. Will this treatment interfere with my currently prescribed medications?
Generally not. Some medications may actually be reduced or no longer be needed.
8. Will you take over as my doctor?
No. Our practice is specialized and limited to BHRT and weight loss. We will be happy to communicate with your current physician if needed.
9. Can I use my health insurance?
The Broadway Clinic is an out-of-network provider for all major health insurance plans. We ask that you pay in full at time of service. We will submit a claim to your insurance company on your behalf and any reimbursement due will be sent directly to you by the insurance company. We are not providers for Medicare or Medicaid.
Some books for reference:
Neal Rouzier, M.D., “How to Achieve Healthy Aging”.
Suzanne Somers, “Ageless: The Naked Truth About Bioidentical Hormones”
Jonathon V. Wright, M.D. and John Morganthaler “Natural Hormone Replacement"
Bio-identical hormone replacement therapy (BHRT) is a major topic of research due to the beneficial effects hormonal supplementation has on overall health and well-being. BHRT uses the same chemical structure as hormones naturally made in the human body. Natural, or bio-identical hormones, are metabolized the same as our own hormones so there are no unpleasant side effects or harm to the body. As we age, our bodies decrease hormone production so supplementation becomes necessary. Low hormone levels are restored with sublingual troches, oral tablets and transdermal creams and gels. Signs of decreased serum levels of hormones include increased visceral fat, overall fatigue, depression, low libido and mental confusion. Supplementation with BHRT is the safest and most natural way to restore balance and health.
Estradiol is the primary estrogen hormone and it metabolizes into estriol and estrone. Estradiol is the most potent estrogen and provides beneficial effects associated with the estrogens. Estrogens are primarily secreted by the ovaries and help protect against many diseases such as heart disease, stroke, Alzheimer’s disease, and osteoporosis. Estrogens are also useful in protecting against and treating vaginal atrophy and urinary incontinence. Estrogen depletion presents with varying symptoms, including fatigue, depression, mood swings, decreased skin elasticity and urogenital atrophy that causes incontinence. Studies have shown that supplementing with bio-identical estrogen produces the same benefits of synthetics but with fewer side effects and better outcomes.
Progesterone, like estradiol, is secreted by the ovaries and is equally as important as estradiol in both perimenopausal and menopausal women. During perimenopause, estradiol levels surge up to 400 or 500 before dropping. This causes abdominal cramping, mood changes, headaches, difficulty sleeping and irregular periods. Along with estradiol, it protects against uterine and breast cancers, osteoporosis, fibrocystic disease, ovarian cysts, and coronary artery disease. There are progesterone receptor sites in the uterus, breast, vagina, blood vessels and brain. All of these organs and vessels benefit from progesterone supplementation.
DHEA is an endocrine precursor for the synthesis of testosterone, estrone, and estradiol and is produced in the adrenal glands. With age, levels of DHEA decrease at a constant rate each year, causing central obesity and insulin resistance present in type 2 diabetes and metabolic syndrome. This hormone is vital in stimulating the immune system as well as decreasing cholesterol and body fat. DHEA is also cardio-protective because it decreases tumor necrosis factor, which causes inflammation within the arteries, leading to atherosclerosis. Since DHEA is an endocrine precursor to other hormones, it works as a preventative treatment for heart disease, diabetes, and osteoporosis.
Testosterone is produced in both men and women and serves to enhance mental health and clarity of thought. This hormone, along with others, decreases with age, leading to depression, fatigue, and poor muscle tone or endurance. In both men and women, testosterone works to improve lean muscle mass, bone density, libido and sexual performance. Studies have shown that supplementing testosterone produces significant results in lean muscle mass, muscle strength, reductions in all over body fat and increased bone density. Testosterone also improves hyperlipidemia, skin tone and healing.
The thyroid gland produces both T4 and T3 hormones. T4 converts into T3, which is the active hormone controlling energy levels and metabolism. Symptoms of underactive thyroid (or low levels of T4 and T3) are weight gain, fatigue, hair loss or thinning, constipation, dry skin and difficulty concentrating. To maximize the beneficial effects of thyroid hormones, we strive for optimal levels in addition to various other hormones.
Melatonin is an endogenous hormone that works to maintain our natural circadian rhythm, which determines our wake-and-sleep cycle. As we age, production of this hormone decreases. Supplementing melatonin improves sleep patterns along with the depth and quality of sleep.