Procedures: Bio-Identical Hormone Replacement

As all of us get older, our bodies slow the production of hormones. This inevitability results in symptoms that in a woman we call menopause. Although the onset of symptoms is not as dramatic with men, they also go through andropause when hormone levels fall.

Bio-identical hormone replacement (HRT) is an alternative to traditional HRT for the treatment of menopausal/andropausal symptoms. Traditional HRT has typically used synthetic oral hormones in a "one-size-fits-all" dosing regimen to treat menopausal symptoms. Even the new topical hormone patches use synthetic hormones. This has led to a number of problems. First, synthetic, non-bio-identical hormones are not handled by the body in the same manner as a person's natural occurring hormones. They are not metabolized and eliminated as quickly as the hormones your body produces. Therefore, they stay in the body longer producing both positive and negative effects. Secondly, when taking hormones orally, they first pass through the liver. The liver tries to "detoxify" these substances resulting in metabolites that are changed chemically and structurally from the hormones you placed in your mouth. These metabolites have been implicated in many of the adverse side effects that have been reported in recent clinical studies. Thirdly, using fixed dose HRT regimens makes it difficult to customize treatment for the individual patient. Everyone's requirement for hormones is unique to that person. A fixed dose may be just right for one person, but it may be too low or too high for someone else. Too high of a dose of hormones can cause as many problems as too low of a dose.

Bio-identical HRT uses hormone (estrogens, progesterone and testosterone) that is molecularly identical to the hormones that your body produces. Your body utilizes these hormones exactly as it has your own hormones. It metabolizes and eliminates them exactly as it has your entire life. Therefore, there is no build up of hormones attached to your tissues that can cause negative effects. Secondly, we typically prescribe bio-identical HRT as topical gels. This allows the hormones to be absorbed directly, unchanged into the body without first passing through the liver. This avoids the problem of harmful metabolites. Finally, by using topical gels, adjusting the dose is very easy. If, for example, a higher dose is indicated to relieve the symptoms, you can increase from 1/8 teaspoon twice daily to ¼ teaspoon. Also, since these gels are prepared by a compounding pharmacy, a wide range of gels strengths are available.

Again, it important to note that men who experience andropausal symptoms can benefit from bio-identical HRT with testosterone gel. Bio-identical HRT is an important part of our anti-aging program.

If you are interested in more information or would like to find out if you are a candidate for bio-identical HRT, contact us to schedule your personal consultation with Dr. Bair.