Bioidentical Hormone Replacement Therapy (BHRT) - Frequently Asked Questions

Hormones are an essential part of the metabolic process of living. Hormones are important for cells, organs, and metabolism. Our hormones decline through aging, menopause, andropause, disease, and trauma. When this happens, we begin an accelerated aging process and become more vulnerable to some diseases. Loss of hormones is one of the major reasons for our deterioration as we get older, both physically and mentally. Hormones are beneficial at any age, but the best long-term protective benefits are achieved if hormones are replaced when you begin to lose them, usually starting in your 40s.

Synthetic hormones are created using mixtures from the urine of female horses called conjugated equine estrogens (CEE). These hormones are made by pharmaceutical companies that have proprietary claims on the drugs. Synthetic hormones can act on the receptors in the human body, but the structural differences can lead to functional issues. Synthetic hormones often bind too tightly to specific receptors, causing overstimulation. This action inhibits the body’s natural metabolic process and can make discontinuing use of these types of hormones riskier.

Bioidentical hormones, unlike synthetic hormones, are derived from natural sources and custom-compounded into different doses and strengths recommended by your medical doctor or nurse practitioner to meet your individual needs. This unique feature is the reason many forms of bioidentical hormone replacement therapy are not patented or regulated by the FDA. However, the Canadian custom compounding pharmacy we use in Ontario only uses ingredients that are approved by the FDA and Health Canada. All formulations are Yam based and do not include Soy.

There is over 25 years of scientific research in the United States and Europe that demonstrate that bioidentical hormones are as or more effective than synthetic hormones and have proven to be safer. Hormones control every function in your body from your metabolism and mood to your sex drive and energy levels; from your appetite and sleep to your strength and endurance.  BHRT gives you a better quality of life and helps you with protection from some diseases. 

In recent years, hormones have been the subject of bad press. Be an informed consumer.  Many reports are from studies that used synthetic hormones with combinations that are not natural to your own body and state of health. We only use bioidentical hormones at our clinic.

Bioidentical hormones are substances with the exact same molecular structure to what your body would normally produce. Bioidentical hormones generate the same physiologic responses as your body’s natural hormones.

Bioidentical hormone replacement therapy (BHRT) helps treat menopausal symptoms such as hot flashes, night sweats, anxiety, moodiness, weight gain, brain fog, and vaginal dryness along with other symptoms associated with menopause. In some cases, BHRT is used to prevent osteoporosis. In men, BHRT is used for the treatment of andropause related symptoms. Some symptoms include, low sex drive, weight gain, muscle loss, fatigue and difficulty having or maintaining an erection.

While dietary and lifestyle changes, supplements and herbs can often resolve symptoms of hormonal imbalance, there are times when hormone replacement is the only option that provides sufficient relief of symptoms. Hormone imbalance affects women of reproductive age as well women going through peri-menopause and menopause. The effects are similar in men who experience symptoms of andropause.

In women, symptoms can include but are not limited to: difficult transition into menopause, PMS and painful periods, irregular periods, fertility issues, bladder infections, adult acne, endometriosis, fibroids, ovarian cysts, abnormal hair growth, weight gain, muscle loss, insomnia, decreased libido, fatigue, insomnia, thyroid dysfunction, bone loss, anxiety, depression, and cognitive decline. Men can experience much of the above symptoms as well as erectile dysfunction.

The only way to know if you need bioidentical hormone replacement therapy is through specific laboratory blood testing. There are specific lab panels available to determine if your hormones are imbalanced.

Hormones are self-administered and are custom made for the individual patient in many different formats. Examples of hormone preparations include: transdermal creams, topical gels and creams, oral capsules, sublingual tablets, pills, tinctures, combinations, subcutaneous injections, slow release capsules, sublingual drops, suppositories, and sublingual troche, scalp solutions for hair growth, and custom compounded thyroid capsules, plus many other formats.

How often should you take the BHRT depends on what the MD or NP will recommend via prescription. It is usually prescribed for daily self-administration.

Side-effects are often minimal and manageable when restoring hormones to physiological levels (to the levels your body has seen before). Some patients report breast tenderness or swollen joints when first starting bioidentical hormone replacement therapy. These and other symptoms can be remedied by reducing the dosage until symptoms resolve. (Please call us and we will adjust the dosage).

You should continue treatment as long as you wish to see results. You will also need BHRT for disease protection.

In general, supplementation by exogenous (external) hormones will result in decreased endogenous (internal) production. However, the body tends to restore hormones to pre-treatment levels after cessation of treatment. If your own hormone production was low before treatment, it will most likely return to the same levels after treatment. As a result, most of the physical changes enabled by BHRT will gradually revert back to pre-treatment levels.

Results of your blood test take approximately 10 business days for the first main panel when you start treatment.  Follow-up blood tests are conducted at three, six and nine months. Follow-up blood tests take approximately five business days to receive results from the time the lab receives your blood samples. Lab results will be sent directly to your BHRT medical practitioner at which time your provider will book a follow-up appointment to review results and make suggestions for your customized prescription therapy.

Bioidentical Hormones are individualized preparations designed to specifically match the values indicated in your blood work. Unlike conventional pharmacies, which prescribe standard doses of synthetic hormone (‘one size fits all’), custom compounding pharmacies prepare bioidentical hormone replacement therapies specific to your body’s individualized levels and needs. They acquire the pure pharmaceutical-grade hormones and compound it into the form, strength and dosage ordered by your physician or nurse practitioner. They are prepared specifically for you, making your treatment program customized and personalized. Keep in mind not all custom compounding pharmacies are equal. Be sure to use a top rated expert compounding pharmacy.

Integrative Medicine is an approach to health care that takes the best of conventional medicine and integrates it with the best of complementary and alternative medicines that are supported by scientific evidence. 

The focus of integrative medicine is to optimize health, vitality and wellness and to prevent illness where possible.
 

Your body is a healing machine! Your provider will work closely with you to create an individualized health care plan in order to address your specific health concerns to attain optimal health in the context of your body’s innate ability to heal.

Preventive medicine covers a broad range of measures taken within conventional and complementary medicine practices to help individuals and populations avoid illness and disease. Some examples include screening for high blood pressure, colon and breast cancer, and diabetes.
 

NP Michelle Martin will conduct a comprehensive health assessment and blood analysis to identify areas of health concern and work with you to create an individualized plan to meet your specific health care goals.

NP Michelle Martin takes time to listen to you and understand who you are. She will work with you to create a customized, long-term plan of care aimed at optimizing your health and achieving your health goals. The integrative medicine process appreciates the innate ability of the body to heal and repair itself. Lifestyle counselling, stress management, complementary, conventional and alternative approaches will be offered to support your unique health care needs.   

NP Michelle Martin is happy to consult and collaborative with your other physicians, NP’s and health care providers.

The short answer is yes.
 

Many people do not like the idea of taking medications and would prefer to manage health issues with diet, exercise, lifestyle changes and supplements. But sometimes medications are indicated and needed for certain health issues. NP Michelle Martin will work closely with you to weigh the benefits and risks of medication use in the context of your unique health situation. 

Absolutely yes!
 

NP Michelle Martin will work with you to help you achieve optimal health and improve your quality of life within the context of your unique health situation. Call now to book a consultation.

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Affecting around 8% of women, the signs and symptoms of PCOS can vary, and may include:

• Infrequent, prolonged menstrual periods
• Excess male hormone (androgen) levels
• Numerous ovarian cysts, failure to ovulate
• Excessive hair growth
• Weight gain
• Acne
• Menstrual irregularities
• Androgen excess
• Excess facial
• Body hair
• Adult acne 
• Severe adolescent acne
• Male-pattern baldness
• Polycystic ovaries (enlarged ovaries that contain numerous small fluid-filled sacs which surround your eggs)

PCOS can be challenging to diagnose because there is no one single diagnostic test.
 

The diagnosis is made based on the presence of 2 out of 3 of the following criteria:

• Irregular menstrual cycles (less than eight menstrual cycles per year)
• Symptoms or blood tests that indicate male hormone levels above the expected range for females
• Pelvic Ultrasound showing specific features such as many “cysts,” “follicles,” or large ovaries

While receiving news that you have this condition may be worrisome at first, it is important to know that this condition is not a life-sentence for symptoms. PCOS symptoms can be managed, and most women will be able to conceive and have a healthy pregnancy. This may be achieved with lifestyle changes. Some women may require medications or additional fertility therapy in order to conceive.
 

When it comes to fertility, it can be useful to review your plans with a specialist to personalize your therapy and optimize your reproductive plan.
 

There is no one-size-fits-all approach to PCOS. Not every drug or treatment is guaranteed to work for everyone, but there are many tools to help women with PCOS achieve successful pregnancies.
 

If you think you may have PCOS or have been diagnosed and are trying to conceive, our experts are here to help you prepare your fertility plan and grow your family.
 

Correcting hormonal imbalance can normalize ovulation.