Frequently Asked Questions about Bio Identical Hormone Optimization

What are Bio Identical Hormones?

In contrast to many pharmaceutical hormones such as Premarin and Provera, bio identical hormones are obtained from plant sources and are modified to have the exact same chemical structure and activity as the hormones that are produced in the human body. They can be measured in simple lab tests and can be adjusted as needed based on symptoms and laboratory levels.

What happens to our own hormone levels?

Aging is the biggest culprit- as we get older our own hormone producing glands, the thyroid, ovaries and testicles produce less hormones. Pollutants and chemical additives impair hormone production and surgeries can remove or limit the production of the key hormones.

What are the symptoms of lower levels of hormones?

The symptoms differ by sex and by hormone. In both men and women, progesterone deficiency can manifest itself with anxiety, depression, irritability and poor sleeping patterns. In women estrogen deficiency may cause weight gain, hot flashes, sweats, mood swings, fragile bones and increased risk of heart disease. In men, low testosterone can cause poor sex drive and erections, weight gain and loss of lean muscle mass and irritability. Lower levels of growth hormone in both men and women can cause loss of skeletal height, lower muscle mass, poor concentration and mental agility.

How are Bio Identical Hormones administered?

Hormone therapies can be taken by mouth, under the tongue, applied as a cream, gels or lotion as well as injection depending on the hormone supplemented. One of the most convenient and reliable forms of administration is pellet therapy. Small pellets of estrogen, progesterone and testosterone alone or in combination can be placed under the skin in the fat of the lower flank. This quick in office treatment performed by Dr. Horton for men and women is relatively painless and then patients are good to go for 3-4 months.

Is Bio Identical Hormone Therapy Safe?

The large scale studies of the Women’s Health Initiative cast doubt on the benefit of estrogen and progesterone supplementation in post menopausal women. There are however caveats to these studies that prevent applying the results to bio identical hormone therapy.  The WHI studies only studied older women and used the most commonly prescribed pharmaceutical hormones of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA). Bio Identical hormones are not the same as the hormones used in the study.

Many past studies have supported a cardio protective effect of testosterone. Recent studies, however,  of testosterone supplementation in men have conflicting results regarding testosterone therapy and the risk of heart disease and stroke. Major guidelines still support treating men (with close monitoring) who have clinical and laboratory evidence of testosterone deficiency.