Bioidentical Hormones are derived from natural sources like wild yam and soybean. They have a chemical structure that is exactly like the hormones naturally produced by your body. In contrast, non-bioidentical hormones or those modified from urine of pregnant horses, differ greatly from those found in humans. The non bioidentical hormone, such as ethinylestradiol, has different chemical properties in your body. The human liver was not meant to process these hormones. Their metabolism is usually slowed down; their breakdown products then begin to accumulate in the body thus taxing the liver over time. These metabolic products create many of the undesirable side effects often experienced by women who use them.
Most pharmaceutical companies produce non–bioidentical hormones instead of bioidentical hormones because they can obtain a patent on them; they cannot patent bioidentical hormones.
What to expect on your first visit
At your first visit, I will spend an hour with you during your initial consultation. I will be discussing all your present and past symptoms as well as reviewing relevant family medical history. In addition we will discuss your diet, lifestyle, exercise, sleeping patterns, and libido, major and minor stressors in your life as well as possible exposure to pollutants like mercury, lead and phthalates. Finally, I perform a thorough physical exam and order comprehensive hormone testing along with other medically appropriate tests to eventually design your customized therapeutic program.
Saliva, serum (blood), and urine samples can be used to measure various hormone levels. Each of these has their pluses and minuses in evaluating hormone imbalances.
I have utilized all these laboratory tests. Over the years I have found that a 24 hour urine testing for estrogen, progesterone, cortisol , testosterone and their metabolites to be the most useful indicator of hormone imbalance and the most accurate indicator for successful monitoring of bioidentical hormone therapy. I supplement this with blood testing since some specific hormone tests are not yet done in urine. Salivary testing of the daily pattern in the rise and fall of cortisol is useful in some patients that may present with disturbances in their sleep wake cycle that don’t respond to therapy based on the before mentioned tests.
I also will review previous lab testing, MRI, ultrasound, mammogram and breast thermograms reports. If you have not had a mammogram, pap and pelvic, breast thermogram done recently within a year of our initial examination I will recommend that the appropriate test is done before I prescribe bioidentical hormone replacement therapy (BHRT).
What to expect during therapy
Along with the proper dosing of bioidentical hormones, I may also recommend specific nutritional, herbal, homeopathic medicines as well as dietary and exercise recommendations that are all designed to support and enhance the effectiveness of BHRT.
Every body is biologically unique. Hence, how you will respond to BHRT may be entirely different than your neighbor. Usually , you need to expect that as your body rebalances your hormone levels your symptoms may vary at times during the initial first 4 -9 months of therapy . This is to be expected. Do not despair. I and my medical assistant are here to help. Most patients begin to notice that within 2-8 weeks their hot flashes, mood swings, sleep, stamina energy and even libido begin to improve. Over the next several months I will work with you to optimize and stabilize your health. It may take several months for issues such as memory, concentration, weight loss and hair loss to improve. Be patient and don’t hesitate to email me with questions and or concerns during therapy.
About 4-6 months into your BHRT program I will have you redo the 24 hr urine test as well as any other relevant laboratory blood testing, breast thermogram etc to check on how your body is responding to BHRT. Once your symptoms are stabilized I generally will see you again in follow up in 6 months. Again, everybody is biologically unique and if there are any questions or acute problems that arise do not hesitate to contact me and or my office staff via phone or email.