Who should be considered a candidate for Bio-Identical Hormone Replacement Therapy (BHRT)?

From about age 30 onward, hormone levels begin their steady decline. The Anti-Aging experts of the world all agree that some type of hormone maintenance is crucial to help prevent the numerous inflammatory diseases that occur with age. Symptom control is a large part of this balance, but more important are the things we cannot see or feel that are the most important.

Specifically, why should women use BHRT as compared to conventional hormone replacement therapy (HRT)?

If given a choice, why would someone not use something natural to their own body as compared to something completely foreign to their own body? Women, as well as men, are becoming more educated about hormone therapy and are demanding answers to that question.

Call us at TW Wellness for research articles to support the use of BHRT

Is there a difference between Medroxyprogesterone (Provera) and Natural Progesterone?

Absolutely. Even though the medical community has traditionally had a hard time distinguishing between the two, there is a tremendous amount of research information to show and prove the functional differences between the two.

Please call us at TW Wellness to learn more about this research

What specific estrogen is the most prevalent in a woman's body?

Estriol (E-3) comprises about 80% of the estrogen found in a womans body. It is considered the weakest of the 3 estrogens found in a womans body, but the most potent, therapeutic estrogen, when used vaginally. It has been labeled as the “forgotten estrogen” and considered by many researchers as a “safe” estrogen by comparison.

We would be happy to provide you with a copy of the JAMA article published in 1988 by A.H. Follingstad, MD on this topic.

Is Estriol commercially available?

No. Estriol is only available in compounded preparations provided by a compounding pharmacist. Ask us about the many compounded preparations available using Estriol.

Does "one size fits all" really work for all women?

Absolutely NOT! Each woman is different in many ways. That’s not to say that many women can’t benefit from the same hormone preparation, but it is the expertise of the practitioner that their ability to identify the needs of the patient that will allow them to be successful in the art and science of hormone balancing.

What type of hormone testing is best?

There are several different methods in which to test hormones: blood, saliva, urine. Remember that hormone levels fluctuate from morning to night and from day to day. In addition to hormone testing, it is you the individual patients “story” that determines how I prescribe specific combinations of hormones and supplements.

What makes saliva testing unique?

Saliva testing measures the concentration of “free” bio-available hormones in the interstitial space. This is the area in which hormones come in contact with individual cells and the hormone receptor sites to have their therapeutic response.

Saliva testing is available at $50 per test. Due to this prohibitive cost I rely on blood testing.

Do women usually gain weight with Hormone Therapy?

Women going through menopause gain an average of 10 pounds. Women on synthetic hormones typically gain 20+ pounds. Women using BHRT typically gain less than 10 pounds.

I can provide you with additional information on the impact of oral estrogens on thyroid function and possible weight gain.

Do men and women need testosterone for a healthy cardiovascular system?

Most definitely. The “reverse cholesterol transport mechanism” is activated by adequate levels of testosterone. This mechanism allows HDL (the good cholesterol) to scavenge the arteries and blood vessels to reduce plaque build-up.

What dosage forms are available for BHRT?

Oral, sub-lingual, troche (lozenge), topical of many types, injectables, and implantable pellets. By far the most popular are the topically applied preparations.

TW Wellness prepares over 1000 BHRT formulations.

When should a person think about hormone support?

Through education, the awareness of hormonal changes has increased. Today both men and women are seeking help to balance hormones to feel and perform better in their daily lives much earlier than previous generations. While lab testing is essential, symptoms are a key to the hormone balance.

Look for the “Awareness Sheets” for both men and women here in this section of our website.

Does testosterone cause prostate cancer?

In the landmark book, “Testosterone for Life,” Harvard professor Abraham Morgentaler thoroughly discredited the notion that testosterone causes prostate cancer. His findings certainly support the notion that if high testosterone levels would cause cancer, then most 18 year old men with incredibly high levels of testosterone should have prostate problems. But they generally don’t.

Please ask me about articles demonstrating testosterone’s protective effects.

Where should a man apply his topical testosterone products?

We recommend upper outer arm right up over the shoulder, rubbing in well until the skin is dry. Then wash hands. Care should be taken with all topically applied hormone preparations and the possible transfer to another person.

Our TW Wellness specially compounded preparations are less of a problem for transmission to another person than others.

Is it important to rotate sites when using topical hormones?

Yes. Sites of application should be rotated every 3-4 days for both men and women. When one site is over used we generally experience tissue and receptor fatigue. The topical preparation just doesn’t seem to work or work as well as it previously did.

Should a man ever consider using testosterone without testing?

Absolutely not. Because of the metabolic cascades of testosterone it is necessary to establish base lines for: free/total testosterone, estradiol, SHBG, DHT, and PSA free/total.

We have a specific series of lab tests for our men patients.

What is one of the most effective products TW Wellness prepares for women with vaginal dryness?

Without a doubt it is the combination of Estriol and Testosterone in either a gel or cream base.

Do opiate drugs used for chronic pain reduce testosterone levels? What effect does testosterone have on the pain threshold of an individual?

All opiate drugs reduce testosterone levels. Reduced testosterone levels lower the pain threshold of an individual, thus requiring more medication to control pain. With this in mind, one can certainly understand the necessity to closely monitor testosterone levels with the chronic pain person.

Can I get Bio-Identical Hormones anywhere?

Bio-Identical Hormones are available through a compounding pharmacy, such as TW Wellness. We make over 1000 BHRT formulas. These preparations are made as patient specific as possible, allowing for flexibility and uniqueness to the individuals needs.

How long does it take for me to feel a difference when using BHRT?

Some people feel better immediately, while others may take several month to titrate to the correct formulation to observe the results they are looking for.

What causes testosterone to convert to estrogen in the adult male?

The enzyme aromatase promotes the conversion of free testosterone to estrogen (estradiol). The more excess fat tissue the male body has the more potential aromatase activity may be present.

We can help identify ways to prevent aromatase activity and reduce estrogen levels in the adult aging male.