Bio-Identical Hormone Restoration Therapy (BHRT) FAQs

1. What are hormones and why do we need them?

Hormones are an essential part of the metabolic process of living. Hormones are important for the cells, organs, and metabolism. Our hormones decline through aging, menopause, disease, or trauma. When this happens, we begin an accelerated aging process. 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.

2. How do bio-identical hormones differ from synthetic hormones?

Synthetic hormones are derived from animal sources, namely the urine of female horses. These 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 specified 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, may be custom-compounded into doses recommended by your doctor to meet your individual needs. This unique feature is the reason many forms of bioidentical hormone replacement therapy are not patented and regulated by the FDA. On the other hand, some bioidentical hormone formulations have been found to work ideally at an established dose and these have been patented by manufacturers and approved by the FDA.

3. Is BHRT safe?

Hormones control every function in your body, from your metabolism and mood to your sex drive and energy; from your appetite and sleep; to your strength and endurance.

In recent years, hormones have been the subject of bad press. Beware of what you believe. Most reports are from studies that used synthetic (not bio-identical) hormones and used combinations that are not natural to your body and state of health.

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

BHRT products have been approved by Health Canada to treat menopausal symptoms such as hot flashes, night sweats, and vaginal dryness and in some cases, to prevent osteoporosis.

4. When should BHRT be considered?

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. Hormone imbalance affects women of reproductive age as well as menopausal women and men.

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

5. How are the hormones administered? How often?

Hormones are self-administered via transdermal creams, oral capsules, or subcutaneous injections.

6. What are the side-effects of BHRT?

Side-effects are often minimal and manageable when restoring hormones to physiological levels (levels your body has seen before). Some patients report breast tenderness or swollen joints when first starting bio-identical hormone replacement therapy; these and other adverse reactions can be remedied by reducing the dosage until symptoms resolve.

7. How long do I need to continue Bio-identical Hormone Therapy?

You should continue treatment as long as you wish to see results.

8. What happens if I stop the program? Will my body stop producing hormones on its own? Will my hormone levels decrease? Will I lose my gains?

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 the program will gradually revert back to “your old normal”.

9. How soon will my lab test results be ready following a saliva hormone test?

Results of saliva testing take approximately 5-10 days from the time the lab receives your samples. Lab results will be sent directly to The Vitality Institute, at which time we will book a follow-up appointment to go over results and suggestions for your customized prescription therapy.

10. What is a compounding pharmacy and how does it differ from a regular pharmacy?

Transdermal creams are individualized preparations designed to specifically match the values indicated in your blood work. Unlike conventional pharmacies, which prescribe a “one size fits all” synthetic hormone prescription, compounding pharmacies design hormone replacement therapies detailed to your body’s individualized levels and needs. These pharmacies are similar to the old fashioned concept of a pharmacist with a mortar and pestle. They acquire the pure pharmaceutical-grade hormones and compound it into the form and dosage ordered by your physician as pills, capsules, liquids and creams. They are prepared specifically for you, making your treatment program customized and personalized.

11. Will my testes shrink on testosterone replacement therapy?

We currently restore testosterone using transdermal testosterone cream and hCG, human chorionic gonadotropin. Using the cream, the testes will likely slow production of testosterone in response to (perceived) higher levels. This condition also may result in minor atrophy or shrinking of the testes. HCG emulates luteinizing hormone, which stimulates the testes to produce their own testosterone, thereby preserving their function and size. This product is injected each morning by the patient using an insulin syringe.