Bioidentical Hormone Replacement

Bioidentical hormone replacement therapy (BHRT) helps women navigate menopause and perimenopause. It involves the administration of bioidentical hormones to supplement and/or replace the natural hormones the body is not adequately producing.

Bioidentical hormones are the safest way to replace your hormones. They are created to look exactly the same as our natural hormones, whereas non-bioidentical hormones look similar.

Taking BHRT compared to a non-bioidentical hormone is like putting a key in a lock that fits perfectly and slides in smoothly versus one that kind of fits, but has to be pushed and jiggled to get it to function. Using BHRT has less side effects and less risk than non-bioidentical hormones because our body uses them in the same way as our natural hormones. BHRT are created with FDA-approved ingredients, but they are sometimes administered in an off-label way (NOT FDA cleared).

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What Types of Hormones Does BHRT Replace?

The main hormones in the human body are estrogen, testosterone, and progesterone. All three can be replaced using BHRT.

• Estrogen is the most essential hormone in the female body. Estrogen BHRT has many health benefits associated with its use, as estrogen contributes greatly to a woman’s overall sense of well-being. Estrogen is protective against osteoporosis, heart disease, high blood pressure, dementia, diabetes, and obesity. It regulates everything from metabolism to body temperature (stops hot flashes and night sweats) to mood. It is essential for women who want to continue to look and feel young.  
• Progesterone is traditionally only replaced in women who have not undergone a hysterectomy as a way to protect the uterus from cancer when estrogen HRT is prescribed. However, progesterone has other important health benefits. It helps to calm the mind, which means it reduces feelings of anxiety and helps you “shut your brain off.” When taken orally, it helps women fall asleep faster and sleep better. Additionally, progesterone is protective for the breasts and reduces a woman’s risk of breast pain, breast cysts, and breast cancer when taken in a bioidentical form.
• Testosterone is not an FDA-approved hormone for women. However, it is very beneficial for women as it works with estrogen in the female body to maintain health. For instance, testosterone BHRT can significantly improve sexual desire; sexual arousal; sexual satisfaction; energy levels; concentration and memory; and muscle mass. It also helps to relieve joint aches and stop the abdominal fat weight gain commonly seen after menopause.

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What are the benefits of bioidentical pellets?

The list of benefits of BHRT is constantly growing. BHRT is proven to:

• Decrease hot flash frequency and severity
• Reduce all-cause mortality
• Improve sexual desire and arousal
• Improve skin tone and slows the progression of fine lines and wrinkles
• Improve sleep by helping you to fall asleep and stay asleep
• Improve mood and reduces irritability
• Decrease the risk of depression
• Reduce the chance of developing dementia
• Slow the progression of atherosclerosis (plaque formation in the blood)
• Decrease the chance of developing heart disease or having a heart attack
• Decrease the chance of having a stroke
• Decrease the risk of diabetes
• Decrease the risk of eye disease
• Reduce postmenopausal weight gain, especially abdominal fat
• Slow the loss of muscle mass
• Slow bone loss to lower risk of osteoporosis and fractures by greater than 30%
• Relax the blood vessels and decreases the chance of elevated blood pressure

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What are the risks of BHRT?

The main risks associated with hormone replacement therapy are fluid retention, breast tenderness, postmenopausal bleeding, acne, hair growth, and worsening of anxiety or depression – all of which are typically due to having unbalanced hormones and needing an adjustment in your BHRT medications. More serious complications include allergic reactions, infection at a pellet insertion site, or extrusion of a pellet.

Risks seen when taking synthetic oral estrogen include an increased risk of blood clots, strokes, heart attacks, and gallbladder disease. These risks have not been seen with other routes of estrogen replacement. Certain types of synthetic progesterone may also increase the risk of blood clots, strokes, and heart attacks when taken orally. The risk of testosterone replacement therapy causing blood clots, strokes, heart attacks, and cancer is unknown.

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There is also an increased risk of breast cancer WITHOUT an increased risk in death from breast cancer for women taking synthetic estrogen with a synthetic progesterone HRT. This risk is no different than the increased risk experienced by someone who is overweight, drinks alcohol multiple times a week, or works in a hospital and walks by the radiology department daily. Additionally, this risk was NOT found in studies when BHRT estrogen and progesterone hormone replacement options were used together. In fact, newer studies are showing both bioidentical estrogen and progesterone may actually be protective for many of the female cancers, as well as for dementia, heart disease, diabetes, eye disease, and osteoporosis.

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Who qualifies for BHRT?

While BHRT offers numerous benefits, not everyone is able to undergo hormone replacement therapy. In order to make sure BHRT is right for you, we recommend scheduling a hormone replacement consult so you can discuss your symptoms and your medical history in detail with our provider. To determine if you qualify for HRT and which method will fit your lifestyle, call our office at (951) 600-7066.

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BHRT cannot be used if you have:

• A history of heart attack or significant cardiac disease
• A heart arrhythmia (Afib) on anticoagulation
• Liver disease
• An undiagnosed breast mass
• Active cancer
• A history of hormone-dependent breast cancer
• A history of ovarian cancer or advanced-stage uterine cancer
• A history of an unprovoked blood clot, pulmonary embolism, or stroke
• Thrombophilia (Factor V Liden, Antiphospholipid syndrome, etc.)

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How are hormones replaced after menopause?

Dr. Shehata specializes in hormone replacement therapy with patches, creams, and pellets to maximize your BHRT benefits. Pellets are the oldest and most effective form of BHRT. It entails inserting pellets in the buttocks for a long-lasting, steady dose of hormones. These need to be replaced every 3-4 months, depending on the severity of symptoms and the patient’s metabolism. If you are interested in BHRT, call our office at (951) 600-7066.

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Why choose bioidentical pellets?

Although bioidentical hormone pellets are not covered by medical insurance, they are gaining popularity because they are the GOLD STANDARD FOR HRT. The small, bioidentical pellets are implanted under the skin in the buttocks during a quick in-office procedure. The pellet doses are individualized to each woman’s symptoms and her lab results. Pellets provide a slow release of estrogen and testosterone over an extended period – usually lasting 4-5 months.

This means you don’t have to remember to take a pill or apply a cream every day AND your hormone levels stay stable. How often they need to be replaced depends on multiple factors including the speed of your metabolism, your body fat composition, and how you feel.

Dr. Shehata specializes in hormone replacement therapy with pellets because they are both the most effective and the easiest way to eliminate those bothersome side effects of menopause.