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Medical Checkup

What are bio-identical hormones?

The term “bio-identical” means the hormones in the prescription are chemically identical to those made by the organs in your body. However, some FDA-approved products — such as Estrace, Climara and Vivelle-Dot, which are estrogen-replacements, and Prometrium, a progesterone-replacements — are also derived from plants.

We favor bio-identical compounded formulations because we can prescribe the amounts you actually need, based on your saliva or blood tests, and not be limited to standard pharmaceutical dosing. Compounding allows us to combine hormones – such as vaginal estrogen + testosterone – for easier use. And if you happen to be sensitive to a cream prepared for topical or vaginal use, our compounding partners have a variety of options to choose from.

How do you test my hormones?

At TIMC, we primarily use blood testing for estrogen, progesterone, testosterone and DHEA-S but occasionally we will us blood-spot testing and saliva testing.

What side effects should I be aware of with hormone replacement therapy?

  • Abnormal bleeding: Occasionally, hormone therapy can stimulate the endometrial lining, leading to bleeding that can range from light spotting or (rarely) as heavy as a normal period.

The abnormal bleeding might result from:

  1. The dosage of your prescription is too high, leading to endometrial hyperplasia

  2. Uterine polyps

  3. An infection in the uterus

  4. Endometrial cancer

If you have vaginal bleeding, it is necessary for you to make an appointment with your healthcare provider, one who can do an in-office ultrasound and possibly an endometrial biopsy.

  • Breast tenderness: If you have been without adequate estrogen for an extended period of time, the estrogenic stimulation may lead to breast tenderness. This should subside within a few weeks. If not, that typically means the dosage of your estrogen prescription is too high OR you are low in iodine.

We fell strongly that women who are taking hormone replacement products need to have an annual thermogram as part of their overall health program. A thermogram is a heat-sensitive scan that can identify potential areas of concern at least seven years before an abnormality can be discovered by mammography. Breast health supplements, especially iodine, are very important for overall breast health.

Portrait of Young Woman

Is hormone replacement right for me?

Hormones may be prescribed for many reasons, but at TIMC, we believe the smallest dose to alleviate your symptoms is best. We maintain that hormone replacement therapy for women works best relief of hot flashes, night sweats, insomnia and vaginal dryness.

While hormones are sometimes prescribed for low libido, depression, help with weight loss, improved cognition and bone health, the results for these symptoms are less consistent and vary from person to person in both men and women.

Do I have to take both estrogen and progesterone prescriptions?

Sometimes, based on your symptoms, we will only prescribe natural progesterone. Natural, bio-identical progesterone is a very different compound from synthetic, pharmaceutical progestins. Progestins are known to contribute to blood clots, high blood pressure, increased vaginal bleeding and are contraindicated during pregnancy. The exact opposite is true of natural progesterone. We will often recommend natural progesterone first before recommending the additional estrogen prescription.

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