What exactly are hormones?
Hormones are the body’s chemical messengers, secreted into the bloodstream and/or used locally, that affect cellular functioning. A hormone affects only specific cells called target cells that have unique receptors for that hormone. Think of it as a lock and key. Cells which do not have the specific receptor for a certain hormone cannot be influenced directly by that hormone, Some cells go even further, and regulate their own internal production of a needed hormone. For example: Estrogen is made inside every cell that utilizes estrogen (brain, bone, heart, etc). This estrogen is made from testosterone through a process called “aromatization”.
Testosterone is vital to the health and well-being of BOTH men and women, Testosterone in men is mainly produced by the testicles and in smaller quantities the adrenal glands. In women, testosterone is produced in both the ovaries and the adrenal glands. Testosterone contributes to muscle mass, strength and endurance, decreased fat, increased exercise tolerance, enhancement of the sense of well-being and psychological health.
Like testosterone, estrogen is a required hormone for the health of both men and women. Estrogens produced inside the cell (from testosterone) are believed to be protective against many health disorders. Thus, bioidentical testosterone is useful for women experiencing menopause symptoms.
Progesterone is produced primarily by the ovary and small quantities from the adrenal gland. Progesterone controls the lining of the uterus. During hormone replacement, women with uteri who take estrogen are advised to also take progesterone.
What is meant by bio-identical?
Bio-identical hormones have the exact same molecular structure as hormones that are made in the human body. The difference between bio-identical and synthetic is the molecular shape of the hormone. In order for a replacement hormone to fully replicate exact functions of a hormone, the structure must exactly match the natural (human form) of the hormone. Structural differences between synthetic hormones and natural hormones are often responsible for undesirable side effects. Bio-identical hormones have fewer side effects than synthetic hormones.
Where do bio-identical hormones come from?
Bio-identical hormones are generally made from plant extracts from yams and soy. Highly-rated, commercially-licensed, compounding pharmacies prepare bio-identical hormone. Bioidentical estrogens are 17 beta-estradiol, estrone, and estriol. (Estradiol is the form of estrogen that decreases at menopause.) Bioidentical progesterone is simply progesterone, which is finely ground in the laboratory for better absorption in the body.
Bio-identical hormones require injection into the fatty part of tissue. Oral preparations of “bio-identical hormones” are not active.
What is Bio-Identical Hormone Therapy (BHT)?
The goal of BHT is to provide an adequate supply of a deficient hormone. Blood tests and reduction of hormone-deficient symptoms are used to find the appropriate dose per individual. Among advantages of BHT is that since these hormone are identical to human form, they can be measured with labs tests. There are no blood tests for measuring synthetic hormones. A disadvantage to BHT is that it is not covered by health insurers.
Getting Started on BHT.
You will have a complete history and physical prior to BHT, including baseline blood tests. Blood tests are reviewed prior to BHT. You will be given a consent to sign.
Pellets are inserted with an injector into the fattiest part of the buttock. The pellets offer slow release of hormone for a period of several months. Once injected they can not be removed.
Normal activity can be resumed after two days. Strenuous exercise can be resumed in 5 days. Improvement can be expected in the first two weeks.
Six weeks after the first insertion, a follow-up blood test is required. We follow up with symptoms assessments at that time to determine appropriate changes for next administrations.
In your first year of treatment, expect 3-4 insertions. Typically, women require reinsertions every 3 months. After that, longer intervals are common. BHT can be used in any age group, generally older than 40.