Hormone Replacement Therapy (BHRT)
What is BHRT?
Bio-identical hormone restoration therapy is restoring hormone levels in a patient to balanced physiological levels of a more youthful age. In bio-identical hormone replacement therapy (BHRT), hormones are biologically identical to human hormones on a molecular level, which helps the body accept the hormone more effectively and avoid side effects commonly experienced with synthetic hormones.
Why do we do it?
The first objective in bio-identical hormone balancing is to address the patient’s symptoms. When proper balancing is obtained patients feel better very quickly. However, equally important is the goal of providing the protective benefits the hormones offer to the cardiovascular system, the brain and central nervous system, bones, muscles, skin, eyes, and practically all the tissues of the body. When hormone levels are balanced, neither deficient nor too excessive, both the protective benefits and the symptom management objectives can be met.
Hormones Examined—The Importance of Hormones
Many factors effect hormone balance including the body’s ability to produce and regulate sufficient hormone levels, stress, lifestyle, and environmental factors. Addressing patient’s symptoms with physiological dosing, therefore, is not a “cookie cutter” approach. Occasionally, it takes time to find the sweet spot on an individual basis. We understand that everyone wants their body to experience an immediate and appreciable response. Therefore, we seek to inform patients that hormones are chemical messengers that send very clear message but the sensitivity, adaptation, and response time to those messages vary from individual to individual. We listen to you and seriously take into consideration not only the results of testing but also how you are feeling throughout therapy.
We strongly suggest making lifestyle, dietary, environmental modification along with hormone replacement because once an exogenous hormone is given, whether to a male or female, it may be difficult to take it away without presenting symptoms. We recommend doing everything you can to support your body’s own natural regulating system because it is wonderfully designed to effortlessly manage myriads of synergistic factors at the same time to obtain balance. We believe there is an appropriate time and procedure for supplementation. Keep in mind, however, once hormones are supplemented, the body down-regulates it’s own production processes to maintain appropriate balance. This causes ‘action-reaction’ consequences that are manageable but may prove challenging if you seek to conclude a supplemental protocol.
Which Hormones are we Replacing?
Much more than a female sex hormone, progesterone can support GABA, the brain’s relaxation neurotransmitter (progesterone receptors are highly concentrated in the brain). We like to think of progesterone as the “feel-good hormone.” When progesterone is low, women can experience anxiety and depression, sleep difficulty and bone loss. Many women can become what is known as “estrogen dominant” and can suffer a litany of problems due to this relative lack of progesterone (think PMS). Progesterone replacement can be incredibly helpful for women who have problems that get worse with their menstrual cycle.
Estrogen is the major female sex hormone (though men have it, too). When a woman doesn’t have enough of it, it impacts her libido, her immune system, her mental health and her heart health, to name a few. Menopause is the time in a woman’s life when estrogen production naturally falls off, leading to such common side effects as hot flashes, forgetfulness, mood swings, vaginal dryness and depression. This is why menopause is the time in life when most women think about hormone replacement therapy. Estrogen replacement has been shown in studies to improve cognition in post-menopausal women. It can also normalize the ups and downs of menopause and help women regain and maintain a feeling of normalcy and wellbeing.
The primary male sex hormone, testosterone in men is responsible for sex drive, muscle mass, bone density and an overall sense of wellbeing. Andropause is the gradual decrease of testosterone production in older men, a little bit like menopause is to women. With its anti-inflammatory properties, testosterone has been connected to chronic pain. In women, testosterone helps protect the nervous system and ward off depression and Alzheimer’s disease.
The thyroid gland drives the production of many neurotransmitters that run the brain. If your thyroid is low, you feel sluggish, mentally foggy and depressed; if it’s high, you feel anxious, jittery and irritable. Experts conservatively estimate that one-third of all depressions are directly related to thyroid imbalance. Low thyroid function remains one of the most under-diagnosed medical conditions in the country and proper evaluation and treatment of this condition is vital to both mental and physical health.
Dehydroepiandrosterone (DHEA) is a precursor hormone to the sex hormones, meaning testosterone, estrogen and progesterone are all converted from DHEA. Stress can take a toll on DHEA levels, which when low have been linked to weight gain, depression and chronic pain. Conversely, studies show that higher levels of DHEA as you age are associated with longevity.
Nutrition and Lifestyle Contributes to Hormone Health
Supporting natural hormone production through nutrition and dietary supplementation is essential whether you are doing BHRP or not. Keeping all your organs properly nourished is a mainstay of longevity. All the organs of the endocrine system whether the adrenals, pancreas, thyroid, hypothalamus, pituitary, testes, or ovaries require nutrition for balance and health. We encourage the appropriate use of food, herbs, and other natural supplement formulations to support healthy natural hormone production.
Along with nutritional support for natural hormone production is the vital role that individually appropriate lifestyle modification plays to effect healthy hormone balance. This has to do with identifying productive and limiting potentially harmful activities and their intensity, duration, and frequency. We like to refer to this as the “action-reaction consequences” to describe the cause and effect relationship that our habits, that we have both consciously and unconsciously formed, will harvest but have yet to manifest their deleterious or beneficial effects. Exercise must not simply be a general requirement for anti-aging prevention, though it is. We stress (pardon the pun) finding age appropriate exercise that also considers the overall “life stress” load each individual is carrying. Balancing exercise stress to be a healthy complement to producing a well balanced life, we must consider many other factors such as liver health, functional adrenal sufficiency, sleep quality and duration, and even bowel regularity and health. Nevertheless, selecting exercise intensity, frequency and duration according to the individual benefits hormone production and balance.
After nutritional support for natural hormone production and modifying your lifestyle positively to influence healthy hormone balance, some patients still ask, “Do I still need replacement?” If you are presenting symptoms and concerns and there is a confirmation of physiological signs of deficiency, you should schedule a consultation with a physician on staff to discuss whether bio-identical hormone replacement therapy is right for your individual concerns. Once BHRT begins, regular evaluations and modifications are typical, but are intended to safely find the balance your body needs.