“Bio-identical” hormones are compounds which are manufactured in the lab to have the exact same chemical and molecular structure as the hormones that are produced by the human body. Though any hormone can be made to be “bio-identical”; the term is most often used to describe formulations containing estrogens, progesterone, and androgens. By contrast, synthetic hormones are intentionally different. Drug companies cannot patent a bio-identical structure, so they most often invent synthetic hormones that are patentable (Premarin, Prempro, and Provera being the most widely used examples) or provide ‘bio-identical” hormones in a unique delivery so the delivery mechanism becomes patentable.

Patients choose DR/M Integrative Health because of the customer service, attention to detail, and high quality of care that they receive as patients. Mary Montes, DNP, FNP spent years training side by side with international hormonal health expert, Dr. Angela DeRosa, and offers her patients a high level of expertise in addressing the confusing and hard to understand symptoms that hormonal imbalance can cause. Many patients have tried to address these concerns in traditional healthcare models only to walk away frustrated and without a solution. Dr. Mary has a proven track record of helping patients achieve hormonal balance and a return to the quality of life that they deserve.

We long ago concluded that the answer to this question is yes. But that doesn’t mean bio-identical hormones are perfect. The great appeal of bio-identical hormones is that they are natural, and our bodies can metabolize them as it was designed to do, minimizing side effects. Synthetic hormones are quite strong; often producing intolerable side effects. Moreover, the compounded bio-identical hormones can be matched individually to each individual’s needs — something that’s just impossible with mass-produced synthetic products.

European medical studies suggest that yes; bio-identical hormones are safer than synthetic versions. While this makes perfect sense, we must be cautious because they have not been well studied especially for long-term use. And in any case, we recommend that women and men never think of any drug as completely safe Let us note here that the WHI studies on the effectiveness and health risks of HRT were based on synthetic/equine-based hormones, and the average age of the women at enrollment was 63. These details did make a difference in their risk. Our providers will be able to discuss these studies with you in detail at your appointment.

Pellet therapy has been available in the United States since 1939. It is a sustainable delivery method for bio-identical hormone therapy and is an ideal hormone treatment that helps balance body chemistry and restores health and vitality in women and men suffering the symptoms of hormonal imbalances. The effect the pellets have is nearly identical to the way hormones are naturally produced in a healthy 30-something-year-old patient.

The long-lasting pellets make this hormone therapy treatment option easy and convenient. Instead of dealing with a daily hormone pill schedule, bio-identical hormone creams or shots, you meet with a DR/M Integrative Health provider every three to six months for easy insertion. During the simple in-office procedure, the tiny pellets are inserted into the buttock area. The small incision site requires just a small bandage. The pellets, which contain estradiol and/or testosterone, react to the needs of your body by secreting additional hormones just as your body naturally would during periods of stress or exercise. In addition, the body does not experience extreme highs and lows because hormone delivery is constantly maintained.

Most patients notice a difference very quickly. However, it can take up to four weeks for the full effect to be felt. Results can last up to six months. DR/M Integrative Health will closely monitor your progress to ensure that you sustain proper hormone levels and to determine the timing for subsequent pellet insertions.

Regardless of your hormonal treatment method(s), you can rest assured that you will likely experience relief from the symptoms and chronic health issues caused by your hormonal imbalance.

The term “transdermal” refers to topical delivery through the skin, by the use of a gel, cream or patch.

Transdermal hormones are usually applied to the skin daily in small doses in an effort to keep a steady level of hormones in the system at all times. This approach avoids the extreme “peaks and valleys” in hormone levels sometimes associated with injectable forms. With injectables, hormone levels can reach a low-point a few days before the next shot is due, which can cause irritability, hot flashes, and low energy in some users. However, with once daily use of gels and creams, you can still experience significant peaks and valley which can cause adverse events. Transdermal application is also attractive to those individuals who are not comfortable with needles and injections.

However, there are some disadvantages to transdermal delivery. Some forms of daily transdermal application, particularly the patch, are substantially more expensive than injectable forms of hormones. Patches often cause skin irritation and/or allergic reactions to users. They can fall off with excessive sweating, and they must be fully protected with plastic when swimming. Creams and gels can be transferred by direct skin contact with a partner; special care must be taken to avoid contact with partners, children, and pets.

In the United States, testosterone patches are not available for women; only estradiol patches. In Europe, a matrix delivery testosterone patch “Intrinsa” is available for women.

Orally delivered hormones (pills) will pass through the liver prior to entering the blood stream. This is called “first pass” metabolism. This has been shown to increase the risk of blood clotting and increased risk of heart attack and stroke; even if the hormone is bio-identical. In addition, when the liver metabolizes hormones it increases a protein called SHBG (serum hormone binding globulin) which bind up free Testosterone and Estradiol. This essentially makes the hormones given ineffective. Estradiol and Testosterone should NEVER be administered orally.

Depot’ drug formulations are created by mixing a substance with the drug that slows its release and prolongs the action of the drug. The two primarily used forms in the US are the testosterone esters testosterone cypionate (Depo-Testosterone) and testosterone enanthate (Delatestryl) which are almost interchangeable. These are only used in men as the doses would be too high for women.

The adverse side effects of injected testosterone esters are generally associated with high peak levels in the first few days after an injection followed by lows after the injection starts to wear off. Some side effects may improve by using a shorter dosing interval (weekly or every ten days instead of twice monthly with enanthate or cypionate.) 100 mg weekly gives a much lower peak level of testosterone than does 200 mg every two weeks, while still maintaining the same total dose of androgen. This benefit must be weighed against the discomfort and inconvenience of doubling the number of injections. Having “peaks and valleys” never allow the body to have sustained levels which can reset all the testosterone receptors causing the most positive effects on the body.