Bio-identical hormones

Though bio-identical hormones have been known for years, most practitioners are unfamiliar with them. There are several brand name versions now available for use in the kind of hormone replacement therapy (“HRT”) typical of synthetic hormones. This is generally a one-size-fits-all dosage regimen.

Today sex hormones are available in bio-identical form, i.e. in the form they normally exist in our body. They can be given in different ways (orally, transdermally, sublinually or intrarectally). A man should make decisions regarding bio-identical hormonal supplementation with her physician based on results of the blood tests. 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 their potential side effects. Moreover, the compounded bio-identical hormones can be matched to the individual needs of each man’s needs-approach that is almost impossible with mass produced products. On the contrary, synthetic hormones often produce intolerable side effects. European medical studies suggest that bio-identical hormones are safer than synthetic versions. We must be cautious here though, because they have not been studied yet for long term use. I recommend them only with a complete risk assessment on the individual basis. I also do not support the notion that bio-identical hormonal therapy be used indefinitely as some kind of “fountain of youth”.

Hormones constantly interact among themselves. The hormonal profile of every man is unique. This means that the amount of hormones taken is dependent on every individual and the dosage right for one man may be too high or too low for another. The need for hormones changes as we age. Therefore, interval tests to determine their current levels need to be undertaken.

There is no doubt that hormones prevent osteoporosis. Osteoporosis is a disease that is the result of a depletion of bone cells, making bones more fragile and susceptible to fracture. Sex steroid hormones also play a role in controlling and regulating your metabolism and blood sugar, your energy output, digestion, and the way your body stores and burns fat. They help to regulate fluid and mineral balance, thyroid function, dramatic mood swings that lead to food cravings, erratic eating and weight gain. Hormone replacement may encourage weight loss and support your body’s insulin response, energy levels, and lipid profile. I think that the greatest success lies in an individual approach. I begin with laboratory test of hormone levels (“male hormone panel”). When warranted I then prescribe a precise dosage of bio-identical progesterone, testosterone or DHEA that is made up at a compounding pharmacy. Each patient is then monitored carefully through regular follow-up hormone panels to ensure adequate levels of hormones. Initially I do a hormone panel every three months. Once balance is restored, I perform hormonal panels once a year at the time of the annual exam.