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Hormone and Infertility Clinic in Noblesville, Indiana

Hormone Replacement Therapy

You may have recently seen, read or heard the BUZZ regarding “bioidenticals” in the media. Oprah, Dr. Phil and several morning talk shows have recently featured coverage on menopause.
 
HRT
 
Hormone replacement therapy (HRT) is a term that is most often used when referring to “synthetic” hormones, including, but not limited to : Provera (synthetic progesterone), Premarin (derived from horse urine) and Prempro (combination of provera and premarin)  Even though these examples of synthetic drugs have been used for decades to “replace” hormones in perimenopause/menopausal women, they are not “natural replacements” for our bodies.
 
Dr. Mac and his staff have been great on my journey through the experience of the stages of menopause. Dr. Mac treats his patients with respect and care in his attitude. I highly recommend him. You will be in good hands at his office.
Jeanne
bHRT
 
Unlike HRT’s, bioidentical hormone replacement therapy (bHRT) are hormones that are biochemically identical to the hormones that are produced in the ovaries (i.e, estrogen, testosterone and progesterone) during the reproductive years.
 
This type of hormone replacement is derived from plants such as soy, black cohosh and yams. Because bioidenticals are “natural,” they seem to be metabolized easier, allowing for more consistent hormone levels, and less systemic side effects.
 
Estradiol, progesterone & testosterone, are measured by blood tests and may be adjusted to youthful levels to help you feel your best. Our goal is to improve your quality of life! I’m sure we would all like to live longer, but actually, we really want to live and feel better. Bioidentical HRT helps you accomplish our mutual goal.
 
Bioidentical hormones may be administered through several routes:
 
  • Oral
Estradiol may be taken orally; it may be compounded or prescribed as Estrace. Natural Progesterone replacement is advised if you have a uterus, to help prevent endometrial cancer. It may be compounded or prescribed as Prometrium. Generally, Testosterone is not prescribed orally due to adverse liver effects. It is also noteworthy that higher doses need to be given, when taken orally, to achieve optimum tissue levels. Also, about 10-15% of women don’t absorb the estrogen adequately when taken orally.
 
  • Patches
The estrogen patch was first approved by the FDA in 1986. The advantages of transdermal estrogen included a lower risk of thrombophlebitis (blood clots in the leg) and better effects on cholesterol. With the patch, estradiol traverses the skin directly into the circulation. A Progesterone patch is impractical due to the size required and the need to change it everyday. Testosterone patches are available for men, but the dose is generally too high for menopausal women.
 
  • Creams
Estradiol, Progesterone, and Testosterone can all be compounded into creams-either alone or in combination. Since the hormones can be inadvertently transferred to others by direct contact, the recommended application sites may vary-particularly is small children are involved.
 
  • Injections
Both estrogen and testosterone injections are synthetic. Daily natural Progesterone injections are impractical. Peaks and valleys result from weekly, bi-weekly, or monthly injections. Mood changes often result, along with headaches-particularly migraines.
 
  • Pellets
Bioidentical Estradiol and Testosterone pellets have been available for use for over 70 years. They are easily inserted, adequate blood levels are rapidly achieved, and they generally are easily absorbed. Pellet therapy is ideal for women who previously suffered from PMS or menstrual migraines and for those who are unable to achieve adequate serum levels to improve their quality of life.
David McLaughlin, MD