Hormone Therpay Questions and AnswersDgreat342020-07-01T18:28:54+00:00
What are Bioidentical Hormones?
Bioidentical, natural hormones are hormones that have the same biochemical structure to those produced by the human body. These hormones are plant derived, natural hormones that are then chemically changed to mirror human hormones. Because they are not artificial molecules designed by pharmaceutical companies, they cannot be patented. Bioidentical hormones are available through compounding pharmacies as ordered specifically by a doctor. They are also available in many different forms, including capsules, sublingual tablets, drops, creams, patches, injections and subcutaneous pellets. The choice of delivery method often depends on the individual patient’s needs, and some methods can be more effective than others.
Bioidentical hormone pellets are rice-grain sized cylinders made to dissolve continuously under the skin over a 3-6 month period. They are impregnated with natural formulations of estradiol and/or testosterone. After numbing the skin with lidocaine, a tiny, 1/8th inch incision is made in the upper outer area of the buttock, and the pellets are inserted into the layer of fat just beneath the skin. Unlike transdermal creams and gels, and oral capsules, pellets release their hormones continuously throughout the day and night, maintaining constant blood levels. Constant levels prevent deficiency symptoms such as hot flashes and night sweats, anxiety or insomnia, and increase the physiologic benefits of these hormones on bone density, cognitive and cardiovascular status.
Are your pellets FDA approved?
The pellets we use in our NHRT therapy are derived from NDC 17-beta estradiol and NDC testosterone. The NDC designation is maintained by the FDA. HOWEVER – the pellets are compounded, not manufactured. The FDA delegates its authority of oversight and regulation of compounded medicines to each individual State’s Board of Pharmacy, under FDA Policy.
What is a healthy testosterone level?
If you look at the results on any medical laboratory test report, for any parameter tested, there is always a reference range listed. For each metabolically important parameter that physicians routinely test, a reference range is available against which to evaluate a specific patient result. In fact, before any laboratory test is approved for use by the FDA, reference range data must be available and approved as part of the test review and approval by the Agency. The important thing to understand from this statement is that the reference range for any given test will be entirely dependent upon 3 primary variables.
Does Bio Identical Hormone Therapy work as a fertility treatment?
CHHC hormone replacement therapy is not a treatment for infertility. If you are lacking estradiol and have a healthy uterus, replacing estradiol can act to proliferate the endometrial lining. When giving estradiol, it must be balanced with progesterone. However, there are many other aspects related to fertility than the health of the endometrial lining alone. CHHC’s Therapy should not be considered fertility treatment.
How much does Hormone Therapy cost? Is it covered by insurance?
We have received a number of questions about price and insurance coverage. First, from a price perspective, it would be difficult to sufficiently explain all the options available to answer each individual inquiry. Carolina Hormone and Health Centers offers a number of approaches to hormone replacement from our all-inclusive therapy to individual treatments and most everything in between. Some patients that live away from a state where we have a Center, travel by air or ground to their nearest (or preferred) Center for care while having necessary lab studies conducted at a place close to their home.
As our hormone replacement treatment plan is individually created, it encompasses the needs and goals of each individual. These obviously vary as each of us is unique. The best way to learn all of the options available to meet your specific needs and goals is to schedule your free initial consultation. Our consultant will provide all the detail you need and help you arrive at a treatment plan that is right for you.
With regard to insurance coverage, there are so many different plans of coverage that it is difficult to answer this question in one way that fits all our inquiries. We can say that many of our patients receive some level of coverage from their carriers. It is best to check with your specific provider to determine what levels of coverage may be available to you.
When will I begin to feel the benefits of hormone therapy?
While the answer to that question differs from individual to individual we often see a cessation of night sweats and hot flashes in the very short term. Some women report relief within days. Night sweats and hot flashes are generally related to low levels of estradiol. When natural estradiol is replenished, the body seems to recognize the restoration quickly and immediately utilizes the hormone to address that symptom.
The ability to enjoy a good night sleep is another symptom that we hear is addressed in the short term. Progesterone is a wonderful hormone often referred to as “the happy hormone”. It helps to quiet the mind and it is taken either orally or dissolved under the tongue about an hour before bedtime.
Shortly after we see the decrease in hot flashes, night sweats and an improvement in the ability to sleep well, we see a revitalization of energy levels, mental clarity and sex drive. Testosterone is the “energy hormone”. It allows us to carry more oxygen to our cells providing for that energy and increased stamina. Testosterone also contributes to an increase in sexual desire and response.
While the timelines may vary from person to person, we can often address the symptoms noted above within days to weeks. We first must attain the necessary blood levels and then sustain those blood levels sufficient to maintain a consistent level of relief. Be patient. The key is determining your individual maintenance level. Arriving at that level for long-term symptom relief is often accomplished within the first few months. So, to say it another way, we see an immediate response that may peak and wane for a brief period until we are able to determine your particular maintenance level and develop the administration frequency to hold and sustain symptom relief over the long term.
Do you work with patients who have had full hysterectomies?
The short answer to your question is yes. The term “full hysterectomies” is somewhat incomplete and the description of this procedure has undergone some changes. A full hysterectomy used to mean taking of the uterus, the cervix and the ovaries. Today, we use more specificity. A partial hysterectomy generally means taking the uterus only, while a “full” means the uterus and cervix. Neither of these really addresses the status of the ovaries and fallopian tubes. The terms “bi-lateral salpingo-oophorectomy” (BSO) means taking both ovaries and fallopian tubes, whereas a “left salpingo-oophorectomy” (LSO) or “right salpingo-oophorectomy” (RSO) means the taking of the left or right ovary and corresponding fallopian tube. Therefore, if everything is removed, it would be a full (or total) hysterectomy with BSO.
In any event, when the ovaries are removed (the major source of your hormones) replacement is indicated. If you retained your ovaries and had your uterus removed (with or without your cervix) your need for treatment would be indicated by your hormone levels and your body’s present ability to produce your estradiol or progesterone or testosterone in sufficient amounts to satisfy your body’s needs.
The best way to ascertain your level is to obtain blood levels of your estradiol, progesterone and testosterone as well as your FSH (follicle stimulating hormone), which is the hormone that stimulates the ovaries to produce your estradiol. Your blood levels along with your symptom report will give the provider information sufficient to determine your need for treatment.
Is Hormone Replacement okay for post-cancer patients?
I am not a physician, but I can tell you that many breast cancers can be related to estrogen dominance (and I am assuming your breast cancer was also) . For that reason, many doctors advise against estrogen (estradiol) replacement therapies in those absent of this essential hormone for fear of ‘awakening’ a dormant cancer. Unfortunately, there is little said about the benefits of balancing estrogen and progesterone. I encourage you to search (“Google”, if you will) “progesterone balances estrogen in breast cancer” and read what has been posted by a number of experts. Estrogen is not your enemy. Estrogen dominance is the issue. You need estrogen for a multitude of body functions and a deficiency of estrogen will create many of the symptoms you suffer. The key is to prevent estrogen from becoming dominate. Progesterone opposes estrogen from becoming dominant. Do not confuse natural progesterone with the progestins.
Taken from Women in Balance.org, “Is progesterone safe? Progesterone has been used in a number of clinical applications since 1940. Its early use was to assist women with infertility. Progesterone has NOT been linked to increased cancer risk. In fact, a large study conducted in France found that using bio-identical progesterone did not cause any increase in breast cancer, whereas use of synthetic progestins did result in a statistically significant increase in breast cancer risk. It is important to note that progesterone is often confused with progestins, which have been linked to increased cancer risk as noted in the Women’s Health Initiative in addition to the French study.” Click here for more.
Educate yourself as to the issue of estrogen dominance and progesterone balancing. Learn the differences between Natural (“bio-identical”) hormones and the synthetics. Then, speak again with your doctor. It may be unnecessary for you to have to suffer with estrogen deficiency. Our doctors would be willing to discuss potential treatment options with your oncologist if he/she is open to having the dialog.
I’ve noticed my skin has more moisture and oils. How does this effect make-up I may be using?
When restoring estradiol and testosterone levels in women, you will see an increase in skin moisture and natural oils. Estradiol retains fluid that brings moisture to the skin, fuller breasts and vaginal lubrication. Testosterone restores natural oils of the skin lost in menopause.
Often, women in menopause, due to increased dryness of the skin, have switched to using makeups rich in emollients. Most emollients are forms of oil or grease, such as mineral oil, squalene and lanolin. They work by increasing the ability of the skin to hold water, providing the skin with a layer of oil to prevent water loss, and lubricating the skin. With the restoration of the skin’s natural fluids and oils in hormone replacement, the addition of emollients can add too many moisturizers to the skin that may result in clogging pores or untoward skin reactions.
Some women have found it best to switch back to using “oil-free” makeups the same as those used when they were younger.