Hormone Replacement Therapy FAQ

Some of the common symptoms of menopause are dry/itchy eyes, dry/itchy skin, thinning skin/more wrinkles, thinning hair, brain fog, lack of focus, memory loss, sleep disturbances, mood swings, anxiety, irritability, depression, migraine headaches, hot flashes, night sweats, temperature intolerance, coldness, sore breasts, palpitations, muscle and joint aches and pains, inflammation, bloating, irregular periods, weight gain, fluid retention, decreased metabolism, fatigue, less energy, vaginal dryness, and decreased libido.

Some of the common symptoms of andropause are thinning skin/more wrinkles, thinning hair, brain fog, lack of focus, memory loss, sleep disturbances, mood swings, anxiety, irritability, depression, muscle and joint aches and pains, inflammation, weight gain, decreased metabolism, fatigue, less energy, decreased libido, decrease in sexual function, less motivation, less endurance.

When you get closer to menopause, your ovaries start to dysfunction, and then it completely shuts down when you go into full menopause. Your estradiol levels start to decrease close to zero, and so do your progesterone levels. As you age, your thyroid glands also start to become underactive and dysfunctional, but this cannot be diagnosed as a thyroid disorder because your thyroid levels may still be within the normal range.

Hormone replacement therapy replaces the hormones you are lacking and optimizes your levels so that most of your menopause or andropause symptoms are relieved. 

Labs will be ordered to check your estradiol, follicle stimulating hormone, progesterone, testosterone, thyroid function levels, DHEA, SHBG, prolactin, and CBC. A recent mammogram that is up to date is recommended. If you have recent hormonal labs from your PCP or GYN, we can use that as well. 

We typically do not like to focus on numbers because that means we are putting you in the same box as everyone else. Not everyone needs to be at a certain level, every person metabolizes differently. Some people need more hormones than others, and some will need less. We are looking for a trend in your levels and symptom relief. 

Yes, bioidentical hormone replacement therapy is SAFE. It is natural and does not mimic the hormones in your body; it has the same molecular structure. It will not cause breast or prostate cancer, and it is actually protective against breast, prostate, and colon cancer. 

Unfortunately, if you are currently diagnosed or in the treatment process for ovarian, breast, uterine, cervical, prostate, or thyroid cancer, you will not be able to start hormone replacement therapy. If you have been diagnosed with any of these cancers in the past, you may be able to start hormone replacement therapy with clearance from your oncologist. It is also contraindicated if you are currently pregnant or trying to conceive. If you have a history of blood clots, stroke, liver disease, or kidney disease, you may be contraindicated in using injectable testosterone. 

There may be side effects with any type of medications. With hormone replacement therapy, some possible side effects that may occur are breast tenderness/soreness/swelling, moodiness when initially starting, bloating, pelvic cramping, possible irregular menses or post-menopausal bleeding, tiredness/grogginess, acid reflux, or upset stomach, irritability, hair thinning, hair loss, acne, facial hair, erythrocytosis, scrotal shrinkage, infertility in men. Usually the side effects are temporary if you do have them, but we do calculate your hormone dose in a conservative manner where you will feel the positive effects before any negative effects.

For bioidentical hormones, you can be on it for life. You do not need to wean off from it like synthetic hormones. Bioidentical hormones have long-term benefits like the prevention of breast cancer, osteoporosis, cardiovascular disease, and decreasing cholesterol.

It is possible, if you have very minimal or close to no menopause or andropause symptoms. Some symptoms can be managed by lifestyle changes and supplements. It is recommended to start hormone replacement therapy if you have mild to severe symptoms. Even if you do not have symptoms, hormones can help with long term benefits.