Bioidentical Hormone Replacement Therapy

Bioidentical hormone replacement therapy (BHRT) is the treatment of hormone deficiencies.   These low hormone levels can lead to a variety of symptoms that can effect ones health and well being. The Apothecary compounds bioidentical hormones for both women and men to increase levels and alleviate symptoms.

Bioidentical compounding uses molecules that are identical to the endogenous hormones found in the human body, which is not the case for other treatments. Traditional hormone replacement therapy includes animal-derived and synthetic molecules that are similar to, but not identical to, human hormones.

When choosing bioidentical hormones over synthetic hormones, patients report fewer side effects, increased happiness, and an improved quality of life.


Bioidentical Hormone Replacement Therapy

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Bio-identical means that it is identical to the hormone produced by the body.  The molecular structure of bio-identical hormones matches exactly the molecular structure of what is produced in the human body.  Since it is the same molecular structure, it will fit perfectly into that hormone’s receptor and will elicit the same response as the natural hormone produced by the body.  The synthetic hormones produced by the drug manufacturers, typically will have “similar” structures, but not exactly the same.  Therefore, synthetic hormones may elicit a different effect on the body, since they don’t fit perfectly into the hormone receptor.

The most common hormones that we compound are Estrogens (Estradiol, Estriol), Progesterone and Testosterone.  We may also compound DHEA, Estrone, and Pregnenolone.

We typically compound capsules, creams, and troches.   The dosage form depends on the hormone.  Certain hormones are not absorbed well orally or may cause effects that may not be desirable when taken orally.  These are the typical dosage forms we compound with each hormone:

Progesterone — capsules, cream, troche

Estrogen — cream, troche

Testosterone – cream, troche

A troche is a lozenge that dissolves in the buccal cavity (between the cheek and gum).   The advantage of a troche is that it is absorbed sublingually, and it bypasses the liver.

Biest means two estrogens.  The female body produces 3 estrogens (Estrone-E1, Estradiol-E2, Estriol-E3).  We will usually use two of the estrogens (Estriol and Estradiol) when compounding.  Very seldom will we use Estrone because over the years it has shown to have an increased risk of cancer.  Most often prescriptions will be written for Biest as “Biest(8:2)” or “Biest(5:5)”.  Biest(8:2) means we will use 8 parts of Estriol and 2 parts Estradiol.  Biest(5:5) means we will use 5 parts Estriol and 5 parts Estradiol.

First, you may want to see if you are experiencing common symptoms that are associated with decreased levels of the sex hormones.  See our symptoms sheet: BHRT Symptom Sheet. If you have a considerable amount of 2’s and 3’s, this is an indication that you may have a deficiency in one or more hormones.  You may want to consider having a test to see actual levels of hormones in your body.  A test may be performed by a provider that specializes hormone therapy, or you can contact us, and we can assist you in determining your testing options.

There are four main testing options for hormones.

  1. Blood (serum)
    This is commonly done in many provider’s clinics and may be covered by insurance.  While this test may be accurate initially in determining the levels of hormones, it also has been shown to be less accurate on follow up testing because the hormones that are applied topically or via a troche do not always show up in the blood.
  1. Saliva
    Saliva is one of the more popular ways to test hormones.  A patient expectorates (spits) into a tube while at home, then will send the test off for results.  This testing is not usually covered by insurance
  1. Blood Spot (capillary)
    This is a finger prick test, similar to the test used for blood glucose.  Because it is testing capillary blood vs. venous blood it is more reflective of hormone levels at the site of the tissue. Hence, it is believed to be more accurate than serum testing.
  1. Urine
    This test looks at the hormone metabolites.  This test is commonly used after a person has started on hormones because it is reflective of how their body is metabolizing the hormones.

Where Should I Start?

Get in touch with us. We’ll answer any questions you might have.