1. Not every health problem you are experiencing is caused by hormone imbalance. I am opposed to “hormone mills” who sell hormone therapy as the solution to all problems. I take a very thorough history of all my patients to look for root causes. Often I discover imbalances in the immune system, metabolic abnormalities, nutritional deficiency or abnormal brain chemistry to name just a few problems contributing to a woman’s symptoms. It is a disservice to women to ignore these important health facts and offer everyone who comes through the door hormones as the solution. I want women to feel better faster and getting to the root cause is the best way to do this.
2. Not every woman is a good candidate for BHRT. I prescribe BHRT often to help women improve their quality of life, but for some women the risk outweighs the benefits and I need to find alternative ways to treat their symptoms. I often see or hear ads that claim BHRT is completely safe - an obvious marketing scheme and again a disservice to women.
3. I do not like hormone pellet therapy or hormone shots. This is a very unfortunate trend in bioidentical hormone therapy that was designed to increase revenue for hormone clinics and is not in the best interest of women. Pellets and shots initially cause extremely high levels of hormones followed by low hormone levels before the next pellet or shot is administered. Steady levels of hormones not highs and lows are what is desired. When these women find their way to my clinic, I am amazed at how unbalanced their hormones are and the side effects they are experiencing from this unnatural way of administering hormones. Not to mention the increased risk when high levels of hormones are used. I like hormone creams or patches for steady, predictable hormone levels that in my years of experience deliver the best and safest relief of symptoms.
4. Saliva versus blood testing – This is technical and difficult to explain in a paragraph, but saliva testing is the preferred way to test when using appropriate forms of hormone therapy (hormones in creams or patches that are absorbed through the skin). Female hormones are very fatty substances and fatty hormones do not stay long in the watery blood – oil & water do not mix. If your own body is producing these hormones, a protein called sex hormone binding globulin is produced that does allow hormones to be in the blood for a period of time. Blood testing is accurate in this situation. When BHRT is used (since it is not made in the body), sex hormone binding globulin is not attached. In this case hormones are not present long in the blood, but go quickly into your tissues. When using BHRT, saliva testing is more accurate since it is a secretion from a tissue and a good indicator of the amount of hormone that has actually reached the cellular level.
5. The role of a compounding pharmacy is to make BHRT, not prescribe them. It is illegal for compounding pharmacies to prescribe, but they often do “suggest” therapies to women or to their doctors. This totally disregards the importance of knowing the whole health story, looking for other factors contributing to ill health and weighing the risks & benefits before prescribing BHRT. I have seen many women on totally inappropriate and harmful therapies over the years due to the unfortunate practice of pharmacies offering inappropriate advice. Ads are often deceiving and many clinicians have very little experience or desire to help women be the best they can be. In this case I do believe “it takes one to know one”. As a woman who has experienced midlife herself, as a woman who has educated herself extensively on BHRT, as a woman who has 23 years of clinical experience treating women with hormones, I have a lot to say about BHRT and I want the correct information to get out to women. Many thanks for taking the time to read this and educate yourself.