BHRT – Hormone Replacement

From a physiological perspective, bioidentical hormones derive from natural plant sources are identical to those that the body produces for itself, in physiological proportions. When we are “replacing” the body’s hormones, we feel it makes more sense to use entities which the body recognizes as its own, rather than hormones from horses, imbalanced versions or overly potent synthetic versions. The hormones we use are mainly Estradiol, Estriol, (E2, E3, respectively), progesterone, testosterone, and DHEA.

Frequent Questions

With the exception of low potency progesterone creams, natural, bioidentical hormone therapy is generally obtained through a physician’s prescription. This is one of the key benefits of choosing Azura Medical Spa. Our Medical Director is a board-certified surgeon and physician with prescribing privileges.

Because the ingredients are naturally derived, it is impossible for a manufacturer to obtain a patent on these substances. Without a patent, it is unlikely that any drug manufacturer will go to the expense of pursuing these products for marketing and sales. Consequently, these bio-identical hormones must be prepared for the patient from pure, plant derived chemicals by a pharmacist at a compounding pharmacy.

Actually, it’s the oldest type of pharmacy in the world: an apothecary with a pharmacist trained in formulating prescriptions and who prepares them from pure ingredients on the order of a physician. A caring and competent pharmacist works closely with the prescribing physician to create just the right dosage form and strength for you, the patient.

Compounded dosage forms are numerous and variable in nature. Each method has its advantages for use. Usage of specific dosage forms depend on patient compliance, type of response desired and medications involved. Oral capsules, vaginal suppositories, transdermal creams, gels and troches (a lozenge that dissolves between the gum and tongue) are types of dosage forms available to be compounded and ideally each patient’s medications would be tailored to their individual needs for treatment.

Natural plant sterols are extracted from soybeans and/or Mexican yams. These are taken to a laboratory where they are converted chemically, or semi-synthesized to hormones that are identical and indistinguishable from the body’s own.

Although these hormones are derived from substances in soybeans and yams (diadzein and genistein), they are natural in the sense that they are biologically identical in structure and function to hormones produced in the body. For that reason, we prefer to call these hormones “Bio-identical, plant derived”. We use the term “synthetic” to describe those entities chemically altered to be many times more potent than the “naturals.”

Although compounds such as these cannot be processed at the pharmacy like mass produced medications, most insurance companies will reimburse a percentage of the cost to the patient. Look closely at your benefit package. If you have a flexible spending account of HSA (Health Savings Account) you may use your account to pay for you consult and/or hormone prescription(s).

The Food & Drug Act of 1938 contains specific exemptions to the approval process, with the specific intention of NOT interfering with a doctor’s ability to treat his patient. “The FDA cannot approve or disapprove of how a legally marketed drug is used by a physician in practice. The agency approves of what the manufacturer may recommend about uses in its labeling (package insert) and advertising.” (Editorial, JAMA 1984; 252:1054-5)

EVERY PATIENT IS DIFFERENT! Dr. Weston and Azura Medical Spa will take many issues into account when dosing replacement therapy: Age, weight, symptoms, gynecological history and prescriber experience will all affect the choice of dose and dosage form. Saliva or blood spot testing to identify specific imbalances of one or more hormones eliminates guesswork when prescribing and regular monitoring with use allows adjustment of dosed as needed.

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