Bio-identical Hormone Therapy (BHRT) for Men and Women


· Decreased energy, motivation, and initiative

· Poor concentration and memory

· Reduced sexual desire (erectile dysfunction in men)

· Irritability, mood swings, feelings of depression

· Loss of muscle mass, decreased strength, and increase in body fat

· Insomnia, increased sleepiness

· Hot flashes

· Insulin Resistance

· Degenerative Diseases (Diabetes, Heart Disease, Osteoporosis)

. Autoimmune Disorders (Rheumatoid Arthritis, Lupus, etc.)

. Fibromyalgia




Bio-identical Hormones vs. Synthetic Hormones

Natural, biologically identical hormones are derived from plants, such as the wild yam, and are chemically and functionally identical to human hormones. Because of this, they produce the same responses and are processed by the body in the same way as hormones made by the body naturally. Synthetic hormones are just like they sound. NOT NATURAL! They have a different chemical structure than what our bodies produce. These foreign substances can produce toxic by-products, which can have serious side effects such as CANCER or heart disease. Bio-identical hormones have not been shown to have these effects. Another big issue with synthetic hormones is that only standard doses are available. I have your prescription compounded especially for you. No cookie cutter dosing for my patients!

BHRT Supplementation at Our Practice


Testosterone is vital to the health and well-being of BOTH men and women. Testosterone in men is mainly produced by the testicles and in smaller quantities by the adrenal glands. In women, testosterone is produced in both the ovaries and the adrenal glands. Testosterone contributes to muscle mass, strength and endurance, decreased fat, increased exercise tolerance, enhancement of the sense of well-being and psychological health. Testosterone protects against cardiovascular disease and reduces blood sugar. It leads to improved lean muscle mass, increased bone density, decrease in cholesterol, improved skin tone, improved healing capacity, and increased libido and sexual performance. It enhances the quality of life for both men and women by decreasing the health issues caused by deficiencies. Because many physicians have an “old school mentality” and only treat patients based on lab results, many don’t receive the treatment they need for optimal health.  Testosterone is present and extremely important in both Women and Men, making adequate tissue levels very important for health in both sexes.

How We Can Supplement

Testosterone can be delivered via:

1. Pellet therapy combines a low dosage of key hormones (testosterone in men and testosterone with or without estrogen in women) with a delivery system that functions similar to the human body. Small dissolvable pellets (about the size of a grain of rice) are inserted underneath the skin, into the fatty tissue. This is usually done in the buttock in women and in the hip in men. This is an in-office procedure, usually taking less than ten minutes and requires no stitches. It releases hormones directly into the bloodstream, bypassing the GI tract and liver. When properly administered, pellet implants provide the hormone release needed for proper blood levels 24/7, over a period of 3-5 months

2. Injections are usually self-administered. For men injections can be self-administered several times a week subcutaneously, like diabetic injections, without painful intramuscular injections like “in the ole days”, and self-administered every 2 weeks in women. These can be self-administered for your convenience, or given at our office if you prefer. These injections can be given intramuscularly, or with smaller needles, just beneath the skin (subcutaneously). Some people may want an injection periodically to extend or boost the testosterone level they receive from pellets and some prefer this as their primary means of receiving testosterone supplementation.

3. Patches or creams are another way for testosterone administration.


Estrogen refers to a group of similar hormones produced in the body. Like Testosterone, Estrogen is a required hormone for the health of BOTH men and women. The main three are estrone (E1), estradiol (E2), and estriol (E3). Estrogens are believed to be protective against heart disease, stroke, osteoporosis, Alzheimer’s disease, and memory disorders. In women it also protects against vaginal atrophy, urinary incontinence, and prevents symptoms of menopause, including poor temperature regulation (i.e. “hot Flashes”). Estrogen deficiency is linked to: increased skin wrinkles of the face, fatigue, depression, mood swings and decreased libido. If estrogen supplementation is required, it can be done via cream, capsule, pellet, patch or trouch. Synthetic estrogens bind nearly 20 times stronger to your cell’s receptors than natural hormones and have been demonstrated to be harmful. Because of this, we only use bio-identical hormones. 


Progesterone is primarily produced in the ovary just prior to and after ovulation. It is also produced in large quantities by the placenta during pregnancy and in small quantities by the adrenal glands. If you are on bio-identical estrogen, you should be on this hormone as well. It protects against uterine and breast cancers, fibrocystic disease and ovarian cysts. Progesterone counteracts the fluid retention, as well as other symptoms, seen in estrogen dominant women.  Estrogen dominant women also have difficulty losing weight and gain excessive weight more easily. Progesterone deficiency can also contribute to moodiness, tearfulness, the inability to handle stress, and can contribute to insomnia. Additionally, it potentiates estrogen’s cardiovascular and bone benefits. Unfortunately, most U.S. women are prescribed a synthetic progestin (Provera), which can cause side effects such as bloating, headaches, fatigue, weight gain, and heart disease. Because of this, we only use bio-identical Progesterone, compounded in a strength specifically for you. The delivery system is by capsule, troche, or rapidly dissolving tablet (RDT). 

Other Hormones we evaluate:

Dihydroepiandosterone (DHEA), Pregnenalone, sex hormone binding globulin, IGF-I (growth hormone), and many others

What is involved in Starting on Bioidentical Hormone Therapy? 

You will fill out a brief medical history and a symptoms questionnaire when you have your lab work done. We will discuss your symptoms, history, lifestyle and goals; also review the results from your saliva test, and blood work. From this, I will make recommendations for a course of treatment. I view health management as a collaborative effort between myself and my patients. After reviewing your options, together we decide which course of treatment is best suited to help you reach your wellness goals.

Should you choose pellet insertion, if prearranged with the office, you may be able to have the procedure the same day. It generally takes less than 10 minutes and you can usually resume normal activities (with the exception of strenuous exercise for approx. 4-7 days).  

During your follow up visit 4 weeks later, we will discuss what you have experienced in symptom relief. We will decide whether any adjustment needs to be done to your future dosage based on your follow up visits and subsequent saliva and blood test approximately 3 months later. Other delivery methods can be prescribed or in some cases, administered on the day of your appointment. I will also encourage you to further enhance your own health by using the new found energy from restored hormone levels to exercise regularly and eat well. You can stop BHRT treatment at any time, which will cause your hormone levels to drift back to your pre-treatment levels and your pre-treatment symptoms to return. 

Cost & Insurance

A frequent question is: How much does this cost? In an effort to keep the costs reasonable for everyone, we require patients to pay for their treatment at the time of service. We accept most major credit cards, debit cards, cash, flex and HSA cards. We also accept MedLoan Finance. There is much variation in coverage for this treatment despite the fact that insurance companies should be clamoring to have you treated, as it can reduce the risk of many chronic diseases, which are expensive to treat, however some of the testing we do is still considered experimental and thus we do charge a cash price for some of our Hormonal testing.  Our staff will be happy to answer your questions regarding these issues

Which Hormones Should I Test? By Jay H. Mead, MD FASCP

Eight Hormone Assessment Panel Estrogen, Progesterone, Testosterone, DHEA and 4x Cortisol  

The Comprehensive Hormone Assessment Panell (estrogen, progesterone, testosterone, DHEA and four diurnal cortisol) is an excellent starting place for evaluating hormone function in the body. This panel tests both reproductive (sex) and adrenal hormones. If you are testing only the sex hormones you are missing valuable information that could lead to more effective treatment strategies. The Whole Picture Clinically it may be obvious to test the estrogen, progesterone and testosterone, but it is equally important to look at the foundation of the balance/imbalance: DHEA and cortisol – the adrenal hormones. Sex hormones are made in both the gonads and the adrenal glands. Often when the reproductive system is out of balance the adrenal glands go into overtime in an attempt to compensate. Conversely, when the body is under a great deal of stress, the adrenal glands produce cortisol and DHEA which reduce gonadal hormone production. Cortisol As we age and our production of sex hormones changes the adrenals will maintain a central role in sustaining optimal health and function. The AM cortisol level represents the maximum output of cortisol for the entire 24 hour period and initiates and maintains waking day activity and function. Cortisol level at noon, late afternoon, and night indicates the pattern of   cortisol production over the 24 hour period and can highlight adrenal exhaustion. DHEA levels are equally important because this hormone has a central role in disease prevention and health optimization, and is often referred to as the “anti-aging hormone”. Including DHEA and cortisol along with the sex hormones in testing results from testing the reproductive hormones is very significant clinically and once both of these systems are addressed, most patients’ symptoms will improve. Measuring DHEA and cortisol production is your first glimpse into the status of the connection between the two endocrine organs.  Once treatment begins the Short Comprehensive Hormone Assessment Panel (estrogen, progesterone, testosterone, DHEA and AM, PM cortisol) is an ideal retest. If symptoms of adrenal fatigue are still severe consider testing all cortisols.