Bioidentical Hormone Replacement
Dr. Cynthia Olson is a family physician trained in Bioidentical Hormone Replacement Therapy. Her approach is designed to not only restore your hormones to a healthy level, but also to address lifestyle, nutrition, stressors and environmental exposures, all of which can profoundly affect your hormones and your health.
Partnering with Relax & Renew Spa, Dr. Olson brings her passion and expertise in Metabolic Medicine to support our clients in wellness and the aging process.
What are Bioidentical Hormones?
Bioidentical Hormone Replacement Therapy is the term commonly used to describe the treatment of hormone deficiencies brought on by aging, by replacing them with hormone molecules that are identical to the hormones produced naturally within the human body.
Hormones are responsible for controlling the delicate biochemical balance in our bodies. They move our bodies through each phase of our lives, from infancy through puberty, reproduction, and old age. They prepare our bodies to fight, to flee, and to mate, and they are responsible for many of our daily mood swings and hunger pangs. Hormones are produced by our cells in very small quantities, and trace amounts can have significant effects.
What are the difference between Bioidentical and Synthetic Hormones?
Bioidentical replacement hormones were first used to provide relief from the symptoms of menopause in the 1930’s. The first synthetic, or mass-produced, hormones were developed in the 1940’s. The synthetic hormones, which are derived from horse urine, do not match the molecular structure of the hormones produced by our bodies. Synthetic hormones can produce unpleasant side effects such as nausea, fluid retention, and dizziness. Worse, studies in the 1970’s began to show that using patented synthetic hormones increased the risk of potential dangers such as breast cancer and uterine cancer.
Unlike synthetic hormones, bioidentical hormones are extracted from natural sources such plants, including soybeans and yams. Their molecular structure is identical to that of the hormones produced within our own bodies. Bioidentical hormones are compounded into creams by FDA-approved pharmacies. They are custom-tailored to suit your specific hormone replacement needs, to allow you to receive individualized treatment.
What are some of the benefits of Bioidentical Hormone Replacement Therapy?
There are many benefits gained by the natural, customized approach of BHRT, including:
• Improved weight loss
• Improved sex drive
• Improved look and feel of hair and skin and nails
• Improved mental health
• Improved memory
• Improved mood and emotional balance
• Lower cholesterol levels
• Decreased risk of osteoporosis
• Decreased risk of heart attack
• Decreased risk of stroke
• Much more!
Once you have contacted our office, you can purchase your information package with patient history form, symptom diary and blood requisition form. We request that you have your blood work completed a minimum of 4 weeks before your appointment as several of the tests take time to complete. There will be a $200 deposit to reserve your spot. Doctor Olson is in the spa once a month.
Frequently Asked Questions
+ What are bioidentical hormones?
Bioidentical hormones are an exact replica of the hormones that are naturally produced by the body. The difference between bioidentical hormones and synthetic hormones is that, although both are created in labs, synthetic hormones are not identical to the hormones naturally created in your body and bioidentical hormones match your body's hormones exactly.
Depending on what your symptoms are and which hormone(s) your body needs, Dr. Olson may choose to prescribe bioidentical hormones such as estrogen, progesterone, testosterone, thyroid hormones, DHEA, or others as needed.
+ Who needs bioidentical hormone replacement therapy (BHRT)?
The only way to know if you need bioidentical hormone replacement therapy is through specific laboratory testing. There are specific lab panels available to determine your hormone levels and ratios.
Signs and symptoms of imbalance may include, but are not limited to fatigue, depression, hair loss, weight gain, muscle atrophy, low energy levels, insomnia, mood swings, hot flashes, night sweats, and anxiety. Hormone imbalances can occur with expected changes in menopause and andropause.
Following lab testing, Dr. Olson will review your results to determine if BHRT is beneficial for you. In some cases, BHRT may not be necessary; however lifestyle and environmental factors may change this need over time, so routine testing, along with a preventive health lifestyle is recommended to keep hormones balanced and maintain optimal health.
+ When should I consider bioidentical hormone therapy?
In general, your body's natural hormones begin to decline after your mid-20s and hormone imbalance symptoms are frequently present by your mid-30s. Men and women often start replacing hormones between the age of 35 and 40. If you are experiencing symptoms of hormone imbalance, it is best not to wait.
+ Does Dr. Olson see children?
Prepubescent children are best served by a pediatric endocrinologist. However, she does see young women if they have started menstruating, especially if there are changes in their energy, mood and /or personality.
+ What is the difference between bioidentical and synthetic hormones?
The difference between bioidentical hormones and synthetic hormones is twofold. Unlike bioidentical hormones, synthetic hormones may be patented by pharmaceutical companies; therefore dosage ranges are limited. Synthetic hormones are not created structurally the same as human endogenous hormones, which can lead to uncomfortable and potentially dangerous side effects. While synthetic hormones can mimic the effects of endogenous hormones on certain biological pathways, they rarely offer the same effectiveness at a deeper, molecular level.
Bioidentical hormones “mimic” the affinity of human endogenous hormones; therefore they are effective on biological pathways, at all levels. Because bioidentical hormones are an exact structural replica of endogenous hormones your body knows exactly how to break down and eliminate them safely. Side effects are rarely observed, and in the event you do experience side effects, talk with your doctor - the dosage may simply need to be adjusted. The added benefit of bioidentical hormones is that each dose is tailored specifically for your needs, not simply what doses the pharmaceutical company offers (as is the case with synthetic hormones.)
+ What are the ingredients of bioidentical hormones?
Bioidentical hormones are hormones derived from plants, such as soy or wild yams, and are designed to be structurally identical to the hormones produced naturally inside the human body. Additional ingredients in each prescription vary by hormone – testosterone, estrogen, progesterone, etc. and form- creams, pills, suppositories, etc. Your pharmacy may be able to provide you with an ingredient list for your specific prescription.
+ How do I take them?
Transdermal is often preferred as this most closely mimics nature. Our glands secrete hormones into the bloodstream where they go straight to the target tissues unchanged. In the same way, creams applied to the skin go directly into the bloodstream to the target organ unchanged.
On occasion, we use the oral route of hormones in order to take advantage of what is called “the first pass effect”. Whenever we swallow anything, it goes from our digestive system to the liver so it can detoxify and break down whatever we’ve swallowed. We can use this “first pass effect” to produce metabolites (or break down products) in order to use the side effects to our benefit. For example, the liver can metabolize oral progesterone to a molecule that studies have shown normalize sleep wave EEG’s. In other words, make you sleep deeper and more restorative. There are other routes that can be very useful but Dr. Olson will discuss those if they apply to you.
+ Where do I apply creams?
This varies between people and genders, but usually creams are best applied to the vulva in women; specifically the labia minora. This skin is thin enough to absorb almost 100% of the hormone in the creams, so you can use very small doses for maximum benefit with few, if any, side effects. It also does not “fatigue”, like other skin and the absorption remains constant over time. For women who can’t tolerate the cream on the labia, it is recommended they apply creams on the inner forearms or the back of the knees. The only place men can apply cream to get the same benefit is on the rectum. For men who are reluctant to do that it is recommended they put creams on the triceps area or the back of their knees. The drawback of applying cream on skin is that it can be transferred to others, especially in the hour or two after application.
+ Why do women need hormones before, during and after menopause?
Hormones affect a multitude of pathways in the body. Women may experience fluctuations in their hormone levels throughout their lifespan unhealthy ratios can occur due to lifestyle and environmental factors, as well as expected changes, such as pregnancy, perimenopause, menopause and post-menopause. Imbalances of hormones, including estrogen, progesterone and testosterone can lead to many uncomfortable symptoms, like night sweats, hot flashes, mood swings, depression and anxiety. The most common decline seen in menopausal and post-menopausal women is estrogen. When estrogen levels become unbalanced, women may experience symptoms such as low libido and bone loss. The bone loss that women experience due to declining estrogen levels can lead to osteoporosis and increase the likelihood of bone fractures. Adjustments to a woman’s hormone levels through BHRT and lifestyle changes can reduce or eliminate these discomforts and improve overall health and well-being.
+ Why do men need testosterone replacement?
As men age, production of the hormone testosterone begins to decline and they experience symptoms of low testosterone. Testosterone is the hormone that is responsible for maintaining mental focus, energy, mood, metabolism, muscle mass, fat levels, and sex drive. By balancing a man's hormones with bioidentical hormone therapy, men can restore their vitality and reduce the symptoms of andropause.
+ How long until I see results using bioidentical hormones?
Most patients begin feeling better within a few months of beginning the program, but some results may take a bit longer to achieve. You may begin to feel a difference within a matter of weeks, especially when it comes to sleep patterns and energy levels. Every patient has a different experience, but the end result is the same – a healthier, stronger body.
Changes like these take time to evolve. Remember, it took some time for you to lose balance of your hormones, so it will take your body some time to recover and adjust. Consistency and compliance every step of the way will improve your results.
+ Are bioidentical hormones approved and regulated by the FDA?
Many people are under the misconception that bioidentical hormones are not FDA-approved. This is simply not the case. The hormones are derived from plant sources, such as soy and yams, which are approved by the FDA.
Bioidentical hormones may be delivered in the form of creams, pills, gels and suppositories. Bioidentical hormones are designed in a lab and shipped to a compounding pharmacy where they are custom designed to fit the needs of each patient. Synthetic hormones are created in specific, patented doses and delivery methods (not customized), therefore, titration of the dose changes needed from individual to individual are not possible.
+ Why don't traditional doctors prescribe bioidentical hormones?
Traditional doctors do not usually have the time or the resources to seek expertise in bioidentical hormones. Dr. Olson is a family physician with extensive training and nearly 10 years’ experience in bioidentical hormone therapy and has specialized knowledge of how BHRT combined with nutraceuticals, lifestyle and nutrition can lead to a markedly improved quality of life as you age.
+ Do I need a prescription for bioidentical hormone therapy?
Yes. Bioidentical hormones are compounded prescription drugs that are produced in a specialized pharmacy. Each prescription is hand made from the highest quality ingredients and made by pharmacists that specialize in formulating drugs. Since every patient is unique, the strength or the dosage form needs to be specially made to fit the individual.
+ My sex drive is low, could it be my hormones?
Yes, estrogen and testosterone work in a perfect balance to fuel your sex drive. Too much or too little of either these hormones can cause a decrease in sex drive or cause performance issues. In some cases, increased levels of cortisol, classically secreted due to chronic stress, can negatively impact the sex hormones and impair your libido.
+ Will my weight change from bioidentical hormone therapy?
Hormones are like stop-lights. When they are balanced the light is green and you will get the optimum results from your nutrition and fitness programs. When they are imbalanced the light is red making it, in many cases, difficult to lose and easy to gain weight.
Hormones are chemical messengers that cause the body to make changes affecting weight gain or weight loss. Changes in hormone levels are also dependent on the lifestyle we lead and can affect our mood, metabolism, and energy levels.
For example, when males become less active there is often a gradual decline in testosterone. This hormone is known to boost metabolism and has the benefit of helping lower fat levels. Thus, when testosterone is balanced a man's ideal weight is easier to achieve.
+ What is a compounding pharmacy?
A compounding pharmacy is a specialized pharmacy that creates tailor-made bioidentical hormones prescriptions. The quality of the ingredients, the expertise of the pharmacist and the quality of customer service are all critical decisions when determining the best pharmacy. Poor quality prescriptions are not effective and may impact results; therefore the choice of pharmacy matters greatly. Your prescription will be sent to compounding pharmacies that are licensed.
+ Will you take over as my doctor?
No, you must maintain your current medical doctor.
+ Will this treatment interfere with my currently prescribed medications?
Typically, there answer is no because bioidentical hormones look exactly like your own hormones. The only time when medications will interfere with bioidentical hormones (and vice-versa) is when the medications or supplements you're taking contain hormones, like birth control and certain acne medications. In many cases, certain medications are no longer needed, once hormone levels are restored to a healthy balance. This generally happens because balancing hormones improves your overall health. It's important to talk with your doctor about what medications and supplements you're currently taking to know for sure if the interaction will have any adverse effects.
+ Do I need to take these hormones forever?
The length of necessity of hormone therapy varies from person to person. Hormone levels are affected by genetics, lifestyle habits and environmental factors. Some patient may be able to wean themselves off of hormones with consistent dedication to their treatment plan, which includes not only hormone therapy, but nutrition and fitness recommendations as well. Unfortunately, there is not one answer that will apply to all individuals. Treatment plans are specifically tailored to each individual and their needs.
+ What are the side effects associated with bioidentical hormones?
Bioidentical hormone therapy has a few potential side effects which are classically linked to dosage – as your hormone levels improve, your dosage may need to be changed. If you notice side effects, contact your physician. • Men and women have reported increased aggressiveness, acne or irritability during the initial phases of testosterone hormone therapy, but these issues are generally resolved with time. • Some women have reported breast tenderness, spotting, cramping and bloating. These symptoms may be experienced initially with estrogen hormone treatment, but are easily reversed with adjustments to the dose. • Occasionally, hormone therapy patients will complain of itching or redness with topical applications. Let Dr. Olson know so that she can change the formulation or site of application.
+ Do bioidentical hormones cause breast cancer?
No, bioidentical hormones do not cause cancer. This false impression began in 1991, when the very controversial Women’s Health Initiative (WHI) was halted due to increased incidence of chronic disease among subjects. This study used the synthetic hormone, Prempro, and subjects of the study were and average age of 63 years. Meta-analyses following this study, including some as recent as November 2011, have shown that most of the subjects had pre-existing conditions that lead to the development of disease during the study and that hormones actually reduce the risk of cancer and other chronic diseases in women.
In fact, more than 15 major medical organizations now endorse bioidentical hormone therapy as a safe and effective treatment plan for many adverse health conditions.
+ What is the best age to consider bioidentical hormone therapy?
The optimal age for treatment varies per person. Some people may be affected at a younger age than others by adverse health conditions that may impact hormone balance. However, on average, men and women may begin to experience age-related hormone imbalances around the age of 40. Symptoms of andropause, perimenopause and menopause, which classically occur around middle-age often prompt many individuals to seek treatment through hormone balance.
Many individuals may find it beneficial to have their hormones tested in their 20s or 30s to establish an optimal baseline. Once you have determined your baseline, you can take steps to ensure your hormones stay balanced and continue routine testing to monitor hormone levels. In the event of an imbalance at any point in your lifespan, your physician may refer to your baseline and develop a treatment plant to restore levels to that optimal baseline easily.
+ If I have a family history of cancer, should I avoid bioidential hormones?
No. It is advisable and strongly encouraged that individuals who have a history of cancer be evaluated by a BHRT doctor. Your physician can analyze and interpret your hormone levels to better determine cancer risk and strategically devise a plan to assist in disease prevention through bioidentical hormone therapy, nutrition and fitness. Retrospective studies from Europe actually show lower rates of all types of cancer in patients who used BHRT as opposed to those who used none or who used synthetic hormones.
+ How long after being cancer free can I use bioidentical hormones?
This question is best answered by the doctor you are seeking to work with. Each doctor has a preference when handling cancer patients, current or in remission. Cancer patients may use bioidentical hormones, however, the use of certain hormones will not be ideal for cancer patients; therefore the doctor needs to be made aware of your condition before you become a patient.
+ Is estrogen therapy linked to increased risk of heart attack and breast cancer?
No. Estrogen therapy does not increase risk of disease, including heart attack and breast cancer. This false impression began in 1991, when the very controversial Women’s Health Initiative (WHI) was halted due to increased incidence of chronic disease among subjects. This study used the synthetic hormone, Prempro, and subjects of the study were and average age of 63 years. Meta-analyses following this study, including some as recent as November 2011, have shown that most of the subjects had pre-existing conditions that lead to the development of disease during the study and that hormones actually reduce the risk of cancer and other chronic diseases in women.