Bioidentical Hormones FAQs

The National Institutes of Health (NIH) established the Women’s Health Initiative (WHI) in 1991 to address the most common causes of death, disability, and impaired quality of life in postmenopausal women. The WHI defined the risks and benefits of using synthetic hormone therapy to potentially prevent heart disease, stroke, breast and colorectal cancer, and osteoporosis in postmenopausal women. To read more about this study and for a list of additional studies completed regarding the use of synthetic hormones, click here. These studies showed that the risk of synthetic hormone replacement therapies far outweighed the benefits.

It’s important to note that the women in this study were all post-menopausal, with an average age of 68. This is significant because most of these women had 15 years since losing their hormones to develop diseases that bioidentical hormones might have prevented.

Safety concerns began to arise as women were prescribed bioidentical hormones and told that they were much safer. Fortunately, more and more research is substantiating that bioidentical hormones are safe and can also provide health benefits.

The ingredients in bioidentical hormones such as estrogen, progesterone, and testosterone are FDA-approved. However, state and local pharmacy boards have jurisdiction over them, not the FDA. It is important to use a high-quality compounding pharmacy that follows stringent guidelines, and also to have excellent quality assurance.

You have probably used some hormones. Birth Control Pills, Hydrocortisone (used for rashes), and Vitamin D in milk are all forms of hormones. Over the last 100 years, as we have doubled our life expectancy, the soft tissue glands which create our hormones are being forced to produce them longer than ever. Our increasingly stressful lives, poor nutrition, and lack of proper fitness result in declining levels of hormones in our bodies as well.

Men and women have successfully used bioidentical hormones for decades. Women suffering from menopause or perimenopause can turn to bioidentical hormones to replace the natural hormones that have declined as their bodies have aged. In well-known medical journals, researchers have reported that the bioidentical hormones estrogen and testosterone are not only safe but also have a preventative effect on diseases like osteoporosis and prostate cancer.

If your female hormones (estrogen, progesterone, and testosterone) are unbalanced, you may suffer ill effects such as hot flashes, night sweats, trouble sleeping, mood swings, depression, anxiety, memory loss, vaginal dryness, fatigue, loss of your sex drive and even weight gain. Women with balanced hormones integrated with proper nutrition and fitness can have a better quality of life as they age.

We design individualized programs specifically for each woman suffering from symptoms of menopause, perimenopause, low thyroid, and other hormone issues.

Sometimes, yes! Women at any age can experience hormonal imbalances. If you suffer from abnormal PMS symptoms or if you have PCOS (polycystic ovary syndrome), we can help you. Women of all ages can experience thyroid issues (which can cause infertility), and our providers can help. We run a full thyroid panel to include TSH, T3, T4, Reverse T3, and antibodies in order to properly diagnose and treat you. Many providers only check the TSH level and possibly T4. Unfortunately, this system is antiquated and doesn’t identify all potential diseases of the thyroid. Our lab panel also includes the testing of all other hormones as well. 

In general, your body’s hormones begin to decline in your thirties. Here at Dr. Leigh Ann Scott MD, we believe that most people should have their hormones checked by age 40 or earlier if they are experiencing symptoms of perimenopause or andropause.

The way to prevent chronic illness and optimize health is to take an active role in addressing healthcare risks before they become a problem. Getting tested when you still feel good gives you a benchmark for later comparison when the inevitable happens, and hormones decline.

Because bioidentical hormones have the same molecular structure as the hormones made naturally by your body, there are relatively few side effects. Side effects occur mainly when the dosage of hormones is too high for the individual. Both Dr. Scott and Nurse Practitioner Elise monitor and evaluate each patient consistently to assure balanced and proper dosing.

No, not in most cases. We will always consider your individual medical history before prescribing hormones. Not all estrogens are created equal. Fears of increased risks of heart disease and breast cancer with estrogen therapy have mainly come from the WHI study that was stopped prematurely in the summer of 1992 because of an increased risk of breast cancer and heart disease that was seen in women taking Prempro. This study actually highlights the risks of estrogen therapy with non-bioidentical (synthetic) hormones, which is NOT the type prescribed by our office. This study also highlighted the risks of synthetic progestins.

Hormones that are non-bioidentical use a one-size-fits-all approach to hormone therapy with hormones that are foreign to the human body. We cannot generalize these study results to all estrogens. Conversely, bioidentical hormones, which are the same as what is in your body naturally, have been proven to be safe.

We use only bioidentical hormones at Dr. Scott’s office, and the two main estrogens that we replace are E2 – Estradiol, and E3 – Estriol. As far as heart disease, bioidentical hormone therapy has never been shown to increase the risk of heart disease. In fact, hormone replacement with bioidentical hormones has been shown to decrease the risk of heart disease and other conditions such as osteoporosis.

When an educated provider prescribes Bioidentical Hormones in the proper manner, there are no increased risks of the occurrence of breast cancer or heart disease.

While it varies with each person and depends on which hormone therapy you are using, you can expect to see results pretty quickly, but it may take three to six months to experience full benefits. Your body needs this amount of time to allow for the proper balancing of your hormones.

Not necessarily. It depends on how well your body responds to the hormones. What’s also equally important is how well you manage your diet, sleep patterns, exercise, and stress levels.  

Some patients can wean off various hormones once they become balanced and have fewer symptoms of menopause or andropause. There are also patients who can wean off adrenal and thyroid support once their adrenals or thyroid glands have healed. There is no single answer for everyone; it depends on your individual hormone stability and how well your diet and lifestyle will support everything else.

In the worst-case scenario, if you decided to stop Bioidentical Hormone therapy, your body would likely return to the state it was in before initiating your program.

There are several ways to formulate bioidentical hormones, including:

• Capsules - a standard form of oral delivery. 
• Creams - transdermal methods are widely used to allow the absorption of medicine directly through the skin.
• Triturates - a popular form used to keep drugs in the mouth. They are generally placed under the tongue and allowed to dissolve, allowing the medication to enter the bloodstream quickly and easily. 
• Troches - larger than triturates and typically dissolve between the cheek and gum. 
• Rapid Dissolve Tablets - RDTs are the newest technology in dissolvable tablets. They are larger in size, which allows them to hold a larger amount of the active ingredient. They are made to dissolve on the tongue within 30 seconds. 

All delivery systems come in various combinations to accommodate even our most sensitive patients. 

Generally, no! Some medicines may actually be reduced or no longer needed.

Yes, birth control pills are a type of hormone therapy but they differ from bioidentical hormone replacement therapy. Birth control pill hormones are synthetic. Synthetic hormones have differences in their chemical structure that are not a replica of the body’s natural hormones. We do not advocate the use of synthetic hormones in our practice.

Traditional/conventional doctors do not usually have the time or the resources to seek expertise in bioidentical hormones. Many of them have antiquated opinions about hormones based on the WHI (Women's Health Initiative) study on synthetic hormones and have not stayed up to date on the studies of bioidentical hormones. Both Dr. Scott and N.P. Elise Lewis have gone through extensive training in bioidentical hormone therapy and have specialized knowledge and interest in this area.

Yes. Bioidentical hormones are compounded prescription drugs that are produced in a specialized pharmacy. Each prescription is handmade 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.

High stress levels are very common in individuals with unbalanced hormones. Regulating hormones with bioidentical hormone therapy will certainly help to decrease stress levels and increase general feelings of well-being. Changing diet, sleep habits, and exercise can also help ease stress. 

Yes. A deficiency of testosterone, estrogen, or other types of hormonal imbalance can cause low libido.

Absolutely. If you are putting weight on easily and having a hard time taking it off, you should know that hormonal imbalances affect weight loss and weight gain and could be part of the problem or maybe even the whole problem. In fact, some hormonal imbalances can make it downright impossible to lose weight!

What many people don’t realize is that there can be many underlying health issues that impede weight loss attempts. Not only that, but these same issues can actually cause weight gain in the first place.

Hormone and other imbalances can likely be the reason. We frequently get phone calls from patients who are desperate for help because the pounds keep packing on no matter what they do. Unfortunately, many of them have sought help from their doctor, only to be told that they just need to eat less and exercise more, period. This leads to not only feelings of shame but also helplessness and can be quite demoralizing.

• Insulin Resistance
• Thyroid Imbalance
• Cortisol/Melatonin Imbalances
• Testosterone Imbalance
• Estrogen Imbalance

In addition to circumstances where hormones affect weight loss, there are other factors that can impede weight loss, such as Candida (an overgrowth of yeast in the gut) and sleep deprivation.

You may bring along any lab work, bone density, mammograms, PAP smears, or other diagnostic tests you have done in the past year. We do not need the actual x-rays or ultrasounds, only the report. However, you will need to do a complete female or male hormone panel, which includes a blood draw. This comprehensive test panel will tell us exactly where your hormone levels are today and assist us in starting you on your way to better health and hormonal balance.

Please understand that coming to our office for care is a different experience compared to other doctor's visits. The appointments are long, and you are going to have the undivided attention of our providers for anywhere from one to two hours. Because of this, we are an out-of-network provider. If you have a PPO type of plan, it is possible that you could get reimbursed for the costs of your appointments or at least have the cost go towards your deductible. It really depends on the type of insurance plan that you have. Our office does not file with your insurance directly. Instead, we provide you with the necessary paperwork so that you can file it with them directly for any potential reimbursement. 

Depending on individual insurance carriers, we can accommodate most patients, and labs will be covered by insurance. However, this is the patient’s responsibility to insure coverage with their individual plans. If a patient pays out of pocket for labs or does not have insurance coverage, the lab costs are around $600 for the initial visit and $300 for follow-ups.

If we find that vitamins and supplements could improve your overall health and hormonal balance, we will prescribe them to you. An example of this would be Vitamin D3. This is actually considered a precursor hormone, and optimal amounts are needed for most physiological processes in the body and greatly improve your immune system. Dr. Scott and N.P. Elise only recommend pharmaceutical grade vitamins and supplements for maximum absorbency. 

• Bioidentical hormone replacement therapy for women and men. BHRT includes an assessment of all hormone functions in the body and not just the sex hormones.
• Thyroid diagnosis and treatment. We run a complete thyroid lab panel to include TSH, T3, T4, Reverse T3, and antibodies. Conditions that we treat include Hypothyroidism and Hashimoto’s Disease.
• Other comprehensive serum lab testing to screen for adrenal fatigue, insulin resistance, blood sugar issues, liver and kidney function, inflammation and other health markers, advanced lipid testing, and key vitamin levels.
• Food sensitivity testing which will indicate allergies and sensitivities to specific foods that may cause you to be ill.
• Gut health testing which will reveal the state of health of the gut biome and test for vitamin and mineral deficiencies.
• Nutritional counseling.
• Weight loss management when appropriate.
• Disease prevention.
• Anti-aging protocols.

At our Las Colinas practice, we use a functional medicine approach to treating our patients. We believe in the power of the human body, and because of this, we also believe that there is a big difference between going through life not feeling good versus living your ideal life. Our mission is to be proactive and assist both women and men to improve their quality of life through an individualized health and wellness plan — through hormone balance, nutrition and supplement support, gut health testing and treatment, and weight management.

In a functional medicine approach, we explore and address all possible underlying issues. When the root cause is correctly diagnosed and treated, all the symptoms associated with it will disappear.

Additionally, some people have multiple health issues going on, and they may be seeing different physicians or specialists. Sometimes this is necessary, however, it can happen that the left hand may not know what the right hand is doing. Not only can this be detrimental to your health, but it can also make things worse. A functional medicine provider is going to look at the big picture and help to fit all the pieces of the puzzle together.