Bioidentical Hormone Replacement Therapy for Women

Bioidentical hormones are derived from plant sources and are structurally identical to hormones the body produces, unlike chemically altered synthetic hormones.

Dosing is individualized to your measured levels and what you are experiencing, and it is reviewed against follow-up lab work rather than set once and left. Hormone therapy has risks as well as potential benefits, and which apply to you depends on your history — including cardiovascular history, breast and gynecologic history, and the medications you already take. A provider goes through those with you before anything is started.

Hormone levels shift substantially during perimenopause and after menopause, and the effects are rarely limited to one part of life. Thyroid function, sleep, iron status, mood, and medication all overlap with the same picture, which is why an evaluation is what distinguishes them rather than a symptom checklist.

Women commonly raise the following. Each is a reason to be evaluated; none is by itself a diagnosis:

• Hot flashes and night sweats
• Disrupted sleep
• Changes in mood, anxiety, or irritability
• Difficulty with focus or memory
• Vaginal dryness or discomfort
• Changes in sex drive
• Changes in body composition
• Questions about bone health

Hormone therapy is not suitable for everyone, and the balance of benefit and risk differs considerably between individuals — particularly by age, by time since menopause, and by personal and family medical history.

The evaluation covers your health history, a physical exam, and lab testing, and the results are reviewed with you before treatment is discussed. Whether to start, what to start, and how long to continue are shared decisions between you and your provider.

Perimenopause is the transitional period leading up to the final menstrual period, and it can last for years. Hormone levels fluctuate during it rather than declining smoothly, which is one reason a single blood test at one moment is a limited picture on its own.

Menopause is confirmed after twelve consecutive months without a period. Estrogen and progesterone levels are lower afterwards, and testosterone — which women produce too, in smaller amounts than men — also declines with age.

What those changes mean for you specifically, and whether treatment is worth considering, is determined during the evaluation.

Progesterone. In women who have a uterus and are taking estrogen, progesterone is prescribed alongside it for endometrial protection. Its role, the form used, and the schedule are all clinical decisions a provider explains at the time.

Testosterone. Women produce testosterone, and levels decline with age. Whether testosterone is measured, and whether any testosterone therapy is discussed, depends on your evaluation. Prescribing considerations here — including the regulatory status of testosterone products for women — are covered with you directly by your provider rather than summarized on a web page.