Bioidentical Hormones

Bioidentical Hormone Therapy (BHT) for Men and Women

Hormones are molecules that are manufactured in the endocrine glands, which include the adrenal glands, ovaries, testes, and thyroid gland. They are released into the bloodstream and exert biochemical effects on receptor sites to regulate our body’s temperature, metabolism, reproduction, growth, aging and immune functions.

Unfortunately, as the body ages, the levels of hormones diminish. In addition, the specific hormone receptor sites in the cells tend to change with age and become less sensitive and more resistant to hormone stimulation. Additionally, present day environmental toxins, diet, stress and lifestyle can also lead to hormone depletion and insufficiency. This leads to the signs and symptoms both men and women experience with hormone imbalance.

  • 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, Cancer, Heart Disease, Osteoporosis)
  • PMS

Replenishment of hormones to optimal, physiological levels has been shown to alleviate these changes.

Bioidentical Hormones vs. Synthetic Hormones

Natural, biologically identical hormones are derived from plants, such as the wild yam or soybean plant, and are chemically and functionally identical to human hormones. Because of this, they produce the same physiologic responses and are processed by the body in the same way as endogenous hormones (those made by the body). Synthetic, or non-bioidentical hormones are those that are manufactured with a different chemical structure to those normally produced in the human body. As the body works to metabolize these foreign substances it can produce toxic by-products, which cause a wide array of side effects like bloating, mood swings, water retention, and more serious problems such as cancer and heart disease. Synthetic hormones have been shown to produce harm and side effects that are not seen with bioidentical hormones. Another issue with conventional hormone replacement therapy is that only standard doses are available. It’s a one-size-fits-all approach to prescribing.

At Dr. Scott’s, we use an individualized approach to hormone replacement therapy. We assess each patient’s individual hormonal status using their medical history, symptoms, and lab work. We then implement a protocol individually tailored for that particular person. Therapy is then carefully monitored, and if necessary, modified or titrated in accordance with clinical and laboratory results.

BHRT Supplementation at Dr. Scott’s Practice

Testosterone

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.   Cells that require Estrogen use Testosterone to manufacture Estrogen inside the cell by a chemical conversion that uses an enzyme called Aromatase. Testosterone is present and extremely important in both Women and Men, making adequate tissue levels very important for health in both sexes.

How it is supplemented

At Dr. Scott’s, we understand there are different hormone delivery systems. Testosterone can be delivered via injection, cream, gel or patch.

Patches or creams are a great way to start Testosterone supplementation. Creams offer the greatest flexibility for dosing. This is a great method of delivery for those just beginning Hormone Replacement Therapy.

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.

Testosterone injections are usually given every 7-10 days for men and 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 intra-muscularly, 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.

Estrogen

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. The vast majority of women we treat need only testosterone pellets (see above) as their body, like men’s, makes all the intracellular estrogen it needs from testosterone, thus avoiding the serious problems that can occur with high circulating estrogen levels in the blood. If estrogen supplementation is required, it can be done via capsule, cream, or pellet. Non bio-identical 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 bioidentical hormones.

Progesterone

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. 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 bioidentical Progesterone, compounded in a strength specifically for you. The delivery system is by capsule, troche, triturate, or rapidly dissolving tablet (RDT). 

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.   If you live out of state or town, we can arrange for your labs to be drawn at a location near you. As early as 2 days after your lab work, we can see you for your initial consultation. We will discuss your symptoms, history, lifestyle and goals and also review the results from your 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 days).   Follow-up: 5 weeks after your first insertion, (8 weeks for men), you will be asked to get another blood test and then come in to 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 blood test and symptoms. 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. In your first year of treatment, expect to have 3 or 4 insertions. Typically, men require insertion every 4 months and women require insertion every 3 months. You can stop BHT 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 Care Credit which does offer NO INTEREST payment plans to those who qualify.. We do not accept insurance. However, upon request, we will provide you with a form that gives you the proper codes to submit to your insurance company or HSA plan. Any insurance reimbursement will go directly to you. There is much variation in coverage for this treatment despite the fact that insurance companies should be clamoring to have you treated, if needed, as it reduces many chronic diseases that are expensive to control in other ways with prescription drugs. A solid case could be made that this treatment will reduce health care costs dramatically…

Female Cost of Treatment

One-time fee: The initial consultation fee is $295.00. Initial labs for hormone panel is $225.00.  Other labs may be recommended after  your initial consult. Follow up visits are approximately every 3 months for the 1st year.

The initial comprehensive blood panel is $225.00; repeated yearly.

The cost for the insertion procedure and pellets is $400.00. First insertion is $100 off!

For non-pellet patients, follow up labs thereafter are $125.00.

Insertions are typically 4 times a year… every 3 months.

Patients receive Vitamin B12 injections monthly, at no charge, as long as they are current on their T-pellets.

We do offer discounts for military, law enforcement, and fire fighters

Male Cost of Treatment

One-time fee: The initial consultation fee is $295.00. Initial labs for hormone panel is $225.00.  Other labs may be recommended after  your initial consult. Follow up visits are approximately every 3 months for the 1st year.

The initial comprehensive blood panel is $175.00; repeated yearly.

The cost for the insertion procedure and pellets is $700.00First insertion is $100 off!

For non-pellet patients, follow up labs thereafter are $125.00.

First follow up labs are included in consultation price with pellet insertion. (If you are on Thyroid meds, small additional charge)   Thereafter, most labs range from $59-$100.00 depending on what is needed.

Insertions are typically 3 times a year… every 4 months.

Patients receive Vitamin B12 injections monthly, at no charge, as long as they are current on their T-pellets.

Testosterone Injections average $159-$179/month, depending on dosage and frequency.

We DO offer discounts for military, law enforcement and fire fighters.

For more information on Bio-Identical Hormone Therapy (BHT), or if you would like to schedule a consultation with Dr. Scott, please contact us today.

Financial Policy

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, and cash. We do not accept insurance. However, upon request, we will provide you with a form that gives you the proper codes to submit to your insurance company or HSA plan. Any insurance reimbursement will go directly to you. Note: Since we have formally opted out of Medicare, no insurance paperwork will be provided for reimbursement submission to Medicare.

Getting Started with BHT

For more information on Bio-Identical Hormone Therapy (BHT), or if you would like to schedule a consultation with Dr. Scott, please contact us today at (704) 494-9355 (WELL) or Contact Dr. Scott here..

For a Health Evaluation by a BHRT Physician

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