BHRT Pellet Oral Aftercare

Estrogen is secreted by your ovaries up until menopause when levels become undetectable. Estradiol is the most biologically active form of estrogen. It protects against cardiovascular disease, osteoporosis, and Alzheimer’s disease. In menopause, low levels lead to vaginal dryness, hot flashes, night sweats, fatigue and decreased libido, just to name a few symptoms. Estradiol replacement treats these symptoms, as well as improves mood and overall well-being.

POSSIBLE SIDE EFFECTS: Occasionally, estradiol can cause nipple sensitivity which may improve with a GLA supplement of 800mg per day. Estradiol may also lead to uterine spotting or bleeding. This is most common during the first year after starting BHRT. It may also occur if progesterone isn’t being taken regularly or there are missed doses. If vaginal bleeding does occur, contact your clinician and we will typically recommend doubling the progesterone dose for 7-10 days, followed by a return to your usual dosage.

Progesterone is secreted by the ovaries and protects against uterine and breast cancers, osteoporosis, heart disease, Alzheimer’s disease, and ovarian cysts. In menopause, low levels lead to insomnia and mood changes. Treatment with progesterone helps women sleep more soundly.

Synthetic progestins are chemically manipulated versions of progesterone and pose a cancer risk and can cause unwanted side effects such as bloating, headaches, fatigue and weight gain. To avoid these risks, we prescribe natural, “bioidentical” progesterone instead.

TREATMENT PREPARATION: Oral micronized progesterone is taken at nighttime, about 1-2 hours before bedtime.

POSSIBLE SIDE EFFECTS: Occasionally, daytime grogginess may occur, and please notify your clinician, who may recommend an alternate time of dosing.

In women, testosterone is a hormone secreted by the adrenal glands and ovaries. It contributes to strength, decreased fat mass, increased exercise tolerance and improved libido and sexual gratification. It improves lean muscle mass, bone density, mood, energy, and healing capacity. It also protects against cardiovascular disease, hypertension and possibly arthritis.

POSSIBLE SIDE EFFECTS: Some women experience transient water retention which can result in weight gain of 2-5 pounds, and/or swelling of the hands and feet. This usually resolves after 1-2 months of treatment, but if it persists, please contact your clinician for a possible diuretic. Testosterone may also stimulate hair growth on your face, chest or abdomen. If bothersome, please let your clinician know for a possible dosage change, or additional medication to reduce this side effect. Depending on your sensitivities to testosterone, pimples may also occur but is usually short-lived, and can improve with a good cleansing routine.

In men, testosterone is secreted by the adrenal glands and testes. It contributes to muscle mass, strength, endurance, decreased fat mass, and enhanced well-being. It protects against cardiovascular disease, hypertension and arthritis. Properly delivered, it can improve healing capacity, cholesterol, libido, and sexual performance. It arguably prolongs quality of life and “health-span” by decreasing diseases associated with aging.

POSSIBLE SIDE EFFECTS: Some men experience transient water retention which can result in weight gain of 2-5 pounds, and/or swelling of the hands and feet. This usually resolves after 1-2 months of treatment, but if it persists, please contact your clinician for a possible diuretic. Testosterone may also stimulate hair growth on your face, chest or abdomen. If bothersome, please let your clinician know for a possible dosage change, or additional medication to reduce this side effect. Depending on your sensitivities to testosterone, pimples may also occur but is usually short-lived, and can improve with a good cleansing routine. While rare, testosterone may increase assertiveness or aggression. It may also cause some breast tenderness or nipple sensitivity due to a small amount converting to estrogen. Please contact your clinician for possible dose adjustments if you experience any of these side effects.

DHEA is an oral supplement that may be recommended by your clinician. It serves as a complement to optimal testosterone replacement. It helps to shift the body toward an anabolic or muscle-building state, reduces cardio-metabolic risk by increasing the breakdown of fat, restores sexual vitality, and improves well-being and immune function. It is taken once orally in the morning.

Thyroid is the main metabolic hormone secreted by the thyroid gland. It regulates body temperature, metabolism, cerebral function and energy. Therapy is usually with bioidentical, dessicated porcine (pig) thyroid pills which have a combination of T3 and T4 hormones.

Thyroid medication should be taken first thing in the morning on an empty stomach with nothing to eat or drink but water for 30 minutes.

Melatonin controls sleep and circadian patterns. As we age, we tend to make less melatonin, thus impairing our ability to achieve a rejuvenating and restful night’s sleep. This can negatively impact our mood, energy, ability to concentrate, immunity and well-being. We recommend taking an individually dosed, sustained release melatonin capsule 1-2 hours before sleep, if needed. A shorter acting liposomal melatonin spray can also be used, if needed, for middle of the night awakening.