BIO-IDENTICAL HORMONE THERAPY

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1 BIO-IDENTICAL HORMONE THERAPY What Is Bio-Identical Hormone Therapy (BHRT) Hormone levels decline as we age; Bio-Identical hormone Therapy replenishes the hormones that your body needs to function. A compounding pharmacy will use natural or Bio-Identical hormones versus bio-similar or synthetic hormones. Bio-Identical Hormones are molecule-bymolecule, exactly the same as the hormones (Estrogen, Testosterone, Progesterone, Cortisol, DHEA, Estradiol and Estriol) present in the human body. Bio-Identical Hormones are derived from naturally occurring sources, such as yams and soy, and are designed to replicate the same chemical structure as the hormones that are produced naturally by our bodies. Based on your hormone levels, a specialized compounding pharmacy can individually tailor a Bio-Identical Hormone regimen specifically designed for you. Who needs BHRT? Women suffering from early menopause symptoms looking to put an end to hot flashes, nightsweats, memory loss, mood swings, weight gain, and low libido. Our individualized programs are specifically created for each woman suffering from early menopause symptoms, menopause, peri-menopause, and severe PMS. Hormonal Balance There are many different factors that can disrupt optimal hormone balance, from growing older to increasing daily stress. The resulting imbalances can cause a variety of different symptoms many of which are confused of aging. This can have a very detrimental effect on your life. You may feel tired all the time or have difficulty sleeping. You may experience hot flashes or night sweats, or your libido or even digestion may suffer. There is not a lot you can do to prevent hormonal imbalances as you age, hour hormone levels will fluctuate and decline but you can restore proper hormones balances through natural BHRT. Once your hormones are in harmony again, those pesky symptoms will usually disappear. The Benefits of Balance When your hormones are properly balanced, you ll feel much better. You ll feel younger, more energized and more emotionally settled. Hormonal balance can have an effect on other efforts to improve your health, as well. When your hormones are optimally balanced, you ll see much greater benefits to eating right and exercising. Balancing your hormones is a crucial step to attaining optimal overall health. Hormones are the chemical messengers of your body, so when they re properly balanced and functioning all of your body systems work more smoothly. An Integrated Approach to Natural BHRT Our office will assess your individual needs and work to restore these hormones and customize a medical plan specifically for you. We will also discuss the importance of good nutrition, fitness and lifestyle choices in your journey to better health with natural hormones. Eating right and exercising are equally important aspects of BHRT. If your hormones are out of balance, your body will not respond optimally to improved nutrition and exercise. As your hormones, nutrition, fitness, and lifestyle improve you will begin to feel like your old self with improved energy, vitality and results.

2 FREQUENTLY ASKED QUESTIONS What to expect for my first hormone implant: Wear comfortable clothing. Getting your hormones is a quick and painless procedure. An area on the back of your hip is numbed, a small incision is made, and pellets are inserted into the subcutaneous tissue. Steri-strips and a gauze bandage are placed over the incision. Bruising and soreness lasting up to a week at the incision site is normal. Itching and redness at the incision site are also normal following implants. Apply hydrocortisone cream to affected area or take Benadryl by mouth. After your implant please avoid exercise/ heavy lifting/ straining for 5 day to 7 days. Please avoid baths, swimming pools, hot tubs (any submersion in water) for 5 days following your implant. When will I feel the hormones kick in: The answer to this question is different for everyone. Our physiology is unique from one another and we all have different hormonal needs. A patient who has had years of hormonal depletion has a greater demand for replenishment. He or She might feel something around the 3 rd or 4 th implant. Do not get discouraged if you don t feel like a different person after your first or second implant. We must first replace and restore what has been lost over the years. Some patients feel relief of some symptoms after the first implant; others notice reduction in symptoms after two to four implants. Don t worry; they will kick in. You might note on your calendar when you start feeling some relief. Do any medications interfere with hormones? Yes! (Selective serotonin reuptake inhibitors/ anti-depressants) and strong pain medications as well as strong sedatives can block the mood enhancing effects/ increase in well-being effects of testosterone. Goal to eventually discontinue anti-depressants. Check with your provider before discontinuing any medication. Anti-depressants, sedative and pain medications should be weaned off of slowly and gradually.

3 How often do I come in for hormones? On average, hormone replenishment is needed every 3 months. After the first hormone implant return in 3 to 4 weeks for labs. This will tell your provider how your body is absorbing the hormones and if any additional hormones are needed. (The nurse will call you with your lab results). Keep in mind that every 3 to 4 months is the optimal situation; some people may need implants more frequently. Blood work? How often? Getting my blood work results? Blood levels of hormones must be drawn prior to EVERY implant. We must know your levels before we give you hormones. Hormone replacement clients may have labs drawn outside BMG. Ask our nurse for a requisition form. If you choose to have your labs drawn outside BMG you will need to provide your personal insurance. Acne Due to skin type and testosterone s oil producing effects, some patients may or may not experience mild acne. Acne can be treated. If you experience acne please let your nurse know. A pimple or two is your body responding to the testosterone. After your body begins adjusting to the elevated levels it will clear up. Bleeding For women: women who receive estrogen may experience bleeding/spotting. This is normal and nothing to be worried about. Shedding of the endometrial wall is perfectly health but must be regulated with the hormone progesterone. Taking oral progesterone not only balances estrogen but controls bleeding. Skipping a dose of progesterone or not taking enough of it will cause bleeding. o If you are experiencing bleeding, double your dose of progesterone for one week and then return to your normal dose. Additional hormones/ medications (not included with your package). For Men & Women: If your thyroid is abnormal we can prescribe something. For men: It may be necessary for some men to take something for a short time to prevent testosterone from converting to estrogen; this will depend on your lab results.

4 For women: Women who get estrogen will need to take progesterone by mouth. Progesterone comes in a capsule form and sublingual (under the tongue dissolvable tablet) form. When will I start losing weight? The answer to this question is different for everyone. Hormone patients who incorporate a healthy lifestyle (diet and exercise), lose weight at a faster rate than those who don t. Take advantage of the high levels of testosterone circulating through your body. o Weight bearing exercises will help you build strong, toned, lean muscle mass. o Building lean muscle will burn fat, speed up your metabolism, and make you feel great. Scheduling appointments Scheduling an appointment is a two step process: o 1: Schedule an appointment to have your labs drawn o 2: Schedule an appointment for your implant o If your lab results indicate that you DO NOT need additional hormones. Please check your voice mail for this reason. If you do not get a call indicating that you DO NOT need additional hormones simply show up for your implant appointment.

5 Hormone/ Implant Symptoms Questionnaire SYMPTOMS N/A MILD MODERATE SEVERE Acne/ Oily Skin Anxiety Body/ Joint Pain Breast Tenderness Decreased Exercise Tolerance Depression Dry Skin Erectile Dysfunction Fatigue Hair Loss Hot Flashes Increased Facial/Body Hair Irritability Loss of Muscle Tone Low Sex Drive Memory Lapses Mood Swings Night Sweats Painful Intercourse/ Vaginal Dryness Palpitations Poor Focus Restless Legg Syndrome Sleep Disturbance/ Insomnia Vaginal Bleeding Weight Gain/ Water Retention Name: DOB: Date: Are you cycling: YES NO Date of last Menstrual cycle: Have you had a hysterectomy: YES NO Are you taking birth control YES NO Do you currently take thyroid medication: YES NO Please list name and dosage: Do you currently take hormone medication: YES NO please list name and dosage: If you have anything else you would like to add please do so below:

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