Restoring Hormonal Balance Through Bioidentical Hormone Replacement Therapy

Restoring Hormonal Balance Through Bioidentical Hormone Replacement Therapy

Dr. Kim on

Our bodies’ hormones control most of our daily bodily functions. Serving as an internal communication system between cells throughout the body, they take part in everything from growth and digestion to mood and libido. It makes sense then, that when our hormones are imbalanced, we feel the negative effects on our health and well-being. For that reason many people seek hormone replacement therapies when unpleasant symptoms manifest. 

Unfortunately not all hormone replacement therapies reap the same risks and rewards. Read on to learn about the benefits of bioidentical hormone replacement therapy (BHRT) and how it could make a difference in your life.

How Does BHRT Differ From Traditional, Synthetic HRT?

Although Bioidentical Hormone Replacement Therapy (BHRT) treats low or imbalanced hormone levels in both men and women, it’s most commonly administered to ease symptoms prior and during menopause. BHRT is also heavily relied on to improve symptoms of cancer treatment and other conditions such as insulin resistance, adrenal and thyroid disorders, osteoporosis and fibromyalgia. 

Bioidentical hormones are different from synthetic hormones in that they are derived from plant estrogens that are chemically identical to those of the human body. The most commonly replicated hormones for treatment include estrogen, progesterone, testosterone and DHEA. Bioidentical hormones are diverse in that they can be given in the form of capsules, transdermal cream, lozenges, rapid dissolving tablets, injection, and pellets (inserted underneath the skin)

Traditionally, hormones for replacement therapy, such as Premarin are sourced from the urine of pregnant horses and other synthetic additives. Synthetic hormones do not share the same chemical structure as natural hormones and thus can give different messages to the receptors and are deemed to show less effectiveness. The extra additives in synthetic hormones are also linked to many side effects such as burning in the urinary tract, allergies, joint aches and pains. The side effects from synthetic additives in traditional hormone replacement therapy, such as equilin (horse estrogen), can remain in the body for 13 weeks due to poor metabolism of these additives. Side effects inflicted from natural hormones on the other hand, are experienced for a few hours thereafter.

The Benefits of BHRT

In cases of perimenopause or menopause, BHRT is administered to increase levels of hormones that have dropped and to improve symptoms including hot flashes, night sweats, mood swings, memory loss, weight gain, sleep issues and loss of interest or pain during sex. Additionally, BHRT may reduce risk for diabetes, tooth loss and cataracts. Studies have also shown that it can improve the thickness and elasticity of skin and aid with hydration and the reduction of wrinkles.

In the context of cancer treatment which drastically affects levels of estrogen, BHRT is effective in ameliorating the general well-being and quality of life. Patients with cancer who underwent BHRT have reported relief from treatment-induced symptoms such as migraines, insomnia, incontinence and decreased libido. 

The Risks and Side Effects Of BHRT

Research has shown that traditional hormone replacement therapy may increase the risk for certain conditions and diseases such as blood clots, stroke, gallbladder disease, heart disease and breast cancer. When compared to their synthetic and animal-derived counterparts, bioidentical hormones have been associated with lower risks of breast cancer and cardiovascular diseases. 

As with any medical treatment, mild side effects may also occur as the body adjusts to the BHRT. These can include acne, bloating, weight gain, fatigue, mood swings and increased facial hair in women. It is also important to note that some patients are not likely candidates for BHRT or any form of hormone replacement therapy. For this reason it is important to discuss the risks and potential for side effects with your doctor and pharmacist as they are most knowledgeable about your health history. The FDA also recommends that any form of hormone therapy should be taken at the lowest dose that produces effective results, for the shortest length of time possible.


As mentioned, the most commonly replicated hormones for hormone replacement treatment include estrogen, progesterone, testosterone and DHEA. Estrogen in particular has over 400 functional purposes within the body including the prevention of memory loss and consequent prevention of Alzheimer’s disease, body temperature regulation and improvement of insulin sensitivity, to name a few. Low levels of estrogen manifest in thinner, oily and aging skin, thinner vaginal tissue, acne, decreased sex drive and an increase in insulin resistance and possible diabetes. High levels of estrogen may present as weight gain, water retention, headaches, poor sleep, panic attacks, hypothyroidism, depression with anxiety or agitation and  increased risk of auto-immune diseases and cancer of the uterus.

Before turning to hormonal replacement therapy, we can increase natural estrogen in the body by exercising moderately, incorporating flax and non-GMO soybean into our diets, eating a high protein diet, consuming omega-3 fatty acids along with vitamin B6, B12 and folate supplements, and lastly by getting our daily dose of indole-3 carbinol which can be found in broccoli, brussel sprouts, cabbage, cauliflower, horseradish, turnip, watercress, etc. 

One caveat to natural estrogen therapy is that the patient’s overall metabolic function needs to be sound – patients with increased adipose tissue especially around the mid-area tend to have higher side effects such as additional hot flashes or night sweats until the body gets adjusted to the dosing.  Adipose tissue tends to produce additional estrogen hormones like “Estrone” to increase estrogen activity in the body.  These patients are not a perfect candidate for BHRT until one’s metabolic/detoxification pathway is controlled.  This is many reasons why skilled hormone therapy specialists need to consult a patient to direct which path would be suited for a patient. 


BHRT can also regulate progesterone which is produced by the ovaries in pre-menopausal women. Women who have low progesterone levels following menopause demonstrate symptoms of anxiety, depression, irritability, mood swings, insomnia and osteoporosis. A study by Women’s Health Initiative (WIH) on the use of synthetic progesterone, known as progestin was terminated due to demonstrated increased risk of breast cancer for those taking these synthetic hormones. Synthetic progesterone also carries several side effects not apparent with natural progesterone. Some of these include breast tenderness, arterial disease, depression, nausea, insomnia, hair loss, increased appetite, rash, headache, rapid heart rate, etc. Additionally, progestin tends to stay in the body longer compared to natural progesterone- Natural progesterone on the other hand has been shown to leave the body quicker, help balance estrogen, aid sleep, lower blood pressure and cholesterol, help the body use and eliminate dats, act as a natural diuretic/antidepressant and may help in protecting against breast cancer. 

It is important to keep in mind that too much progesterone, whether synthetic or natural, can have negative consequences for our health. An excess of progesterone can lead to increased fat storage, insulin resistance and cortisol, decreased growth hormone and glucose tolerance as well as suppressed system functioning. 


While widely known as a male hormone, testosterone functions as an androgen by which the adrenal glands and ovaries are responsible for producing. Testosterone has many functions including increased sexual interest, increased self-confidence or motivation, increased muscle mass and strength, decreased body fat, maintenance of memory and maintenance of bone strength. As a woman ages, less testosterone is produced by her ovaries. When given with estradiol, a metabolized form of estrogen, testosterone can decrease cardiac risk in patients receiving combination therapy. Synthetic testosterone should never be used because it is shown to be carcinogenic to the liver. Natural testosterone replacement is effective in topical cream, gel, or oral mucosal tablets like a lozenge or a rapid dissolving tablets form. 

The following are symptoms of testosterone loss: muscle wasting, weight gain and decline in muscle tone, decreased energy, low self-esteem, decreased HDL, decreased sex drive, dry thin skin and anxiety. Symptoms of testosterone gain are as follows: anxiety, depression, changes in memory, decreased energy, hypoglycemia, decreased HDL, irregular periods, infertility, weight gain, fluid retention, mood swings and hair loss.


DHEA (dehydroepiandrosterone) is another sex hormone primarily made by the adrenal glands that declines with age. It is responsible for producing the other sex hormones in the body includng estrogen, progesterone and testosterone. Some other functions of DHEA are decreased cholesterol, formation of fatty deposits and allergic reactions, increased brain function, stress management and immune system support, prevention of blood clots and promotion of weight loss. DHEA has also been shown to have a protective effect against cancer, diabetes, obesity, heart disease and autoimmune diseases. Women are generally more sensitive to the effects of DHEA and require less than men.  

How Do I Measure My Hormone Levels? 

Clinical symptoms from hormones deficiencies or imbalances in the body can be measured by testing the blood, urine and saliva. Results from these tests provide a rational basis for treatment and can assist in monitoring the progression of hormone levels during treatment. In terms of which test is superior is based on what a clinician is trying to look for and must be determined by the clinician.

When the blood is tested for hormone levels, the amount of free and bound hormones can be observed in the blood. In certain instances, blood testing can lead to misinterpretations when there are low levels of free hormones as it leads to the assumption that the patient is not receiving an adequate amount of hormones. As a result some patients might receive an excess of hormones and experience associated side effects. 

Urinary testing is used even less frequently because it requires a 24 hour urine sample to be obtained to correctly measure the hormone levels in the body. This inconvenience for the patient is partnered with an issue of test reliability; the results derived from the test are a cumulative amount of hormones collected throughout the day. Urinary testing does not take into consideration that hormone levels can fluctuate throughout the day which can be significant in some cases. However, when checking for hormone metabolites, urinary testing is ideal for this reason. 

Among the three tests, saliva testing is the most efficient method and also measures the amount of free hormones circulating in the body. Saliva tests are proven to be accurate and can provide a detailed report of fluctuation in hormone levels throughout the day. As well, they are affordable and convenient because you can take your own saliva samples in the privacy of your home. 

Is BHRT Appropriate For Me?

Your practitioner will most likely prescribe nutritional and lifestyle changes, herbs and supplements to restore hormone balance; these are easily accessible at Robinson Rx. In resistant cases, where these interventions do not resolve your health concerns, BHRT can be a beneficial treatment addition. 


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