Frequently Asked Questions
1) What is the difference between synthetic and bioidentical hormones?
Bioidentical hormones are natural hormones that are chemically identical to the hormones that are produced by your own body. Synthetic hormones are chemically different from those made by the human body and these differences may account for the side effects that are experienced with the synthetic hormones.
2) Where do bioidentical hormones come from?
Bioidentical hormones are made from a substance called diosgenin which is extracted from Mexican wild yam, or from soybeans. Our bodies however cannot obtain the hormones directly from these sources. In the laboratory diosgenin is synthesized into the chemically identical equivalent of the hormone (for eg. progesterone) produced in the body.
3) What are the common examples of bioidentical hormones?
Progesterone, estrogen, testosterone, DHEA, melatonin and pregnenolone.
4) How would I know if I need bioidentical hormone supplementation therapy?
Bioidentical hormone supplementation may be required if you have a hormone imbalance. To assess any hormone excesses or deficiencies, we suggest that you initially answer the hormone imbalances questionnaire. Once you have done this you may like to consider having your hormone levels tested or you may like to visit a practitioner that specializes in bioidentical hormone supplementation.
5) What is the difference between saliva and blood testing?
Saliva testing is the most reliable way to measure free bioavailable hormone activity; those hormones actually doing their job at the cellular level. In contrast, standard blood testing measures total hormone levels in the body. The issue is that this test does not decipher between active (bioavailable/free) or inactive (bound) hormones.
6) My laboratory blood levels fall within the normal range, do I still need hormones?
Your blood level may be within the ‘normal’ reference range, however this does not necessarily mean that this level is optimal for you. If you are experiencing hormone deficiency symptoms, we suggest enquiring with your doctor whether your hormone levels are in the optimal area (usually upper half) of the reference range.
7) How can I get bioidentical hormones?
Bioidentical hormones can only be obtained from a compounding pharmacy with a prescription from your doctor. For contact details of compounding pharmacies see the useful links under the educational resources section of our website.
8) What is a compounding pharmacy?
A compounding pharmacy is a pharmacy that can legally make medications to suit your individual needs in a safe and correct way. This means that they can make the medication into a form (eg. capsules, cream, suppository) that is right for you.
9) What dosage forms of bioidentical hormones are available?
Compounding pharmacies can make bioidentical hormones in the form of capsules, cream, oil, gel, liquids, troches (oral lozenge), suppositories (for rectal or vaginal application) and pessaries (for vaginal application). Dosing is patient specific, so each dose can be compounded according to the patient’s needs, where as in a synthetic hormone, one dose and one form fits all.
10) How soon do bioidentical hormones work?
Provided that appropriate prior testing and consultations have been done to ascertain the hormone deficiency, once a bioidentical hormone supplement is used a difference may be noticed within a week or two. Menstrual irregularities (heaviness and/or length of cycle) may take a couple of months to balance. In addition, keep in mind that each person’s response and absorption is different. Therefore bioidentical hormone use should be monitored to ensure optimal levels as well as clinical results are achieved and maintained.
11) How can I know if I am receiving the adequate amounts of hormone supplementation?
Symptom relief is one of the main indicators for ascertaining correct supplementation doses. However, follow up testing is recommended to ensure that levels do not go under or above minimum and maximum requirements. Dosage adjustments can be tailored according to both symptoms and test results.
12) What sort of side effects should I expect?
If the dose of bioidentical hormone is optimal no side effects should be experienced. However, because hormones work in a ‘symphony’, side-effects may occur if one hormone is out of balance with another one. For eg. If testosterone is used and an increase in facial hair growth is experienced, it may not be due to excess testosterone use but a deficiency in estrogen.
13) Can hormone replacement benefit men?
Yes, many hormones can be beneficial for men such as testosterone, DHEA, and melatonin. Some of the symptoms that can be relieved by the use of bioidentical hormones are:
- Erectile dysfunction
- Reduced sex drive
- Disturbed sleep
- Muscle weakness
- Poor concentration and memory lapses.
14) If I had a hysterectomy, do I still need hormones (other than Estrogen)?
Hormonal (for eg Progesterone) receptors are found in many areas in your body other than the uterus, such as breasts and bones, so it doesn’t matter if your uterus is removed, your body still needs hormones to function properly.
15) How do I get off synthetic hormones and into bioidentical hormones?
Under your doctor’s supervision, you can start by lowering the dose of synthetic hormones, then in time start adding the new dose of bioidentical hormones.
16) Are there any books that I can read to learn more about bioidentical hormones?
Dr John Lee’s books such as:
- “What your doctor may not tell you about menopause”
- “What your doctor may not tell you about premenopause”
- “What your doctor may not tell you about breast cancer”.