Bioidentical Hormone Replacement-The Basics

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Hormone imbalance is very common for both men and women of all ages. The imbalance we are most familiar with is the decrease in sex hormones that occurs with age, causing symptoms of menopause or andropause. Menopause is defined as the absence of periods for 12 consecutive months without any other obvious cause. Andropause in a man is a condition that is associated with a decrease in the male hormone testosterone. This is different from menopause in a woman, as the decrease in hormone levels and symptoms occur much more gradually. The average age of menopause in a woman is around 50, but remember--this is the time that your periods stop. Did you know that perimenopause, or the period of time leading up to menopause, may begin in your 30's? You may notice that you just don't sleep like you used to. You are waking up tired. You notice worsening of PMS with breast tenderness, bloating and irritability. These are all signs that you are entering perimenopause, which typically begins with a drop in progesterone. Restoring balance in all of these situations requires making the proper diagnosis and then using Bioidentical Hormone Replacement to replenish the body of what is needed to function optimally.

Click here to download the ADAM questionnaire to determine if you have symptoms consistent with andropause.
Click here to download the menopause rating scale to determine if you have symptoms caused by menopause or perimenopause


Why bioidentical hormones?

Since bioidentical hormones have the same chemical structure as the ones made naturally in your body, they are extremely safe when used properly. In fact, there is a significant body of evidence to suggest that bioidentical hormone replacement sustains a much healthier aging process than going without hormone replacement.  Additionally, we have found that these forms of hormones cause fewer side effects in both men and women and even appear to be associated with less risk of breast cancer in women, particularly testosterone pellet therapy.  Once bioidentical hormones are introduced, many unwanted symptoms begin to ease and you experience a greater sense of well-being.

we approach bioidentical hormone replacement differently

How? By taking a functional, whole-body approach. When you reach the period of perimenopause, menopause or andropause, just replacing the hormones will certainly make you feel better. But that's not the end of the story. When your therapy is initiated in the context of a functional medicine evaluation, your individual lifestyle factors are addressed, along with comprehensive evaluation of thyroid and adrenal function. Genetic differences are taken into consideration. Our goal is not just symptom relief. We want you to feel your absolute best by optimizing all of the factors that may affect how your body uses and metabolizes your hormone replacement.


While we commonly prescribe bioidentical estrogen, progesterone and testosterone in many forms, we have had amazing results with Testosterone Pellet Therapy.  Pellet therapy allows for a higher, longer term and consistent delivery of hormones and therefore more consistent relief of symptoms. This method of delivery eliminates fluctuations that can occur with other methods. The release of bioidentical hormones from pellets is cardiac driven, which means your body absorbs the pellets based on what it actually needs and this most closely mimics the body's way of naturally releasing hormones. The pellet is inserted in a small area between the hip and buttock through an incision so tiny it doesn't even require stitches. 

Benefits of testosterone therapy in men include:

  • Relief of andropause symptoms including improved sexual function
  • Maintenance of bone density
  • Possible cardiovascular benefits including improved outcome in diagnosed ischemia and improvement in congestive heart failure
  • Metabolic benefits (increased muscle and decreased fat)
  • Neuroprotection and improvement in certain domains of brain function
  • Improvement in functional capacity (strength and balance)
  • Maintenance of skin, soft tissue and hair

For women, the benefits of hormone replacement will depend on your choice of method. We recommend one of 2 possible options for hormone replacement.

 #1) Bioidentical testosterone pellets with or without an estrogen blocker (depending on your history). The benefits of testosterone pellet therapy include:

  • Relief of menopausal symptoms
  • Reduction of risk of breast cancer
  • Maintenance of bone density
  • Cardiovascular benefits including improvement in congestive heart failure
  • Metabolic benefits(increased muscle and decreased fat)
  • Improvement in functional capacity (strength and balance)
  • Maintenance of skin, soft tissue and hair
  • Neuroprotection

Click here for an article addressing common myths and misconceptions about testosterone therapy in women.

#2) The combination of bioidentical,  transdermal (think cream or patch) estrogen and oral or transdermal progesterone replacement (plus or minus testosterone). The benefits of estrogen plus progesterone replacement in these forms include: 

  • Relief of menopausal symptoms

  • Improvements in cognition/memory
  • Metabolic benefits (increased muscle and decreased fat)
  • Cardiovascular benefits 
  • Maintenance of bone density
  • Maintenance of skin, soft tissue and hair

A discussion on your personal risk and which method of replacement would be most beneficial for you should be an individualized discussion between you and your healthcare provider. It is important to have an updated well woman exam and mammogram before contemplating therapy or if you are a man an updated prostate cancer screening including a digital rectal exam and bloodwork

If you are interested in learning more about bioidentical hormone replacement therapy for relief of menopause or andropause symptoms, contact our office at 850.269.9000 to schedule your New Patient Consultation. Or visit our website at


Foundations Medical Center is a comprehensive medical practice providing anti-aging, functional medicine and preventive care. We offer bioidentical hormone replacement, testosterone pellet therapy, IV nutrition / IV drip therapy, infrared sauna, medical grade nutritional supplements and medical grade anti-aging skincare products.