Hormone Replacement Therapy (HRT) Treatment and Medication Details

Bioidentical Hormone Replacement Therapy (BHRT) supplements your bodies natural hormones with bioidentical hormones derived from plants. BHRT is often used to treat pre and post menopausal symptoms, however it has applications beyond menopause. Forms of BHRT exist for both women and men. The specific types of hormone, dosage, and delivery method is something you will work closely on with your doctor. Testing is typically required to establish current hormone levels prior to beginning treatment.

Bioidentical Hormones

A bioidentical hormone is a chemical that is has the exact same chemical structure as the hormone produced by the human body. Most bioidentical medication is produced from Phytosteroids generated from plants. Phytosteriods are a naturally occurring chemical produced by plants that can be transformed into a chemical identical to a human hormone.

In a survey of 175+ women, 65% said that bioidentical hormones were more effective than synthetic (BHRT w/ P4 vs HRT with synthetic MPA)1

Estrogens and Progestogens

The two most common types of hormone used for supplementation are estrogens and progesterones. The female body produces these hormones naturally in varying levels through the menstrual cycle. The most abundant of these hormones are estrogen and progesterone. Mono-therapy with just estrogen can cause some unwanted side effects that are often negated when combine with progesterone. Your doctor will identify the correct ratio and ingredients.

Testosterone

Testosterone is primarily used when treating men, however it is sometimes used for Women in combination with estrogens and progestogens. As men age their testosterone levels decrease, sometimes prematurely. Supplementation with testosterone can help negate some of the side effects of aging such as bone density loss, sexual dysfunction, skin degradation.

Administration Methods

Studies looking at administration routes for HRT have shown that there are wide variations in efficacy2, 3. Common administration methods are:

Sublingual

Utilizing sublingual hormone therapy, the patient will place a specially manufactured tablet under the tongue and hold while it dissolves. The membranes under the tongue allow for rapid absorption of the drug without the potential damaging effects of stomach acid and liver. Crestview specializes in a proprietary type of sublingual administration that has shown to be more effective than certain other application methods such as topical therapy.

Studies have shown that sublingual administration outperforms topical creams by an average of 24% for vasomotor, mood, and quality of life improvement.4

Topical Cream

Topical creams are specially designed penetrating creams with a mixture of hormones. There is some debate about the efficacy of the topical cream method of administration. In certain cases such as testosterone it may be superior to the oral (not sublingual) as the liver can convert testosterone to estrogen. Hormone levels often need to be tested more often when using a topical cream as the specific dosage delivered to the body can be harder to regulate.

Oral Pill

Oral HRT involves a traditional pill. As the specific combination of hormones is balanced based on each patients needs, compounding is typically required.

Vaginal Insert

Vaginal administration is typically used when the goal is to treat localized problems in the genitals and urinary system. This method is not effective against osteoporosis or menopause related hot flashes.

  1. Ruiz et al.: The effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy in postmenopausal women: an observational cohort study. Int J Pharm Compd. 2014 Jan-Feb;18(1):70-7.
  2. The effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy in postmenopausal women: an observational cohort study. Link
  3. The effect of hormone replacement therapy and route of administration on selected cardiovascular risk factors in post-menopausal women. Link
  4. Holtorf K et al: THE BIOIDENTICAL HORMONE DEBATE: ARE BIOIDENTICAL HORMONES SAFER OR MORE EFFICACIOUS THAN COMMONLY USED SYNTHETIC VERSIONS IN HORMONE REPLACEMENT THERAPY. Postgrad Med, 121, 73-85, Jan 2009