Bioidentical Hormone Replacement Therapy

Bioidentical hormones are plant-derived hormones that are chemically identical to those the human body produces. Unlike synthetic hormones used in traditional hormone therapy, bioidentical hormones match the molecular structure of your natural hormones. This includes estrogen, progesterone, and sometimes testosterone.

Hormonal imbalances can show up in subtle—and not-so-subtle—ways. You may not realize your symptoms are hormone-related until you look at the full picture.

• Common signs of hormonal imbalance include:
• Hot flashes or night sweats
• Mood changes: irritability, anxiety, or depression
• Dry, itchy skin
• Sleep disturbances or insomnia
• Vaginal dryness or recurring urinary tract infections
• Low libido or changes in sexual function
• Fatigue or low energy
• Brain fog or difficulty concentrating
• Unexplained weight gain or weight changes

At SPOKEmed, we take your symptoms seriously. During your consultation, we’ll review your health history, assess patterns, and—if appropriate—order testing to determine if bioidentical hormone replacement therapy (BHRT) may help restore balance.

While compounded bioidentical menopausal hormone therapy is often marketed as superior, the safety of compounded bioidentical hormones has not been as thoroughly studied as FDA-approved options. We primarily recommend FDA-approved bioidentical hormone therapies that provide the benefits of bioidentical hormones with the safety assurance of regulatory oversight.

While compounded bioidentical menopausal hormone therapy is often marketed as superior, the safety of compounded bioidentical hormones has not been as thoroughly studied as FDA-approved options. We primarily recommend FDA-approved bioidentical hormone therapies that provide the benefits of bioidentical hormones with the safety assurance of regulatory oversight.

Many women notice improvement in symptoms like hot flashes and night sweats within 2-3 weeks of starting therapy. Other benefits, such as improved sleep and mood, may follow shortly after. Some effects, like changes to skin texture and bone density, develop more gradually over months of treatment.

FDA-approved bioidentical hormones undergo rigorous testing for safety, efficacy, and consistent dosing. Compounded bioidentical hormone therapy is custom-made by specialty pharmacies and hasn't undergone the same level of testing. While compounded preparations offer customization, they may lack consistency in quality and potency.

No, we do not use pellet therapy at SPOKEmed. While some providers offer hormone pellets as a delivery method, we have concerns about:

• The inability to adjust hormone dosing once the pellet is inserted
• Inconsistent hormone levels over time
• The inability to remove the pellet if side effects occur

Because hormone balance is complex—especially when multiple hormones are involved—we prioritize delivery methods that allow precise, flexible dosing and easy adjustments to ensure your safety and optimal results.

• The U.S. FDA has approved several bioidentical hormone therapy products for treating menopausal symptoms. These products have undergone rigorous clinical trials confirming their safety and effectiveness.
• However, the FDA has expressed concerns about custom-compounded bioidentical hormones, as these preparations have not undergone the same level of testing or regulation.
• Despite marketing claims that bioidentical hormones are more effective than synthetic hormones, the National Academies of Sciences states that all hormones—bioidentical or conventional—carry similar benefits and risks.
• When considering hormone therapy, it’s important to choose FDA-approved products whenever possible to ensure safety and quality.

While bioidentical hormones can effectively manage menopausal symptoms, it’s important to be aware that they may cause side effects similar to traditional hormone therapy:
Common side effects:

• Breast tenderness
• Spotting or irregular bleeding
• Headaches
• Mood changes

Rare but serious risks:

• Increased risk of certain hormone-sensitive cancers in women
• Blood clots
• Cardiovascular issues

Bioidentical hormones come in various delivery methods—such as creams, patches, and pills—each carrying its own side effect profile.

During your consultation, we will:

• Review your medical history
• Discuss how different hormone products affect your body
• Determine the safest and most effective estrogen replacement therapy plan tailored to your needs