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Bioidentical Hormones Replacement Therapy

BHRT

Pencol Compounding Pharmacy has been compounding bio-identical hormones for over 20 years. We have thousands of patients using BHRT, whose uncomfortable symptoms of hormone imbalance have been alleviated while avoiding the potential long-term risks that come with synthetic hormone replacement.

BHRT, used most often in the treatment of symptoms of menopause, can be used in any combination of bio-identical progesterone, estrogen and testosterone, at levels specific to each patient as determined by the physician. BHRT offers the physician an option to individualize hormone replacement based on the patient’s symptoms and unique hormone profile.

Synthetic Hormones

Synthetic hormones are either synthetically created or chemically modified animal hormones. Synthetic hormones are estrogen copies of estradiol used in combination with synthetic progestin. The synthetic agents (Prempro, Estratest, Provera, Premarin – to name a few) are molecular cousins of the natural agents – estrogen, progesterone and testosterone. They are neither structurally identical nor identical in activity to the natural hormones they attempt to emulate.

Bio-identical Hormones

Hormones used in BHRT are plant-based hormones that are extracted from soybean and wild yams. They are molecularly (biochemically) identical to true major ovarian steroid hormones – progesterone, estradiol and testosterone. They are distinguishable from those the human body produces, identical in structure and function and readily accepted by the human body.

Pencol pharmacists compound customized BHRT prescriptions for progesterone, testosterone and the three human estrogens – estrone (E1), estradiol (E2) and estriol (E3). At Pencol, we use only FDA approved USP chemicals from reputable laboratories in our compounding process.

BHRT is generally administrated in the form of a troche (lozenge) or as a transdermal (tropical) cream. The pleasantly flavored troche is dissolved and the ingredients easily pass through the membrane of the mouth directly into the bloodstream in a way that emulates the glands as closely as possible. When appropriate, transdermal cream is used as it also avoids the digestive tract and liver.

The effectiveness of BHRT is evaluated by the physician by monitoring symptoms and physical findings such as blood or saliva level testing of hormone levels, cholesterol levels, bone density, breast – mammograms and measuring the uterine lining.

Goals of BHRT

Alleviate symptoms of menopause
Using only hormones that match the exact molecules made by the human endocrine system
Introduce hormones into the bloodstream closely emulating glandular delivery
Avoid the digestive tract and liver minimizing the first-pass effects and SHGB elevation
Produce fewer side effects than synthetic hormones
Slowly decrease the level of hormones over time as symptoms are controlled
Discontinue use of hormones when possible

Benefits of BHRT

Synthetic derivation – side effect reduction or complete resolution:

Examples; bloating, breast tenderness and irregular bleeding
Side-effects are most often dose related and corrected with proper dosing
Dosages are adjustable and individualized for patient’s needs and goals
A broader spectrum of hormones, at lower doses, providing a more complete physiological balance

Prescribing BHRT

A combination of one or more of the estrogens – estrone (E1), estradiol (E2) and estriol (E3) is often used in BHRT protocols. Frequently recommended combinations are referred to as ‘Biest’ (estriol & estradiol) – or – ‘Triest’ (estriol, estradiol & estrone). Delivery methods are either topical or sublingual to prevent SHBG elevation.