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Cleveland Clinic | Bioidentical Hormones

Bioidentical Hormones

Bioidentical Hormones
Bioidentical hormones are defined as man-made hormones that are very similar to the hormones produced by the human body.These are then used as treatment for men and women whose own hormones are low or out of balance.
What are bioidentical hormones?
Hormones are special chemicals made by parts of the body called glands. They are messengers that tell other parts of the body how and when to work. Hormones control almost all tasks in the body. These include sex and brain function, growth and the breakdown of food. When hormones are out of balance, symptoms can occur.

Bioidentical hormones are defined as man-made hormones that are very similar to the hormones produced by the human body. Common hormones that are matched are estrogen, progesterone and testosterone. These are then used as treatment for men and women whose own hormones are low or out of balance. Some prescription forms of bioidentical hormones are pre-made by a drug company. Other forms are custom-made by a pharmacist based on a doctor’s order. This is called compounding. The US Food and Drug Administration (FDA) has approved a number of preparations of bioidentical estradiol and progesterone, which are molecularly identical to the structure of the hormones generated by the human body. They have been through testing for safety and purity and to be sure each dose has the same amount of hormones. The compounded forms have not been tested and approved by the FDA. Though it is often advertised that products that are made from plants like soybeans and yams are “natural” choices, they are altered greatly in a lab so are no longer natural when done with processing. Both the FDA-approved and compounded hormones come in a variety of doses and routes of delivery (pills, creams, gels, sprays, and vaginal inserts).

Customized bioidentical hormones are often advertised as being a safer, more effective, natural, and an individualized alternative to conventional hormone therapy. However, these claims remain unsupported by any large-scale, well designed studies. Also, the lack of FDA oversight for compounded hormones generates additional risks regarding the purity and safety of custom compounded bioidentical hormones. Although custom hormone combinations often include blends of the same ingredients found in FDA-approved bioidentical hormones (i.e., plant-derived 17β-estradiol or micronized progesterone), some custom compounded preparations include additional hormone varieties (i.e., estriol, pregnenolone, and DHEA). These additional hormones have not undergone adequate testing and are therefore not included in any FDA-approved products.

Why are bioidentical hormones used?
As men and women age, the levels of some key hormones in the body go down. These include estrogen, progesterone and testosterone. This can lead to certain symptoms. Some are very common to women who are past the age of having periods (menopause). Some common effects of low hormones include:

Hot flashes
Night sweats
Vaginal dryness
Loss of interest in sex
Pain during sex
Problems sleeping
Loss of energy
Loss of muscle mass
Weight gain
Foggy thinking
Mood changes
Memory loss
The treatment is to replace the hormones that have been lost with the hormone therapy. As a result, hormone levels will increase and symptoms will improve. Currently, national societies and expert recommendations state that the risks and benefits of conventional and bioidentical hormones should be considered equal. Your doctor can discuss with you the variety of options available, and guide therapy based on your preferences.

How common are bioidentical hormones?
The use of the compounded type is very common in the U.S. in women in menopause. The North American Menopause Society (NAMS) reports that about 1.4 million women are using this treatment. NAMS notes that that is 40% of all prescriptions for hormone therapy in women who are in menopause. The number of men using this treatment is not noted.

How are bioidentical hormones given?
There are many ways to get bioidentical hormones. These include pills, patches, creams, gels, shots and implanted pellets. Your doctor will decide which method is best for you. You may try more than one way before you find one that works well for you.

How does my doctor select my dose?
People on hormone treatment are watched very closely by their doctors. Most often, doses are adjusted according to a patient’s symptoms and needs, with the goal of keeping the dose to the minimum required to achieve your goals. Depending on your doctor, you might have routine blood, urine or saliva tests to check your hormone levels. Your doctor may adjust your dose based on your changing hormone needs. It should be noted that the FDA recommends against using hormone levels to guide the dosing of hormone therapy in women, as normal levels fluctuate day to day, and vary between patients. In particular, salivary hormone levels are known to fluctuate widely, and have not been shown to be related to menopausal symptoms.

Are bioidentical hormones safe?
The bioidentical hormones that have been approved by the FDA have been tested for safety. They have passed the FDA’s very strict standards and have been shown to be safe for people to use. The compounded hormones have not gone through the FDA’s testing. As yet, little research has been done on them. They have not been proven to be safe or unsafe. Many major medical groups do not support using them because not enough is known about their safety and long-term side effects.

Are compounded bioidentical hormones bad?
There are risks to taking the compounded hormones. But in some cases, they might be the better choice. They might be needed to get the right source (gel, cream, pill, etc.), dose or mix of hormones for a patient. Also, a patient might have a bad reaction to the pre-made form. Your doctor will know which type is better for you.

What are the risks of bioidentical hormones?
It has been shown in research studies that there are risks for women who take hormones, called hormone therapy (HT). It can increase the risk of blood clots, stroke, and gallbladder disease. In women who are older, and who use hormone therapy for an extended period, the risk of heart disease and breast cancer may also increase. Many doctors who use bioidentical hormones claim they are safer than regular HRT. But there have been no large research studies of bioidentical hormones. It has not been shown that they really reduce the risk of these problems.

What are the side effects of bioidentical hormones?
When the FDA approves a drug, the drug company must report on any side effects they are told about, including prominently noting it in the paperwork when picked up at the pharmacy. Pharmacies that compound hormones do not have to report drug side effects to the FDA, or provide such paperwork. This contributes to the myth that compounded hormones are safer, when in fact doctors don’t know all of the possible side effects of these hormones.

Side effects can occur when a dose is first given. The body is not used to the new level of hormones. The dose may need to be changed. Some side effects can be linked to a certain hormone in the mixture. Many side effects get better as the body adjusts to the new level of hormones. Some common side effects include:

Weight gain
Blurred vision
Increased facial hair (women)
Breast tenderness
Mood swings
You may itch or get red around the area where you get a shot or where you apply your hormones if you use a patch, cream or gel.

Weight Loss and Nutrition


Symptoms of Aging in Men

in Men

Hormones in men are known to regulate the following

  • Sex Drive
  • Weight gain / Loss
  • Energy Levels
  • Metabolism
  •  Insulin
  • Memory
  • Mood
  • Hair Loss
  • Sleep Cycles
  • Erectile Dysfunction
  • Prostate Conditions

Hormone Levels Change With Age


Hormone levels decrease with age.  This is true regardless of whether we are looking at testosterone, estrogen, growth hormone, or DHEA.   To a large extent, this is true because of of major advances in prolonging life expectancy.  Some of the the effects of normal hormone levels in men include proper sex drive, increase in energy levels, maintenance of muscle mass, and fat burning. 

Testosterone, in particular will decrease after the age of 30.  The decline is slow but steady at a rate of about 1-2 percent per year.  By middle age, most ben will experience some of the effects of their decline in testosterone levels.  The effects are slow and subtle and might go unnoticed.  It is after all, the natural effect of aging, right?


Are you ready for Hormone Replacement Therapy?

Your Complimentary Consultation
Getting to know you

Your experience will begin with your consultation.  We want to hear about your previous health experiences, your diet, nutrition, and exercise history as well as your thoughts on living a healthier and longer.  Getting to know you is the most helpful way to create a treatment plan for you.

Law Work + Review of Results
Know the problem to identify the solution

Your body will often lose its ability to adequately control normal biologic levels of hormones and electrolytes as we age.  The feedback mechanism, DNA and organ systems progressively break down.  Lab work is needed to check for these vital biological components to help us understand how you are aging.  Labs can often be performed from or near your home.

Visit with your Med-Health Doctor
Med-Health 360 expertise

Dr. Chang or one of the Med-Health 360 practitioners will sit down and explain your results.  We welcome your questions and input.  The best results are found in our patients who understand the reasons behind their treatment plans.

Your Med-Health Program is Built
Nutritional Counseling | Individualized Fitness | Hormone Replacement

Integrative medicine involves coordinating health and nutrition, fitness, managing biological hormones and electrolytes and calming the soul.  These are the elements that will be emphasized in the creation of your wellness prescription

Weekly Support
No man or woman should be an island

Our counselors and staff will help you stay on course with weekly support sessions where you will get feedback on your weight, metabolic tests, and evaluations on how you are progressing in the programs

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Our goals are simple.  If you succeed, then we succeed.  Our goal is for you to adopt a healthy lifestyle that is reproducible and easy.  We know that if the program is too complicated, you won’t stay on it.

Programs Designed For You

Sexual Dysfunction Therapy
Male Hormones

There are two components to a satisfying sex life for men; the desire to have sex, and the ability to perform.  If you have challenges with either, we can help

Estrogen Therapy
Male Hormones

Our primary objection when it comes to treatment of your andropause symptoms are safety and efficacy.  We can accomplish either without managing estrogen

Bioidentical Testosterone Therapy
Male Hormones

For Men, better aging includes testosterone therapy.  Its the foundation for everything we do to get you back to being you

Growth Hormone Therapy
Male Hormones

People who want to kick their better aging efforts up to the next level may consider growth hormone therapy as more thing they can do to further efforts.

Growth Hormone Therapy
Male Hormones

People who want to kick their better aging efforts up to the next level may consider growth hormone therapy as more thing they can do to further efforts.

Thyroid Therapy
Male Hormones

The interplay between thyroid hormones and your other hormones is too critical to ignore.  Better aging means balancing everything including thyroid hormone.  

DHEA Therapy

Your body needs DHEA.  But how much matters.  I you want the right dose of DHEA, doctor supervision is essential

Injectable Nutrient Therapy
Diet and Nutrition

Nutrition is essential to your health and wellness.  But it can be difficult to get the nutrients you need from food and oral supplements alone

Adrenal Fatigue Therapy
Male Hormones

Few things pose more risks to your health than stress and excess cortisol production.  Excess cortisol is toxic, and can eventually lead to adrenal fatigue.  

Hair Loss Therapy
Male Hormones

Hair loss may not impact physical health, but it can take an emotional toll.  We believe this is reason enough to give hair loss the attention it deserves

Facial Treatments
Cosmetic Anti-Aging

Women aren’t the only people who care about their skin.  That’s why we have options for men too.

Nutritional Supplements
Diet and Nutrition

Because getting sufficient nutrients from food is a challenge for most people, supplements are often necessary for better aging and maximum health.

Lab Testing
Med-Health 360

Our doctors use two primary diagnostic tools when assessing your better aging needs an assessment of your symptoms obtained from your lab tests

Dietary Counseling
Diet and Nutrition

Most patients don’t know what foods are healthy.  But also don’t now how and when to eat. 

Weight Loss Counseling
Doet and Nutrition

Most patients don’t understand the physiology and balance between lifestyle, diet, and exercise

Lifestyle Counseling

Most patients don’t understand the balance between the different aspects of their lives including sleep cycle, dietary choices, stress control, and lifestyle balance.

Ketamine Infusion for Depression

Ketamine infusion therapy is revolutionizing the treatment for depression.  Most patients can expect an 80% reduction in their depression symptoms after a single dose

Physical Training

Physical fitness is an integral part o health, wellness, and longevity.  Part of your program will include a prescription for your physical wellness.

Chinese Wellness Therapy


Weight Loss and Nutrition


Symptoms of Aging in Men

Hormones in Men

How Our Solutions For Men Are Different

Med-Health 360 is an integrative program that believes that lifestyle changes are needed in most people in order to live a long AND healthy life.  These changes begin with nutritional education, fitness, and spiritual well-being.  But these components address only surface problems if we don’t also address your hormonal ecosystem.  In the simplest terms, we have been solely focused on the effects of aging for longer—and have accomplished more success in treating clients—than our competition.



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