Hormone Replacement Therapy FAQ

What are the symptoms of high estrogen levels?

High estrogen levels in women may cause weight gain, impact menstruation, increase PMS symptoms, cause non-cancerous lumps in breasts or non-cancerous tumors in the uterus, fatigue, and feelings of depression or anxiety. In men, high estrogen levels may cause gynecomastia (enlarged breasts), infertility, and poor erections. It may also contribute to prostate cancer and heart disease. As men age, testosterone is transformed into estrogen and low levels of testosterone may cause loss of muscle mass, fatigue, low libido, and erectile dysfunction.

How is estrogen produced?

Women of reproductive age produce three types of estrogen: estradiol, estriol, and estrone. Estradiol is common among women of childbearing age, estriol is produced during pregnancy, and estrone is the only estrogen made after menopause. Generally, estrogen is produced by the ovaries; however, smaller amounts of some estrogens are produced by the liver, adrenal glands, breasts, and fatty tissues and, during pregnancy, by the placenta.

How are estrogen levels corrected?

Low levels or estrogen can be treated with hormone replacement therapy. Estrogen and other hormones may be given to women to prevent osteoporosis and to treat the symptoms of menopause. To balance hormone levels, systemic treatments such as pills, patches, gels, and sprays are released into the bloodstream. Local treatments creams, rings, or inserts may also be used. To determine whether or not hormone replacement therapy is right for you, be sure to discuss your individual needs, existing health conditions, and preferences with your healthcare team. In men, high levels of estrogen may be treated with testosterone replacement therapies.

What are symptoms of low estrogen levels?

In women, symptoms of an estrogen deficiency include periods that have lessened or stopped, hot flashes, insomnia, vaginal dryness, thinning of the vaginal walls, low sex drive, mood swings, and dry skin. Men with low levels of estrogen may experience excess belly fat and a reduced libido.

What does estrogen do?

In women, estrogen helps regulate the menstrual cycle, keep cholesterol at appropriate levels, accelerate metabolism, increase vaginal lubrication, maintain skin elasticity, and more. Estrogen also reduces bone resorption. In men, estrogen promotes healthy weight and heart health.

What is estrogen?

Although both men and women have estrogen in their bodies, estrogen is one of the two primary sex hormones that women possess. Estrogen is responsible for the development and regulation of the female reproductive system and secondary sex characteristics. Estrogen may also refer to synthetic or natural medications or substances that mimic the effects of the hormone on the body. While men possess significantly lower levels of estrogen than women, the hormone still serves an important function.

What causes testosterone deficiency?

As a man ages, the amount of testosterone in his body gradually declines. This natural decline starts after age 30 and continues throughout life. The significance of this decline is controversial and poorly understood. Amount other potential causes of testosterone deficiency are:

  • injury or infection to the testicles
  • chemotherapy or radiation from treatment for cancer
  • genetic abnormalities such as Klinefelter’s Syndrome (extra x chromosome)
  • hemochromatosis (too much iron in the body)
  • dysfunction of the pituitary gland (a gland in the brain that produces many important hormones)
  • medications, including hormone analogues used to treat prostate cancer and steroids
  • chronic illness
  • cirrhosis of the liver
  • chronic renal (kidney) failure
  • AIDS
  • inflammatory disease such as sarcoidosis (a condition that causes inflammation of the lungs and other organs)
  • stress
  • alcoholism
  • congential conditions

What are the side effects of testosterone replacement therapy?

In general, hormone replacement therapy is safe. It is associated with some side effects, including:

  • acne or oily skin
  • mild fluid retention
  • stimulation of prostate tissue, with perhaps some increased urination symptoms such as decreased stream or frequency
  • breast enlargement
  • worsening of sleep apnea (a sleep disorder that results in frequent night time awakenings and daytime sleepiness)
  • decreased testicular size

Many of the side effects are not common.

  • Laboratory abnormalities that can occur with hormone replacement include:
  • changes in cholesterol concentrations
  • increase in red cell count
  • decrease in sperm count, producing infertility (especially in younger men)”

If you are taking hormone replacement therapy, regular follow-up appointments with your physician are important.

What are symptoms of testosterone deficiency?

Symptoms of testosterone deficiency including the following:

  • decreased sex drive
  • decreased sense of well-being
  • depressed mood
  • difficulties with concentration and memory
  • erectile dysfunction

What are the changes that occur in the body with testosterone deficiency?

Changes that occur with testosterone deficiency include:

  • a decrease in muscle mass, with an increase in body fat
  • variable effects on cholesterol metabolism
  • a decrease in hemoglobin and possibly mild anemia
  • fragile bones (osteoporosis)
  • a decrease in body hair

How do I find out if I have a testosterone deficiency?

The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. It sometimes may take several measurements of testosterone to be sure if a patient has a deficiency, since levels of testosterone tend to fluctuate throughout the day. The highest levels of testosterone are generally in the morning. This is why doctors prefer, if possible, to obtain early morning levels of testosterone.

What options are available for testosterone replacement?

The options available are:

  • Intramuscular injections, generally every two or three weeks
  • Testosterone patches worn either on the body or on the scrotum (the sac that contains the testicles). These patches are used daily. The body patch application is rotated between the buttocks, arms, back or abdomen.
  • Testosterone gels that are applied daily to the shoulders, upper arms, or abdomen
  • Testosterone pellets to be inserted in to the buttocks

There are currently no pills available in the United States that provide adequate levels of hormone replacement. In addition, oral medications may produce liver abnormalities and are to be avoided.

The choice of hormone replacement therapy is best made with a thorough discussion between a patient and his physician.

Who shouldn’t take testosterone replacement therapy?

Testosterone replacement therapy may stimulate growth of the prostate. If early prostate cancer is present, testosterone may stimulate the cancer’s growth. Therefore, men who have prostate cancer should not take testosterone replacement therapy. It is important for all men considering testosterone replacement therapy to undergo prostate screening before starting this therapy.
Although it is a rare condition, men who have breast cancer should not take testosterone replacement therapy.

What does BHRT stand for?

Bioidentical hormone replacement therapy. BHRT is the use of supplemental doses of hormones that have a chemical structure identical to the hormones that the human body naturally produces.

What does BHRT do?

Treats the symptoms of menopause, perimenopause, and andropause.

How are BHRT treatments created?

If bioidentical hormones are purchased at a compounding pharmacy, a cocktail of hormones is created, uniquely tailored for each individual patient. If they’re purchased at a conventional pharmacy, these hormones are available in a range of set doses. In both instances, the prescriptions are based on a series of tests administered by a doctor. Many of the bioidentical hormones used are made from soybeans and wild yams, which contain unique compounds that are processed chemically and made into identical replicas of hormones the body produces. They are used for their cost-effectiveness as well as their ability to readily extract compounds and turn them into exact replicas of human hormones.

How is BHRT taken?

Bioidentical hormones are applied via a cream, a suppository, taken orally or are injected.