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Bio-identical Hormones: Hope, Hype or Hazard–Sound advice from a hormone balance specialist

As many of you know, I am a board-certified gynecologist who specializes in hormone balance. I’ve seen a disturbing trend in the past 4-5 years, soon after celebrities like Oprah and Suzanne Somers started talking about the benefits of hormone therapy. Suddenly I started seeing a number of hormone therapy clinics open, often affiliated with large national chains, and not infrequently manned by practitioners that were not adequately trained in gynecology and the possible serious risks of hormone therapy in certain patients. I see a number of patients who were initially seen in clinics like these and the dosages of hormones that I see are at times, alarming. Don’t get me wrong, I’m a big  proponent of the importance of hormone balance and the use of bio-identical hormones in many situations but my concern is that some of these practices use a cookie-cutter approach to hormone replacement that ignores some of the potential dangers and overstates some of the potential benefits in certain patients. This was brought home to me about a week ago when I read that the FDA is now requiring the pharmaceutical companies that produce and sell bio-identical testosterone for men, to carry a warning about increased risk of blood clots. The FDA is examining the possible increased risk of heart disease and stroke. (This may be a dose effect and I’ll discuss this in a future blog.)

Whether or not you come to see me to discuss hormone balance, I want you to know what bio-identical hormones are, what the potential risk and benefits are, what the difference between pharmaceutical grade bio-identical hormones and compounded hormones are, and which you should use and when, and most importantly, what questions to ask your doctor or practitioner when you are considering hormone use. I’ll discuss the hormone doses I most often use and reasons I deviate from these doses and I’ll discuss what I test and how I test it.

This is a big topic and will cover several blog entries and will cover all of the main hormones; estrogen, progesterone, testosterone, DHEA, thyroid, cortisol and insulin. We are very complicated hormonally. My focus will be on women because that is where my training is, but if there is a subject that is important for men also, such as testosterone and insulin, I’ll weigh in with my opinion. I hope you enjoy learning about hormone balance as much as I enjoy teaching about it.

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