Is Hormonal Therapy Women & Men?             

 For most people the first thought that  comes to mind regarding hormone imbalance is a women in menopause.  The decline of a woman’s hormonal levels is generally seen at a stage in life known as menopause.  The decline is usually rapid and dramatic and accompanied by symptoms such as hot flashes, mood swings, weight gain and a loss of sex drive to name a few.

 Unbeknownst to most of us however, men too go through a period or phase similar to a women in menopause known as andropause.  Andropause  sometimes referred to as “midlife crisis”, is experienced by nearly every male at some point in their life although the onset is more gradual and therefore not as readily noted as are those symptoms affecting women in menopause.

 Who Needs HRT and Why?

 Any man or woman of any age that suffers from symptoms of hormone imbalance should seek out advice and possible treatment for this imbalance.  We age as a result of a change in our hormone levels not the reverse.  Staying young and healthy is the key to a better quality of life and longevity.

Is Hormone Replacement Therapy Safe?

 It depends on who you talk to and what type of Hormone Replacement Therapy (HRT)

you choose.  In a nut shell,  Many studies have shown the safety and efficacy (positive

benefits) of Bio-Identical HRT (BHRT) as opposed to the long term results of the

“synthetic” hormones commonly used such as Premarin or Prempro.  These synthetic

Imitators have been shown to be unsafe and not beneficial in certain subsets of women in

a large multi-center trial known as the WHI Study in 2002.

 What is Bio-Identical Therapy?

 BHRT is a therapeutic process wherein the hormones that are deficient in the body are supplemented utilizing only compounds that are the exact replica of those the body normally produces and utilizes.  It is because of this that the side effects of BHRT are minimal in relation to those dangerous and life threatening ones seen wit the synthetics.  Bio-Identical hormones are derived from a natural plant source of soy or other plant derived product that are compounded by hand to be an exact duplicate of those found within the body.  BHRT essentially is giving back what the body can no longer produce.  This type of therapy has been documented and researched in the medical literature for nearly ¾ of a century but has been pushed aside by the advent of the pharmaceutical industry and the development of a patent process leading to PROFITIBILITY.

 What Can BHRT Do For Me?

 The quality of life given back to any man or woman utilizing BHRT is second to none.  Some of the quality of life benefits reestablished by BHRT are as follows:

*Restored or increased sex drive and performance

*Improvement and Consistency of moods

*Relief from anxiety and depression

*Increased mental clarity, focus, energy and memory

*Greater capacity to get your body back into shape*

* Decrease min chronic disease states such as heart disease and cancer

*Improved sleep

 How Do I Obtain BHRT? 

Most conventionally trained physicians know little if anything about BHRT and therefore will dismiss it as being an option despite their concerns about the safety and value of the synthetic alternatives.  This leaves you with the choice to seek out an open minded but excellently trained and knowledgeable physician in the use of BHFRT or to take your chances with the synthetics or no treatment at all.  There are several physicians highly trained and skilled in the area of BHRT.  A list of these providers can be found on the internet. 

 I heard that there are Different Types of BHRT, is this True?

 Yes there are a variety of different forms of BHRT all with there pros and cons, pluses and minuses.  A list of some of the most frequent forms available is below

Pills and Touches

Oral/Rectal/Vaginal Suppositories

Sublingual Drops

Shots/Injections

Patches, Creams and Gels, Lotions

*Implantable Pellets

 Which is the Preferred mode of therapy?

 The choice should be individualized and discussed between the doctor and the patient and based on ease of administration, cost and the presence of other medication or therapies that you are currently receiving.  In my practice I encourage the use of the implantable pellet therapy for a variety y of reasons the most being the excellent track record in terms of safety and best results as well as the ease of administration.  The choice however is ultimately up to the patient.

 Why do most patients opt for pellet therapy versus other forms of therapy?

 The majority of patients like best results followed by convenience over any other factor when it comes to BHRT.  Pellet therapy is best when it comes to these two issues.  Although the thought of having a foreign object inserted into your body may sound displeasing and unnatural, it is the only form of BHRT that will give you a constant level of hormones 24/7 and without the hassle of applying creams or gels or having to stick yourself with a needle or remember to take pills everyday.  The pellets are implanted into an area where there is body fat and is an essentially painless procedure.  It is more costly initially but they last four to six months and will not give you that  “roller coaster effect” seen with the other forms of therapy.  The reason for this roller coaster effect is because the half life or the amount of time many of the other forms of BHRT are effective within the body is short lived—six to ten hours for most other therapies.  Because of this short half life, treatment must be taken at least twice a day.

 Okay, so now that I know what BHRT is and the different modalities available, what  hormones will I receive?

 Both men and women require all three sex hormones namely estrogen, progesterone and testosterone but the type of hormone and the dosage is individually based on the results of your lab testing and your body’s needs.

 Will my insurance cover the cost of BHRT?

 It depends.  Every insurance policy is different and some cover BHRT and other services while others do not.  Many insurance companies however may cover the cost of the office visits and the workup i.e. lab testing.  At ICAM a receipt is given to all patients so that they may submit to their insurance carriers.  ****The exception is for Medicare and Medicaid.  Since neither Dr. Bartiss nor ICAM participate in these two governmental agency insurances, it is illegal for either Dr. Bartiss, ICAM or the patient to submit for payment  or reimbursement for services rendered within this office.  ALL  patients are made aware of this prior to their first appointment and are asked to sign a statement that they will not do so prior to being seen.

 What is the cost of the various BHRT options?

 Because of the changing economy and the interference with the FDA and the pharmaceutical industry in terms of BHRT the costs vary from month to month and region to region but the average costs of the various modalities are given below:

 ORAL FORMS:  these range from two to four dollars a day

SUBLINGUAL FORMS:  can cost from $.50 to about $1.00 per day

INJECTABLE FORMS:  average cost is about $55 to $100 per month

CREAMS AND GELS:  can range from $20.00 to $150.00 per month

PELLET THERAPY:   is based on the amount and type of hormone required plus the $300 to $400 surgical insertion fee.

Men: pellets average between $700.00 and $900.00 every six months

Women:  pellets average between $350.00 and $525.00 every four months

Mark J. Bartiss, MD

(For ICAM) 2007