Hormone Therapy
Bioidentical Hormone Replacement Therapy (BHRT)
Hormone Therapy
Depending on the patient’s underlying issue, we take one of two different approaches.
For patients experiencing age-related hormone depletion, we replace and balance the hormones. We don’t just address the sex hormones, but also assess the precursor and other associated hormones.
Hormone fluctuations are a natural part of the ageing process. Thyroid, insulin, human growth hormone, melatonin, testosterone, oestrogen and progesterone all decrease. Someone in their 40s and upwards will typically have a depleted hormonal profile when compared to someone in their 20s, for example.
We may first start to notice this when we cannot party the way we used to, when our libido drops, when our skin starts to sag, when our tolerance to stress starts to decrease – the list goes on! And you may not always associate changes in the way you feel or your energy levels with a hormone imbalance (when there is too much or too little of a hormone being produced).
In women, towards their late 40s and 50s, we call this process the perimenopause and menopause, and in men, andropause (also known as the male menopause or low testosterone).
Women that are perimenopausal or much younger (in their 20s, 30s or 40s), may find that they have symptoms of a hormonal imbalance. This may present as PCOS (polycystic ovarian syndrome), endometriosis, poor fertility or multiple miscarriages, bad PMS, weight issues, anaemia and so forth. In these instances, we assess the hormone profile and balance the hormones in order to optimise and improve wellbeing.
At Harpal Clinic, we provide a holistic, integrated approach to healthcare, combining cutting-edge treatments with preventative functional medicine. We use BHRT – also sometimes referred to as Bioidentical Hormone Optimisation Therapy (BHOT) – to optimise our patients’ hormones so they can live a life they love and do the things they enjoy.
We are different to a gynaecology-only or an endocrinology-only practice because we combine the two approaches whilst also incorporating preventative and functional medicine to treat the entire body. We address all the hormones, plus lifestyle, stress, the gut, immune system, and nutrition. Hormones are messengers. It is important not to isolate them but understand that all hormones communicate with one another.
BHRT is a really effective treatment for both men and women. We use it to replenish any depleted hormones to the levels that are optimal for the individual.
When we look at your hormone profile to ascertain your optimal levels, we look at the whole range of hormones including pregnenolone, DHEA, growth hormone, melatonin, cortisol, thyroid, oestrogen, and progesterone (plus many more!). In fact, this is one of many details that set Harpal Clinic apart from other similar clinics. We tailor every treatment regime to the individual and take into account not only symptoms and test results but your lifestyle, individual reactions to doses, age, fertility and budget.
Conventional HRT uses synthetic hormones that are analogues with a similar but different molecular structure to those found in the body. The bioidentical hormones that we use in the clinic are biologically identical to those that the body naturally produces. One simple way of explaining the difference between BHRT and regular HRT is this:
Water has a molecular formula of H2O. It is clear and mostly tasteless. When we add an extra oxygen molecule to it, it becomes H2O2. This is now hydrogen peroxide. It looks very similar to water (H2O) but you wouldn’t really want to drink it.
The simple addition of just one extra oxygen makes a huge difference. It is now a different product and used for different purposes. And really, we shouldn’t be drinking it! We already know the molecular formula of oestrogen, progesterone and testosterone. It is the same in every human being. Why change it?
Ultimately, your doctor will be able to advise whether BHRT is appropriate for your individual needs. They will look at your symptoms, test results, and other factors. However, you may be a good candidate if:
There is a lot of confusion surrounding the terms ‘bioidentical’ and ‘body identical’ when it comes to hormone therapy so we’d like to clear things up.
Both of these terms refer to hormones that are molecularly identical to the hormones produced in the body and both are licensed in the UK – we outline this further below.
At Harpal Clinic, we offer both types of hormone; these are prescribed based on preference, suitability and cost.
Some of the most common medications you may have heard of include oestradiol, progesterone and testosterone. In the UK, oestradiol and progesterone are both available as body identical and bioidentical. Testosterone, however, is only available as bioidentical in the UK.
Body Identical
Large pharmaceutical companies.
Bioidentical
Small compounding pharmacies.
Body Identical
Standardised.
Bioidentical
Can be specific to each patient so that sensitivities and intolerances are taken into consideration.
Body Identical
They can last years. For example, Utrogestan has a 3-year shelf life.
Bioidentical
Usually around 6-12 months as they are freshly made to order.
Body Identical
All big pharmas are tightly regulated by MHRA and GPhC in the UK (or by the equivalent bodies within their own country). Doses of medication are highly standardised and very accurate.
Bioidentical
All compounding pharmacies in the UK and Germany are tightly regulated by GPhC in the UK and the equivalent body in Germany. Doses, whilst usually very accurate, can be subject to variation due to the bespoke nature of each batch. In our experience, this is incredibly rare.
Body Identical
Oestradiol, oestriol and progesterone used are licensed in the UK for medical hormone management. The specific formulation is licensed.
Bioidentical
Oestradiol, oestriol, progesterone and testosterone used are licensed in the UK for medical hormone management. The specific formulation is unlicensed as it can vary due to the bespoke nature of the product.
Body Identical
As a result of mass production the cost of body identical hormones are relatively inexpensive.
Bioidentical
Due to small batch production and the bespoke nature of bioidentical hormones, these are more expensive to produce.
Body Identical
Bioidentical
Much wider range of applications including:
Body Identical
Standardised
Bioidentical
Bespoke to each individual.
Body Identical
Most patients tolerate this extremely well with a small number who require more precise dosing and delivery methods.
Bioidentical
Most patients tolerate these extremely well as their medication has been designed for them and tweaked according to how they respond. Particularly effective for patients with very precise dosing requirements, multiple chemical sensitivities, gut issues, and/or absorption issues.
When administered and overseen by your hormone doctor, BHRT is a safe and effective treatment. As always, we encourage all our patients to do their own reading and research into any recommended treatment. It is important to us to ensure that any supplements or medications prescribed are not only accurate but of the highest quality, and so all prescriptions are sourced from our trusted suppliers.
