Bio-identical Hormone Replacement Therapy

Bio-identical Hormone Replacement Therapy (BHRT)

Who it can help ?

Those suffering from fatigue, mood swings, weight gain, depression, low energy, insomnia, or night sweats. Symptoms of hormone imbalance can vary greatly and are not limited to the above, and while it may be due to normal changes with ageing, BHRT can help alleviate those symptoms.

What is it ?

Extracts from plant sterols that act exactly like the hormones you produce in your body.

How is it delivered ?

Typically cream or gel applied to the skin in a 1mL syringe to allow the hormone to be dispersed over a wider area for better absorption. This method also allows for the hormone to bypass the liver and get to the site of action without changing into a metabolite of the hormone. Transdermal routes (skin) have been shown (when compared to oral) to decrease fat mass and increase lean body mass, have less negative effects on the serum lipid profiles, and result in less production of thrombolytic substances. Vaginal routes have been shown to have 4x more effect on vaginal tissues and 4x less effect on other tissues (vs oral).

Different forms

Progesterone cream, Biest [combo of estradiol (E2) and estriol (E3)], Progesterone Suppositories, Estriol Vaginal Cream.

How we test hormones

There are 3 ways to test hormones. The most familiar is blood test which is limited in the information it provides. It typically just shows information from a snapshot in time. The second test is saliva, which can be done in a single day, over a few days, or over 30 days. The third is a urine test (DUTCH) which measures hormones and conjugated hormones (metabolites).

BHRT and Breast Cancer

There is some evidence that shows estriol may actually be protective against breast cancer. BHRT is also associated with lower risks, including the risk of breast cancer and cardiovascular diseases. They have been found to be more efficacious than their synthetic and animal derived counterparts.


Usually better tolerated, mimics human hormones more closely, much less side effect, can compound customized formulas, can titrate doses in small increments.


Even though it is a prescription medication, it is more expensive than synthetic drugs, occasionally not covered by drug plans.