Getting Started With BHRT

Copyright © 2023 BHRT Training Academy, Donna White All rights reserved solely by the author. The author guarantees all contents are original and do not infringe upon the legal rights of any other person or work. No part of this material may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, records, or by an information storage and retrieval system-except by reviewer who may quote brief passages in a review to be printed in a magazine, newspaper, or on the Web without permission in writing from the author. The views expressed in this material are not necessarily those of the publisher.

Disclaimer: The information in this Guide is intended to provide basic general information about the subject matter covered. The author and publisher do not intend that the information in this Guide substitute for professional medical evaluation and treatment from a licensed medical doctor or other licensed health professional. The information in this Guide is intended only as general information and should not be used in any way to diagnose, treat, cure or prevent any disease, illness or condition. The treatment regimen and any medications prescribed must be determined by the doctor or other medical professional who is solely responsible for all matters relating to any patient treatment. The information provided in this Guide is taken from generally available sources believed to be reliable by the publisher and author, but the information is not universally applicable to all persons and is not a substitute for the evaluation and treatment provided to each individual patient. The publisher and author are not responsible for the use of any information in this Guide by individual practitioners. Every effort has been taken to make this material as complete and accurate as possible. The purpose of this Guide is for educational information only. Any suggestions or information in this Guide is not intended for use without a licensed medical physician’s approval. The author and publisher have no liability or responsibility to any person and/or entity with respect to any loss, damage, or injury caused or allegedly caused directly or indirectly by the information contained in this Guide. Nothing contained in this Guide should be used to replace established, conventional medical approaches, especially in cases of emergencies, serious or life-threatening diseases or conditions. Although the author and publisher have made every effort to ensure the accuracy and completeness of information contained in this Guide, they assume no responsibility for error, inaccuracies, omissions, or any inconsistency herein

What are they?

During my past 25 years in the field of HRT, my experience is that there is a lot of confusion when it comes to this topic so let’s get clear right from the start. The term bioidentical does not indicate the source of the hormone but rather the chemical structure. ioidentical hormones are originally derived from a molecule called diosgenin in either soy or yam. Through a series of chemical processes first developed in 1942, the plant molecule, which is structurally similar to a steroid hormone, is converted to a specific hormone molecule that is an exact match to human endogenous hormones. There is no difference between bioidentical hormones and endogenous hormones in structure or function. This is critical because the molecular structure is what determines the function and activity of the hormone. This is why when you prescribe bioidentical hormones you can be assured that they convey the same action and effect, are metaboli ed into the same downstream metabolites, have same binding affinity, and are expected to restore normal physiology. Confusion about different types of HRT is due to the lack of clear distinction between the molecular formulas and the lack of focus on their significantly different effects in the body. 1, 2, 3, 4

“All hormones are not the same and have different actions, which must be distinguished and described accordingly.”

Are Non-Bioidentical Hormones Really That Different From Bioidentical Hormones?

Absolutely ince there is a molecular difference between non-biologically identical hormones and biologically identical hormones, they have different effects. Data indicates that bioidentical hormones do not have the same risk profile especially in regard to cardiovascular, clotting, and breast cancer risk factors.

To be clear, even though a non-bioidentical hormone may mimic some of the endogenous hormone actions, that does not make it the same in structure or function. Non-bioidentical hormones interfere with normal physiological processes and can lead to adverse events otherwise known as side effects or increased risk of issues. For example, rogesterone is a pregnancy class drug, that supports pregnancy and prevents miscarriage. Medroxyprogesterone acetate is a pregnancy class drug, used in the morning after pill, known to cause birth defects. To view the difference in the different molecular structures, see the chart below.

Bioidentical Hormone Replacement Therapy (BHRT)

ioidentical HRT often referred to as HRT, is a prescription modality for hormone replacement and hormone balancing for treating the signs and symptoms of M , perimenopause, menopause as well as post-menopausal issues. rescriptions for bioidentical hormones are available from compounding or conventional pharmacies in cream, pill, patches, or pellets and typically administered after assessing history, symptoms, a physical or gynecological exam, review of lab work, and then monitored appropriately by practitioners trained in HRT.

Are Bioidentical Hormones Safe?

Twenty-five years of research and hundreds of published studies conducted in the and Europe have demonstrated bioidentical hormones to be equally or more effective than non-bioidentical hormones for symptoms. ublished studies also show their safety. In the January 2009 issue of ostgraduate Medicine, Dr. ent Holtorf, published an article citing 196 research studies. He comments, “ hysiological data and clinical outcomes demonstrate that bio-identical hormones are associated with lower risks, including the risk of breast cancer, cardiovascular disease, and are more efficacious than their synthetic and animal derived counterparts. ntil evidence is found to the contrary, bioidentical hormones remain the preferred method of hormone replacement therapy.” 5

WHY YOU SHOULD LEARN BHRT

earning HRT isn’t ust beneficial to your patient’s health and quality of life – its beneficial for yours as well.

1.Your patients are symptomatic!

Over 55 million women in the are in menopause. That is a lot of hormonal women As you know these women have hot flashes, they cannot sleep or lose weight, their moods go haywire, they struggle to remember words, they are tired and are frustrated about rapid skin aging. Moreover, they will live the last 1 3 of their life post-menopausal.

Even before they stop having their menstrual cycle, your female patients are struggling with perimenopausal symptoms and 70-80 of women complain of M . Not to mention (ok I will mention) in my estimation, 90 of the thousands of hormone lab tests I have read show stress hormone (cortisol) imbalances. As you know 75-90 of visits to medical providers are due to stress related ailments.

After all, you are their trusted provider and they are counting on you to help with their symptoms and help them stay healthy. Just as important, they want and need you to be educated about bioidentical hormones in order to help clear up all of the confusing information they read online.

ioidentical HRT is a highly effective therapy, especially for women experiencing symptoms of hormone imbalance and hormone deficiency. atients may be as young as teenagers or even elderly. These patients may present with M , peri-menopausal and menopausal symptoms, androgen deficiency in men, or other conditions that result from or are associated with hormone imbalances. These include but are not limited to insomnia, mood disorders, low sex drive, metabolic syndrome, migraines, obesity, fatigue, hypothyroidism, bone loss, uterine fibroids, fibrocystic breasts, skin disorders, CO , Chronic Fatigue yndrome, hirsutism, and connective tissue disorders.

2.Subo ptimal Hormone Levels Coexists with Diseases

The second reason you should learn to prescribe HRT (when indicated) is that suboptimal hormone levels coexist with or can contribute to diseases including:

Cardi ovascular Disorders

Neuro logical Disorders

Gastrointestinal Disorders

ystem ic Conditions, ie. diabetes

Autoimmune Diseases

3.Diseases Increase When Hormones Decrease

The third reason you should evaluate your patients’ hormones and prescribe bioidentical hormones as indicated, is that as hormone levels decline diseases increase. Hormones, such as estradiol and testosterone for example, are anti-inflammatory. Inflammation affects as much as 90 of the chronic diseases your patients would like to prevent including heart disease, Al heimer’s, diabetes and cancer. ince hormones are neuroprotective, declining levels contribute to cognitive decline and increased risk of Al heimer’s and dementia, and lead to decreased bone density.

4.HRT is Supported by Scientific Evidence

ublished Trials on HRT or ERT demonstrate:

Reduc tion on all-cause mortality

Reduc tion in Al heimer’s Disease reve ntion of CAD via numerous mechanisms

Reduces cardiovascular morbidity

Reduce risk of MI reventi on of colon CA reve ntion of Osteoporosis reve ntion of Age-Related Macular Degeneration

Reduc tion of deaths from MI and reast Cancer

No increased risk of reast Cancer (except synthetic progestins)

No inc reased risk of thromboembolism

No increased risk of stroke

Ad ditionally, ho rmoneshavemanycritical n on-reproductive fun ctionsthatsupp ortou r health. H RThasbeenshowntoincreaselon ge vityandoptimal le velsofhormones imp rove the qualityof l ife for yourpati e nts.

5.HighDemand

Ha v ing beenin the fie ld of HRT foro ver 25years Ih ave fol lowedit s historyand w atche ditg rowsinceprovi ders f irststart ed prescribingitinthe e ar ly9 0’s. I can c onfidentlysay th at HRTismorethan ust a high d emandtherapy:itis a movement. It ’s apa t ient d riven m ovem e nt.No l on ger satisfiedwithtraditionalHR T, womenhave a nd wil l continue toseek H RT.

It’s a movem e ntdriv enby women,an d supported b y p ractitioners,pharmacists andeven a numberofmedicalassociations.Currently,there stillaren’ t en o ug h HRT provid e rstomeetthe de mand.Itisin yourp atients be st inte rest aswellas y oursto l earn thi sl ife-changing,health pro motingmodality. READY

6. Outstanding Patient Response

HRT is truly one area of your practice that your patients should notice great symptomatic improvement. When you help your patients start sleeping better, eliminate night sweats or hot flashes, alleviate mood issues like hormone induced anxiety or depression; t hat is truly life changing. It a ffects their relationships, their ability to function better in their career, etc. This in turn will help grow your practice because they will tell their friends and colleagues.

HRT providers en oy great patient feedback. It i s not uncommon at all to have patients come back after starting HRT and say things like, “You have changed my life”, I feel like myself again or “My husband thanks you ” The following comments are from patients that reveal common sentiments.

“Hi to everyone who is years or older that is experiencing even the slightest menstrual related symptoms or symptoms such as heavier periods, tender or cystic breasts, difficulty going or staying asleep, weight gain especially around the mid section, mood swings, etc. Don’t wait until they become unbearable or believe that your only options are birth control pills, antidepressants, sleep medications and or a hysterectomy None of these options get to the root cause of the actual problem. The actual problem is the natural aging process of declining hormones. (B MM R, but true I personally started on BHRT at and sailed through peri menopause and menopause with only with a few night sweats to which I was recommended to add more estrogen. I am confident that the long term benefits will include a reduced risk of all cancers and heart disease as well as a reduced risk of declining brain function and declining uality of life. I am fortunate that I was able to start on them at a young age and that I have been able to avoid any other prescription medications. Do I pay out of pocket Do I take multiple prescriptions of BHRT in every form available Do I see my prescribing doctor regularly and get labs done ABS L T L as it is worth every penny to me. These are not sacrifices to me, they are musts to maintain the level and uality of life that I want for a long time to come.”

Jeny K

“At my primary care doctor’s office, I was introduced to Donna hite, a BHRT linical ducation onsultant. Donna provided education on how to properly test and treat hormones and their related imbalances. I was immediately switched to bioidentical hormones by my doctor. ithin the rst week, I became noticeably less depressed, and I had a marked decrease in anxiety and tremendous improvement in food cravings. And over the next year, I lost eighteen pounds without even changing my diet. eople are always asking me what I have done to my face, too, because they say my skin looks so much better, and I look younger. Before BHRT, I was on antidepressants, sleep, pain, and anxiety medication. Now I don’t have to take any of those. My life has totally changed thanks to BHRT. I would like to encourage women to help themselves with this type of testing and treatment."

Janice G.

7. BHRT is Rewarding for Providers

One of the reasons HRT is very rewarding for providers is that they can spend time with these patients and watch them experience dramatic changes in their quality of life. During a HRT consultation, providers spend quality time with each patient doing what they chose their profession for: helping patients. T he providers that have learned how to prescribe HRT are the heroes and heroines. They are the ones women are seeking out and then telling their hormonal friends about

In my years in this field I have never met a HRT provider that regrets learning and using bioidentical hormones in their practice. It i sn’t uncommon at all to hear from providers sentiments like this nurse practitioner:

“I’m doing the course and it is AMAAAAZING!! I’ve studied hormones [before] and all the other courses are so complicated only to leave me confused (like I don’t know a single thing. Literally this is going to change my practice. I’ve been turning patients away because I didn’t have the confidence or clarity and I am not one to ‘dabble’ because it could be dangerous in my opinion. Thank you for…this!”

MonicaSood,MD

“As a pharmacist the course has been fantastic to help inexperienced providers with BHRT, and it will help set us apart from other pharmacy providers in the area who don’t have the clinical knowledge on prescribing, dosing, and testing BHRT. Thanks for putting the mentor and weekly training sessions online on the site. The mentor sessions and Master level trainings as well as supplemental learning at the end of the modules have been great and added tremendous insights to augment the modules.”

HarryPorter,R.Ph.

8. Revenue Potential

Revenue from implementing HRT comes from office visits (4 or more the first year), hormone testing (3 or more the first year), and supplement sales. It i s not unrealistic to add an additional 10,000 - 20,000 in monthly revenue by adding 10-12 new hormone patients a month. A dding HRT is also an opportunity to cross-sell patients with additional services such as other functional medicine modalities, aesthetic services, etc

WHAT YOU NEED TO LEARN – 4 KEY COMPONENTS

Comprehensive HRT training that covers 4 key components is essential.

1.BHRT Foundation

First of all, you will need a strong foundation in the scientific validation behind HRT. You need to be savvy on the studies so you can confidently recommend, substantiate and implement bioidentical hormones into your care. You will be ama ed to see the vast amount of research behind the use of bioidenticals dating back to the 1970s. There is even research comparing the non-bioidenticals to bioidenticals.

2.BHRT Assessment

You will need to learn how to identify and assess patients for hormone imbalance by recogni ing symptoms and ordering appropriate lab testing. The combination of lab results, in con unction with a review of symptoms and history, effectively directs the protocols necessary to reach optimal patient outcomes.

To help you identify symptoms, here is a symptoms chart adapted from the HRT roviders Training Manual provided for students of the BHRT Training Academy

Hormone testing assists practitioners in detecting hormone imbalances, helps monitor dosing, and supports increased patient compliance. When testing for endogenous hormone levels (prior to replacement therapy), providers can choose between serum, saliva, capillary blood spot, 24-hour urine, and dried urine hormone testing. However, testing methodologies do offer varying benefits and limitations. To monitor replacement therapy, it is important to utili e the appropriate method based on the dosing form the patient is taking and the desired parameters the provider wants to measure. astly, due to the intricate interactions of hormones, it is critical that testing is inclusive of the sex hormones, adrenal hormones, and thyroid hormones to assess hormone status.

3.BHRT Application

To apply HRT you need an in-depth understanding of hormones and their actions and effects in the body and precisely how to prescribe them. Here’s an introduction to 3 sex hormones. ( ee next page.)

PROGESTERONE TESTOSTERONE ESTROGEN(S)

The ovaries make approximately 4 to 28 milligrams of progesterone during ovulation, which tends to occur sporadically by the mid-thirties. This means that typically progesterone is the first hormone that begins to decline leading to many symptoms. Women without ovaries and women on the pill or hormones that block ovulation are likely to be progesterone deficient.

Progesterone has 300 jobs in the body and over 9,000 genetic mechanisms. Therefore, it is imperative to have a normal level. It helps normalize menstrual periods and reduces PMS. Progesterone reduces anxiety, irritability, and improves sleep. It also decreases hot flashes and night sweats and protects the breast, uterus and ovaries from cancer. Additionally, progesterone is a bone building hormone, and it supports thyroid and adrenal function.

The ovaries make 60% of our estrogen while the other 40% comes from other sources, including the adrenal glands. The body converts androgens such as DHEA and testosterone made by the adrenals or ovaries into estrogen. Women make approximately 0.01 to 0.03 mg of estradiol, one of the three primary estrogens.

Estradiol is the strongest estrogen and is the most abundant estrogen produced premenopausally. Estrone is the main estrogen made after menopause. Both estradiol and estrone are stimulatory estrogens especially to the breast and uterine tissue. Therefore, they need to be used in small amounts and monitored properly. Estriol is not considered to be stimulatory and believed to be protective against hormone-related cancers.

Estrogen has an estimated four hundred crucial functions in the body. It is important in preventing heart disease, bone loss, dementia, depression, and weight gain. It maintains health of the skin (against dryness and wrinkles), eyes, and vaginal tissue.

Total testosterone production is around 0.3 mg of testosterone daily. Approximately 60% is made by the ovaries. The remaining testosterone comes from DHEA, which is made by the adrenal glands. By age 40, most women only make half as much testosterone as they did in their 20’s.

Testosterone helps maintain lean body mass, strength, and stamina. It increases libido and supports sexual function, mood, energy, and brain function. Testosterone reduces risk of cardiovascular disease, diabetes, and bone loss.

It is important to note that comprehensive HRT training must include education on the the adrenal hormones, thyroid hormones as well as insulin and glucose metabolism. T his is because no hormone works in isolation. T hey are like a symphony that must all be in tune to play beautiful music.

Once you are really strong in your understanding of the hormones you will need to learn the different dosing forms and how to prescribe and monitor them. ioidentical hormones are available in pills, creams, gels, vaginal tablets or creams, patches, and pellets. In addition to HRT prescriptions, hormone balancing also requires supplements, dietary changes, and lifestyle modification measures.

The best part of learning this information is that it is so fascinating In 20 years I’ve been teaching this material I can tell you first hand that you will be hooked on hormones. The more you learn the more you’ll want to learn.

BHRT Implementation

In order to start seeing patients you will need to work through an implementation process for HRT into your current practice or set up your new practice if that is your plan. Here are some important items you will need to consider.

Consultations rocedures – what to do at each visit, how often to see patients, labs to order

Treatment lans - rotocols for hormones, supplements, and dietary measures for issues and conditions related to hormone imbalance

Administration – required forms or Electronic Health Record system, consents, patient education materials, laboratory and supplement accounts

NEXT STEPS

in ce HRT is not taught in medical school, p roviders ha ve to be willing t o in vest time to le ar n t his modalit y HRT is complex and definitely not a one dose fits all a pproach like HRT or b irth control p ills. It r equires purposef ul de cision making based o n e ach individual’s nee ds,histor y, labs, health goals, main c omplaints, etc. ut this is what makes it so f ascinating and rewarding

Ad ditionall y, like many therapies, training requires a financial investment. harmaceutical re ps do not drop by the office to lea ve literature. C onferen ces and training programs are p aid for by the providers themsel ves.

De spite these challenges, the HRT mo vement ad vances on d ue to the demand. W omen ar e savvy and m ore well-read than e ver. It w a s women that pushed t he trend toward birthing ce nters or suites instead o f cold hos pital rooms. They want what they read a bout in u anne ome rs books and what they see on Oprah and Dr. O . Once they hear about bi oidenticals it becomes very logical a nd p atients want o p tions to the traditional standard of c are, whichthey know clearly has many undesirable side effects. Women are l ooking for p roviders that w ill l isten to them and n ot tell them they are cra y or critici e a therapy that the provider h asnot really gi ven serious consideration. I would s ay that e ven though HRT h as beenaround for 25 years in the , it is still i n i ts early stages and the market is still u nderser ved. I c a n’ teven keep up with the number of women that say they wish their d octo r, N , or A would p resc ribe bioidentical h ormones for them or at the very least be open mindedabout HR T. I ust checked g oogle and 1 18,000 people sear ched HRT doctors in the past 76seconds

Though it might sound a bit overwhelming, as long as you learn from the pioneers that have gone before you to bla e a trail in HRT you won’t have to reinvent the wheel. Y ou won’t have to struggle like many of your colleagues did to get started. O n behalf of the HRT providers all across the and millions of women struggling with hormone imbalance, what are you waiting for I suggest that you get started pretty soon. You could be seeing patients as soon as 8 weeks. Women are going somewhere for help. Why let your patients go somewhere else when they should be coming to you

You can do this. My team and I would be honored to walk you through the process In fact, I have created the BHRT Provider Training Program to ensure your success. Click here to apply to our next class and get more information.

PROVIDERS SPEAK OUT ON THE BHRT PROVIDER TRAINING PROGRAM

"I definitely recommend Donna White’s HRT rovider’s rogram to any clinician new to HRT or experienced in HRT but wanting to enhance their knowledge or grow their practice. The protocols are very easy to use and very thorough and easy for clinicians to go back and reference. If you are looking for a training program that’s thorough and concise, I think you’ll find the HRT rovider’s rogram the way to go."

Diana Williams, MSN, RN, FNP-C

Precision Wellness Functional and Anti-Aging Medicine

“Donna White’s HRT provider’s training course was invaluable. It was easy to follow, comprehensive and armed me with exactly what I needed to feel confident about seeing patients. Even a year later I still refer back to my notes when I have a complicated case or need a refresher.”

Nicole M. Bentivegna, MSN, RN, NP-C

Signature Wellness, Integrative & Functional Medicine

"Donna’s training has been invaluable to my practice. It p rovided me with the knowledge and confidence to safely and effectively prescribe HRT, and my practice is thriving because of it "

Shawnie Perkins PA

Arbor Vitae Medical Center

“If you’reconsideringtakingthiscourse,Ihighlyrecommendit...I’vetriedothercourses...oneinparticularinFortLauderdale, anditjustwasn’tverycomprehensive.Ididn’tfeellikeIgotmymoney’sworthfromit.Thiscoursehasagreatmentorshipprogram withotherprovidersinthecountry There’salotofsupport.There’salotofeducation .Barnone[it’s]betterthananyothercourse I’vetaken,andI’vetakenseveral Wastedalotofmoney.Thiscourseiswellworththeinvestment.”

MikeGriffin,NP

"I absolutely loved training I did with Donna! She has so much knowledge and does an amazing job at explaining what can be a somewhat complex subject for a provider. She not only covered the basics, but alsogave tips that will help with some of the more “zebra” type cases. I am starting a BHRT Job and feel like she provided me with the tools to practice with confidence. I highly recommend her training! And I hope to have continued training with her too"

Amy Kilbarger

BHRT TRAINING PROGRAM

• All training programs include:

• Convenient online lessons viewable on any device

• Online ifetime access including training updates

• Mentoring and support

• atient case reviews

• Ongoing training

• No hidden fees or contracts

• CME Category 1 Credits

• Certificate of Completion

BHRT Provider Training Program

This comprehensive training program equips providers to prescribe all dosing forms (creams, patches, pills, pellets), male and female hormone balance and replacement, thyroid, adrenal, and insulin optimi ation, supplement protocols, ow Dose Naltrexone, gut health and male and female sexual health. 30 hours of instruction, weekly mentor sessions, case reviews and monthly advanced training webinars. Also included are practice set up resources, tools, templates, consents, and more 24 CMEs available.

Male Hormone and Sexual Health

The Male Hormone and exual Health training program includes 15 hours of education, 4 practice implementation coaching sessions, and case reviews. Instruction covers all Testosterone Replacement Therapy (TRT) dosing forms (topical, in ectable, and pellets), thyroid, TRT options, adrenal, thyroid and insulin optimi ation, supplement protocols, TRT ad unctive therapies, sexual dysfunction, ED treatment options, and e aculatory issues. Resources include consents and patient training materials. 20 CMEs available.

Peptide Therapy: Foundations

The HRT Training Academy has partnered with the eeds cientific Research erformance Institute ( R ) led by Dr. William A. eeds, the Father of eptide Therapy to educate medical providers in the pillar peptides that make up almost every peptide protocol. Along with the use cases, dosing, protocols, and side effects, eptide Therapy: Foundations covers the amino acid and molecular structures with the goal of controlling enescence and restoring cellular efficiency by using the signaling pathways of peptides, the key to eptide Therapy. Includes discussion board access, consents, and mentor support.

IV Nutritional Therapy

Coming soon!

REFERENCES

1 Mueck A, Seeger H, Wallwiener D Comparison of the proliferative effects of estradiol and conjugated equine estrogens on human breast cancer cells and impact of continuouscombined progestogen addition. Climacteric. 2003; 6:221-227

2 Lippert T, Seeger H, Mueck A. Pharmacology and toxicology of different estrogens. G Endodonzia. 2001; 15:26-33.

3 Schindler A, Campagnoli C, Druckman R, et al. Classification and pharmacology ofprogestins. Maturitas. 2003; 46: S7-S16.

4 Stanczyk FZ. All progestins are not created equal. Steroids. 2003; 68:879-890.

5 Holtorf K. The bioidentical hormone debate: are bioidentical hormones (estradiol, estriol, and progesterone) safer or more efficacious than commonly used synthetic versions in hormone replacement therapy? Postgraduate Medicine. 2009 Jan;12 1(1):73-85

EVIDENCED BASED BENEFITS OF HRT AND ERT CITATIONS:

Reprinted from, H RM N S And Bioidentical HRT rescribing Manual, by Donna hite

Cardiovascular

“The reduction in incidence of clinical ischemic events has been substantial ranging from 30% t o 90%.H RT alters the biology of the vessel wall, causes vasodilation and provides anti-inflammatory benefits, reducing heart attacks.” New England Journal of Medicine 2000; 343(8):572-574.

“HRT also causes sustained increases of nitric oxide levels and reductions in norepinephrine, plasma renin activity and endothelin. These endothelial changes have been associated with vasodilation, reduced blood pressure, increased blood flow and improved cardiac performance. J G en Intern Med 2004; 1 9 (7):

791-804

Alzheimer’s

“Our findings, along with other recent work, suggest that HRT may be effective for the primary prevention of Alzheimer’s Disease-if not for its treatment”. JAMA 2002; 28 8:2123-2129

“Human neuroimaging studies provide evidence that estrogen containing hormone therapy influences the pattern of brain activation during memory processing…Findings from a number of case-controlled studies and 2 prospective investigations suggest about a 30% reduction (of Alzheimer’s Disease, added) in women who report ever having received hormone therapy compared to nonusers.”

Resnick S , JAMA 2002; 288: 2170 (editorial)

“As in the previous studies, the adjusted risk of incident AD among lifetime HRT users was reduced to little more than half that among nonusers.” JAMA 2002; 288: 2123-29.

Bone Density /Diabetes

“Hormone replacement has beneficial effects other than cancer and cardiovascular disease, such as a 35% decrease in hip fractures, 35% decrease in new onset diabetes and a 60% decrease in recurrent urinary tract infections. “J Gen Internal Medicine 2004:19(7): 791-804.

Mortality

“Pooled data from 30 trials, with 26,708 postmenopausal women followed for a mean duration of 4.5 years, indicate that hormone replacement does not increase total mortality.” J Gen Intern Med 2004; 19 (7): 791-804.

Central Obesity/BMI

“In women with diabetes mellitus, HRT reduces central adiposity and improves glycemic control and physical functioning.” J Gen Intern Med 2004; 19 (7): 791-804.

“Hormone replacement therapy in postmenopausal women and testosterone replacement in older men appear to reduce the degree of central obesity.” Obesity Review 2004 Nov; 5(4): 197-216.

“Age-adjusted comparisons indicated intermittent and continuous hormone users had significantly lower mean BMIs at baseline than women who never used hormone replacement therapy.” JAMA 1996; 275(1): 46-49

BENEFIT OF ESTROGEN REPLACEMENT

Cognitive

“Multiple medical studies have demonstrated estrogen’s protective effects against Alzheimer’s, memory loss, loss of cognition. Estrogen decreases colorectal cancer, cataracts, macular degeneration, prevents tooth loss and gingivitis, and prevents urogenital atrophy, painful intercourse and stress incontinence.”

Biomedical Jan 2000; V ol 3 (1):6-9.

Cardiovascular

“Estrogen therapy alters the biology of the inner vessels (of the heart). Hormone replacement therapy protects through vasodilation, anti-inflammatory and anti-proliferative effects, providing significant coronary artery benefits.” NEJM 2000; 34 3: 572- 574.

“Current estrogen use is associated with a reduction in the incidence of coronary heart disease as well as in mortality from cardiovascular disease.” N EJM 1991; 325: 756-62.

“In addition to potentially benefinial vascular effects of ERT, well established lipid alterations with oral ERT include favorable reductions in

low-density lipoprotein (LDL) cholesterol and lipoprotein(a) and increases in high-density lipoprotein (HDL) cholesterol.” AHA Scientific tatement. Circulation 2001; 104: 499-503.

“Fibrinogen, plasma viscosity, plasminogen activator-1, tissue plasminogen activator, insulin sensitivity, homocysteine and markers of platelet aggregation and endothelial cell activation are favorably affected by estrogen therapy.” Circulation 2001; 104: 499-503.

“Moreover, estrogen inhibits intimal hyperplasia, promotes angiogenesis and has antioxidant properties.” Circulation 2001; 104:499-503.

“There is an impressive, large collection of biological data and observational studies indicating that postmenopausal HRT protects against heart disease and stroke. There is good reason to believe that the full impact of estrogen’s beneficial actions on cardiovascular tissue requires the presence of healthy endothelium (normal blood vessels. It is most appropriate to prescribe hormones to post-menopausal women to protect against cardiovascular disease. Vascular biologists are convinced of estrogen’s essential role in protecting against cardiovascular disease. Estrogen’s role is protecting against the development of atherosclerosis.” Circulation 2001; 1 04:499-503.

Bone Density

“In older women, a dosage of 0.25 mg/d of 17-beta-estradiol increased bone density of the hip, spine, and total body, and reduced bone turnover, with minimal side effects.” JAMA 2003; 290 (8) :1042-1048.

All-Cause Mortality

A recent study done by doctors at Yale evaluated the result of this widespread reduction in HRT use in women aged 50-59 post hysterectomy. According to their calculations, estrogen avoidance may have led to as many as 90,000 preventable deaths and breast cancer in these women. According to the authors: “Estrogen therapy in younger postmenopausal women is associated with a decisive reduction in all-cause mortality.” Philip M. S arrel, Valentine Y. Njike, Valentina Vinante, and David L. Katz. The Mortality Toll of Estrogen Avoidance: An Analysis of Excess Deaths Among Hysterectomized Women Aged 50 to 59 Years. American Journal of Public Health: September 2013, Vol. 103, No. 9, pp. 1583-1588.

TESTOSTERONE REPLACEMENT IN FEMALES – BENEFITS

Sexual

“Testosterone administration resulted in increased sexual activity, pleasure, and orgasm in women. There was an increase in sexual fantasies, masturbation and frequency of sex. There was an improvement in well-being and mood.” New England Journal of Medicine 2000; 34 3:682-88.

Sexual Health / Bone Density /Cardiovascular

“Testosterone increases bone density in women. Testosterone protects against heart disease in women.” Journal of Reproductive Medicine 1999; 44( 12): 1012-20.

“Testosterone replacement in women significantly decreases carotid atherosclerosis and cardiovascular disease.” A merican Journal of Epidemiology 2002;1 55: 437-445.

“Restoring a physiological level of testosterone to women after hysterectomy not only can improve quality of life in terms of sexual libido, sexual pleasure, and sense of wellbeing but also can build bones – and may be a key to protecting cardiovascular health.” J W omen’s Health 1998; 7: 8 25-29.

ANDROGEN DEFICIENCY – WOMEN

“A persistent view of testosterone as the male hormone deprives many clinically androgen deficient women of effective treatment.” J R eprod Med 2001; 46: 28 1-90.

“Our results suggest that in the physiological range, DHEAs and androgens in women are correlated with lower risk of carotid artery di sease.” J C lin Endocrin Metabol 1999; 8 4: 2008-2012.

“We found the lowest odds of carotid atherosclerosis for women with the highest total testosterone concentrations”. A mer J Epidem 2002; 1 55 (5): 437-45.

“Testosterone is an important component of female sexuality, enhancing interest in initiating sexual activity and response to sexual stimulation. Testosterone is also associated with greater well-being and with reduced anxiety and depression.” J R eprod Med 2001; 46 : 291-296.

“Androgens offer positive effects on bones.” J Reprod Med 2001; 46 : 281-290.