Understanding Hormone Therapy
What bioidentical means
The term describes a hormone’s molecular structure, rather than its source or safety profile. Bioidentical hormones are available in both FDA-approved medications and compounded preparations. They are not inherently safer because they are described as natural or plant-derived.
When treatment may help
Hormone therapy can be effective for selected symptoms associated with menopause, including hot flashes, night sweats, vaginal dryness, and discomfort with intimacy. For suitable patients, systemic menopausal hormone therapy also helps prevent bone loss.
Testosterone replacement has a separate role in appropriately diagnosed testosterone deficiency. Symptoms such as fatigue, low mood, or reduced libido warrant assessment rather than an assumption that hormones are the cause.
The OWM Approach
A comprehensive consultation
Your provider reviews your symptoms, menstrual or reproductive history, medications, and personal and family medical history. Testing is selected where it can meaningfully inform diagnosis or treatment.
Individualized prescribing
The hormone, dose, and delivery method are chosen according to the clinical indication and your preferences. Your provider explains the expected benefits, potential risks, and available alternatives before treatment begins.
Ongoing review
Follow-up considers symptom relief, side effects, and any monitoring relevant to your prescription. Treatment is adjusted as needed, with periodic reassessment of whether continuing remains appropriate.
Hormones Used in Care
Estrogen
Systemic estrogen may help manage hot flashes and night sweats. Local vaginal estrogen may be considered for vaginal dryness and related urinary or intimacy concerns. The appropriate formulation depends on the symptoms being treated.
Progesterone
For patients with a uterus who receive systemic estrogen, an appropriate progestogen is generally needed to protect the uterine lining. Micronized progesterone is a bioidentical option, commonly prescribed as an oral capsule.
Testosterone
Testosterone may be prescribed for men with symptoms and consistently low blood levels that support a diagnosis of hypogonadism. Its use for women requires a separate, indication-specific assessment rather than routine supplementation for energy, weight management, or healthy aging.
The Experience
Your prescription may involve a patch, gel, oral capsule, vaginal preparation, or injection, depending on the hormone and purpose of treatment. If home injections are prescribed, your team provides instruction on administration and safe handling.
Nutrition, sleep, movement, and stress management may be addressed alongside medical treatment to support your overall well-being.
Hormone therapy carries risks that vary with the medication, route, dose, duration, and your health history. These may include blood clots, stroke, and certain cancers. Treatment is not prescribed to prevent cancer, dementia, or cardiovascular disease.
If a compounded preparation is proposed, your provider will explain why it is being considered. Compounded hormones are not FDA-approved, and FDA-approved options are generally preferred when they meet a patient’s needs.
