By Cynthia Elliott, MD

For some women, the drop in estrogen, progesterone and testosterone levels that occurs during menopause can cause debilitating symptoms. 

Hormones send chemical signals to nearly every system of the body to control many physical processes, including your metabolism, mood, appetite, sleep cycles, libido, fertility, and growth, so a change in any of their levels has multiple repercussions. For your hormones to work optimally they need to be in balance. 

Menopause occurs when the ovaries stop functioning and can no longer make the hormones estrogen, progesterone, and testosterone. Most women are expected to spend 1/3 of their lives in menopause.

The most common symptom experienced with menopause is hot flashes, but other symptoms can include insomnia, difficulty concentrating, depression, painful joints, weight gain, thinning skin, mood swings, loss of libido, bladder leakage, anxiety, thinning hair, increased risk of bone fractures, vaginal dryness, decreased recent memory and decreased energy. It’s understandable then how menopause can have a devastating effect on a woman’s relationships, career, and self-esteem. 

Replenishing a woman’s hormone levels can relieve most if not all menopause symptoms but many women don’t seek the treatment because they’ve been misled about the risks. Over twenty years ago the Women’s Health Initiative (WHI) study concluded women taking a combination of oral estrogen obtained from horse urine and a synthetic version of progesterone had an increased risk of breast cancer, heart attacks, strokes, and blood clots. Because of major design flaws in the study, these conclusions were later disproved, and research done since then has shown the benefits of hormone replacement.  In fact, a pooled statistical analysis of thirty clinical trials found that women who began hormone therapy before age 60 had a 39% lower risk of death than women who didn’t take hormones(1).

Benefits of balanced hormone replacement started in perimenopause or within 6 – 10 years after menopause:

  • Decreased risk of Alzheimer’s
  • Improved insulin resistance
  • Improved libido 
  • Reduced hot flashes and night sweats
  • Reduced loss of bone density
  • Improved skin thickness & elasticity
  • Better mood, concentration & memory
  • Improved sleep
  • Reduced risk of Alzheimer’s disease
  • Reduced risk of endometrial cancer
  • Reduced risk of breast cancer
  • Reduced risk of colon and gastric cancer
  • Reduced risk of heart disease
  • Improved cholesterol levels
  • Reduced incidence of hot flashes
  • Reduced risk of osteoporosis

Bioidentical Hormones

The safest most effective type of hormone replacement is done with hormones that are identical to your own, hence the term “bioidentical”. 

When a hormone delivers a message to a cell, it must bind with a receptor that is specific for that hormone. Bioidentical hormones are an exact structural match to the hormones made in your body and therefore fit their receptors perfectly. Synthetic hormones have a slightly different chemical structure which may not fit the receptor as well. Because they don’t bind to the receptor exactly like your own body’s hormones, they can produce unwanted effects. This is what makes bioidentical hormones the perfect “keys” for hormone replacement.

The most prescribed bioidentical hormones are estrogen, progesterone and testosterone and they are available with a prescription from both compounding pharmacies and retail pharmacies. Compounding pharmacies can provide custom strengths and dosage forms including hormone pellets that are inserted under the skin and last about three to four months in women.

A recent, national survey determined that 35% of U.S. women currently using hormone therapy (and 41% of U.S. women aged 40–49 who have ever used hormone therapy) are using compounded hormones(2).

Results with hormone replacement take several weeks to feel the initial benefits and up to three months before the full effects are achieved. 

There is no limit on how long you can continue bioidentical hormone therapy. According to the North American Menopause Society (NAMS) 2022 Hormone Therapy Position Statement Advisory Panel, there is no general evidence for halting hormone therapy even for women over 65. The researchers wrote that older women with persistent vasomotor symptoms like hot flashes can continue HT with appropriate counseling, a regular assessment of risks and benefits and shared decision-making with their physician.

With bioidentical hormone therapy you don’t have to suffer the symptoms of hormone deficiencies. 

About the Author:

Cynthia Elliott, MD is the owner of Skinspirations, an aesthetic and regenerative practice in Clearwater Fl. Originally board-certified in emergency medicine, she spent fifteen years practicing emergency medicine and was an Associate Professor for the University of South Florida College of Medicine. As a national trainer for aesthetic companies including Allergan, she teaches other doctors her injection techniques. Dr. Elliott has served as an expert witness in cosmetic medicine for the Florida Board of Medicine. She received her MD from the University of Illinois College of Medicine and completed her emergency medicine residency at the Denver Health Medical Center. For more information, please visit

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