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Bioidentical Hormone Replacement Therapy (BHRT) For Menopause

Navigating the challenges of menopause can be a real rollercoaster, with hot flashes, brain fog, and sleep disturbances often taking your life off balance. If you've found yourself seeking relief, you've likely stumbled upon Bio-identical hormone replacement therapy in your quest for a solution.

In recent years, these medicines have gained attention for being a more balanced alternative to non-bioidentical hormone replacement therapies. Our clinical experience shows this form of treatment offers promises of not only easing menopausal symptoms but also slowing down the aging process

But what exactly are bioidentical hormones, and do they live up to the hype? Join us as we delve into the details of bioidentical hormone therapy for menopause to uncover the facts and their potential benefits.

What are Bio-identical Hormones?

Bio-identical hormones, though not an official term, are commonly used to describe hormones that are the same molecules as the ones naturally produced by your body. Despite being touted as more natural, it's important to note that these hormones, as are conventional prescription hormones, are synthesized in a laboratory setting. 

They are typically derived from a plant steroid called diosgenin, sourced from soy or wild yams; the process involves a chemical conversion in the lab. 

While consuming soy or wild yams won't yield the same benefits, the resulting hormones closely mimic the ones your body produces, both in appearance and effects. They are assayed and purified so that exact dosages can be prescribed. There is an art as well as science in the collaboration between Dr. Collins and the world-class compounding pharmacists on our team.

Compounded Bio-identical hormones

Compounded Bio-identical hormones, often the core of Bio-identical hormone replacement therapy, are specifically tailored for individuals by compounding pharmacies. These hormones can take various forms, such as vaginal suppositories, oral capsules, or topical creams, providing flexibility in usage. The unique aspect lies in their customization—both in strength and ingredients—to address individual needs effectively. If you're considering Bio-identical hormonal replacement therapy, understanding the personalized nature of compounded options is critical to finding the right fit for your health journey.

Examples of compounded Bio-identical hormones include:

  • Estrogens (estriol, estradiol, and estrone)

  • Progesterone

  • Testosterone

  • Dehydroepiandrosterone (DHEA)

Compounded hormone products can consist of one hormone or a mix of several. For instance, Dr. Collins may blend different types of estrogen with Bio-identical progesterone. 

These compounded Bio-identical hormones are an option when using a commercially produced medicine that does not fit the patient. Sometimes, this is due to allergies, heightened risk of the unbalanced prescription, or simply lack of relief from previously prescribed medicines.

Dr.Collins uses custom blood tests to pinpoint how he creates his custom Bio-Identical Hormone formulas as well as the best delivery system. At times, the commercially available product is chosen, or Dr. Collins can work with other professionals and supplement what they can not get for an otherwise working relationship.  Not every doctor is free to or has the knowledge of or access to Bio-identical Hormones.

Two main types of hormones are used in hormone replacement therapies: Bio-identical and proprietary commercially available non Bio-identical hormones. 

Premarin, for example, has been around for a while but is derived from pregnant horse urine. In 2002, when the Women's Health Initiative revealed potential risks like increased breast cancer and heart disease in postmenopausal women, they were using this form of hormone.

On the other hand, Bio-identical hormones have not been used in large clinical trials in the U.S. since they do not have a large pharmacy sponsor as an advocate who stands to benefit from their success. In other words, they are not going to be promoted if the large expense for clinical trials can not result in exclusive market share.

Choosing between Bio-identical hormones, whether custom compounded from generic nonproprietary or offered by a large Pharmaceutical company, is not a problem.

The bioidentical molecule is better than whoever makes it.  The real difference is taking a thorough health history, listening to the needs of the patient, requesting custom laboratory testing, and then blending the best possible protocol for each patient using all the forms of medicines at Dr. Collins's disposal. That is not the experience of most women seeking help with their hormonal transitions in traditional gynecology or primary care.

Hormone replacement therapy requires careful consideration and consultation with an expert like Dr. Collins. Understanding their options can empower individuals to make informed decisions about their health.

Bioidentical hormones and Menopause

Bioidentical hormones and Menopause

As individuals age, hormonal fluctuations become more pronounced, particularly during Menopause in women. Declining levels of estrogen and progesterone in women can lead to a variety of symptoms. Women may experience symptoms such as hot flashes, sleeping problems, and vaginal dryness.

Hormones, including bioidentical hormones, replace these in your body to help provide relief. This is referred to as hormone replacement therapy (HRT). Sometimes, the term "BHRT" is used when specifically talking about bioidentical hormones. 

Bioidentical hormones are used to treat several menopause symptoms, including.

  • Hot flashes

  • Brain fog

  • Sleeping problems

  • Irritability

  • Vaginal dryness

  • Pain during sex

  • Bladder problems

Some hormone products are also used to help prevent certain medical conditions influenced by hormone levels, like osteoporosis. 

Dr. Collins will recommend the best option depending on your specific menopause symptoms. For example, vaginal estradiol may work best if you're experiencing vaginal symptoms. 

What are Bio-identical hormones used for?

Dr Collins For Menopause Treatment

As women age, sex hormone levels decrease in very individual ways. In fact, Dr.Collins says, “Your Hormones are not low because you are aging, You are aging because you have decreasing Hormones”. So, there is a great deal we can do to change the trajectory of aging and all the symptoms that come with it.

Dr.Colllins tailors the treatment based on individual menopause symptoms, using specific hormones like vaginal estradiol for vaginal symptoms or testosterone for issues like low libido. 

We can address menopause symptoms like hot flashes, sleep disturbances, and mood swings, most commonly using Bio-identical progesterone and estrogen replacement to bring rapid relief.  Bio-identical hormone therapy in menopause aims to address these symptoms and provide relief by adding back in just the right blend to bring our patients up to a high normal level relative to their age group. 

Bio-identical hormones, often referred to as BHRT, are specifically used for menopausal symptoms like hot flashes, brain fog, irritability, and more. They are even employed in preventing conditions like osteoporosis (Bone Loss), which is most directly related to failing hormonal influence.

It's essential to note that Bio-identical hormones aren't exclusive to treating women; they are also utilized in men to combat symptoms associated with declining testosterone levels, such as hair loss, erectile dysfunction, and mood changes. Weighing these options can help you make informed decisions about hormone replacement therapy.

Side effects of Bio-identical hormone replacement therapy

Side effects of Bio-identical hormone replacement therapy For Menopause

All hormones are powerful. After a thorough medical history and screening gynecological internal exam, baseline digital mammogram, and PAP smear, they should be prescribed with the confidence of an expert physician working with specialty pharmacists. Dr.Collins requires his patients to perform laboratory tests every six to eight months to ensure the balance and safety of the protocol.

Like any medication, bioidentical hormones can have side effects. Some common side effects of Bio-identical hormonal therapy in menopause include bloating, headaches, acne, breast tenderness, swelling of hands, lower legs, or feet, slight weight gain, and gastrointestinal issues such as diarrhea or vomiting. While many of these side effects may lessen over time or not appear at all, menopausal replacement therapy will always require monitoring, especially if non-bio-identical hormones and unbalanced protocols are used. 

These risks depend on factors such as the specific hormone regimen, how it is administered, the duration of treatment, other prescription medications, diet, lifestyle, social environmental exposure, and past medical history.

Dr.Collins benefits from close communication with his patients so that we can make changes before problems occur.

It is the responsibility of the patient to participate in their outcome by learning potential symptoms that may require adjustments in their protocol.

It's essential to be aware of some severe side effects of certain medications. These may include heart attacks, strokes, blood clots in the lungs and legs, and risks like breast cancer and uterine cancer. You must know these potential risks and side effects and consult with Dr.Collins about any concerns you may have.

Understanding these potential complications of hormonal therapy in menopause is crucial for making informed decisions about Bio-identical hormone therapy and menopause. Always prioritize your well-being and stay informed about the possible effects of any medication you may be taking.

Are Bio-identical hormones safe? 


The Women's Health Initiative (WHI) shocked the world by emphasizing severe risks associated with Hormone Replacement Therapy (HRT). However, ongoing research has provided more nuanced insights into HRT's benefits and risks. Today, experts recommend FDA-approved HRT ( commercial products, 99% of which are not Bio-identical) for most healthy women within ten years of menopause (up to age 59) to alleviate symptoms. To mitigate risks, strategies such as using the lowest effective dosage for the shortest duration and opting for local vaginal estradiol only are advised. 

Dr. Collins will evaluate your situation to determine if Bio-identical hormonal replacement therapy is suitable for you.

It's important to note that compounded hormones, although medically legal and enjoying a great clinical track record of safety, are individualized for every patient and as such, are not the standard of care for most insurance-covered gynecologic and geriatric care.

FDA tests have revealed significant variations in hormone strengths among compounded products.

Quality varies between pharmacies, which could impact effectiveness and side effects.

Dr. Collins prides himself in hand selecting a team of pharmacists who are experts in this field. It brings confidence to the medicine he prescribes.    

How much does bioidentical hormone replacement therapy cost?

The cost of Bio-identical hormone replacement therapy varies based on your specific treatment plan. Sometimes, Bio-identical commercially available hormones are the most affordable. 

Dr. Collins can also prescribe those if it is the best choice for the patient. Brand-name-only products might come with a higher price tag.

Individually compound bio-identical hormones, customized for individuals, can have even more diverse costs as prices differ between pharmacies, and factors such as the number of hormones and form of administration can change the costs.

Your health Insurance may not cover compounded medications, meaning you may need to cover the cost out of pocket. Understanding these cost factors is crucial when considering Bio-identical hormone replacement therapies.


While the term "Bio-identical" lacks an official designation, it commonly refers to those hormone molecules naturally found in the human body. This classification can be found in commercially available as well as custom-made medicines.   

If you're considering Bio-Identical Hormone Replacement Therapy (HRT) for Menopause, you can engage in a thorough discussion with Dr. Collins at Proactive Choice. He can guide you in selecting the most suitable option based on your health needs and preferences. Taking this proactive step ensures that you will make informed decisions about your hormone therapy journey. Call today (858) 333-5196 and get started on the new you!

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About The Author: Dr. Collins

Author: Dr. Collins

Dr. Collins is a Pacific Northwest native and University of Oregon graduate in biology and comparative religions, practicing Naturopathic Medicine. Committed to harmonizing ancient traditions with modern science, he prioritizes holistic patient care in Oregon.



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