Frequently Asked Questions

What exactly is hormone replacement therapy?
It is important to understand that bioidentical hormones do not carry the risks that the older nonbioidentical hormones do. As said, they are structurally and biochemically different structures. The “WHI study” of a decade ago frightened many women.  Premarin and medroxyprogesterone were the replacement hormones used in that study and both were non-bioidentical. So that study taught us that older women over 60 have a higher incidence of cardiovascular events heart attack stroke on Premarin. The women taking the medroxyprogesterone had a higher incidence of breast cancer. Again this study did NOT USE Bioidential Hormone Therapy.

There has been so much confusion about Hormone Replacement Therapy going back a long time; but especially since the WHI study that showed an increase in cardiovascular events in women taking Hormone Replacement Therapy. Realize that in the WHI study women were older 60’s or so, and were taking Premarin, an older, non-bioidentical form of estrogen. Premarin is actually equine or horse estroge. The form of progesterone the women in the study were given was a synthetic one. Only the women given the Premarin plus the synthetic progesterone had an increase in breast cancer.In this study even the women taking taking Premarin, the nonbioidentical estrogen had no more risk of breast cancer than the general population or women not taking any hormones.

Is transdermal estrogen safer than oral even if it is bioidentical?
We now believe that if a woman is started on bioidentical estrogen within 5 to 10 years if is very good for her; it conveys protection against cardiovascular disease.  For women over 60 who have never been on Hormone Replacement Therapy there is a slight risk of coronary occlusion within the first year. Transdermal estrogen does not carry that risk but it is probably not cardioprotective either. As a highly experienced internist, risks will be carefully weighed in each patient. Each patient in Hormone Replacement Doctor will feel confident and well informed during their treatment.

What is the best way to take HRT, creams gels pills shots etc?
The method of delivery is determined by the actual hormone prescribed. Its important for the patient to be comfortable with the way he or she takes it. For example, some testosterone gels have an alcohol base and can burn. Yet,  as mentioned, maintaining therapeutic levels is key to treatment success.

Can testosterone cause sterility?
This can be a complication of testosterone however, only the injectables. Injectable testosterone can yield levels that are way too high. Testicles can shrink as can sperm count. In our practice, we feel that cream is the best form of testosterone for men.

Forever Health – Bioidentical Hormones and Wellness
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Sue Decotiis, MD | 120 E 46th St., #1201 | New York, NY 10017 | Phone: (212) 685-3640