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What is “Natural” hormone replacement?

Bio-identical Hormone Therapy, or BHRT, is the process of restoring and maintaining hormone balance with hormones that are biologically identical to the hormones produced by the human body.

What are Bio-identical Hormones?

Bio-identical hormones are custom created by specialized compounding pharmacies and have the same chemical structures of human body hormones.  They are not prescribed in a “one size fits all” approach and instead are prescribed for the unique needs of each patient.

How are they different than synthetic hormones?

The synthetic hormones such as Premarin, Provera, progestins and birth control pills are made using a mix of plant and animal based compounds which have some overlap with your naturally occurring hormones but differ in significant ways.  The “pro” part of the Provera for instance is a progestin which sounds very similar to progesterone, however, the effects are very different.  Like progesterone, progestins help to regulate uterine tissue.  However, unlike real progesterone, there are no receptors for progestins in your brain to help you sleep, calm your nerves, or in your breasts to decrease your risk of breast cancer. Many of the side effects of progestins in fact, are because the progesterone so necessary for your metabolic functions is actually being blocked by the progestin.  Yet, many people in the healthcare community think of and use these products as though they were interchangeable, when in fact, there are marked differences at the core level of physiologic function. Often, progestin use is associated with adverse effects including increase risks for cancer, blood clots, stroke and coronary disease not associated with proper balanced transdermal bio-identical hormone use.

Why is this difference important?
Hormones are the messengers of the body.  They act much like a lock and key mechanism. The receptor organ is like the “lock” that the hormone must fit into. The “key” is the hormone. When the hormone fits perfectly into the receptor, it sends a recognizable message to the body and the effect of the hormone is translated correctly to the tissue.  When synthetic hormones are used, they partially fit in the receptor but are not a perfect fit.  This results in confusing messages to the body.  If you have used synthetic hormones before, you may have felt partial relief of certain symptoms, or you may have not felt well at all on synthetic hormones.  This is not usually a reflection of how you will feel on a well-balanced bio-identical hormone regimen.

How are your levels determined?

Levels are checked using saliva testing, blood testing or occasionally urine testing depending on your individual needs.
Dr. Dam uses only the most advanced specialty labs to provide these services.  These results are then combined with a thorough review of your symptoms, medical history, lifestyle, diet and sleep and exercise habits in order to outline and prescribe an individualized balanced hormone regimen tailored to each patient's unique needs. Various routes of hormone delivery are available – transdermal (though the skin) -  ( creams, gels or patches), injectable, or pellets (implanted through a minor office procedure).  Additionally, some hormones may best be prescribed orally at times.  Using bio-identical hormones in a balanced regimen with the correct route of delivery insures that you receive the optimum response possible while minimizing the risks that the synthetic hormones are associated with.  Also, there may be variations with regard to cycling or non- cycling women’s hormones depending on the individual.

Bio-identical Hormone Therapy and Bio-identical Hormones

Bio-identical hormones are key components to your overall health.   How are they different than standard hormone therapy?

Are Bio-identical hormones for you?


When we are young, most of us have the abundance of hormones we need to keep our bodies functioning well and at peak performance.  However, as we get older, these levels decline and we begin to see the signs and symptoms of aging.  For most women, we understand the strong relationship of hormones to our well-being.  The decline that begins in the years before menopause  (peri-menopause) comes on slowly and includes irritability and mood swings, sleeping interruptions, anxiety, brain fog and just generally not feeling “like you”. This can begin at any time in a woman's life, though it often continues on for about 10 years before actual menopause is reached.   The sharp decline that marks menopause (when our period stops) for most of us is inevitable if not treated  and  usually marks  even worse irritability,  anxiety, feelings of  warmth all of the time, marked memory loss, decreased energy, poor sleeping, weight gain and general lack of sexual interest with your partner.   Left untreated, your life and your health declines dramatically.  Worse than that, your core health and physiologic function decline as well. Bone strength, muscle mass and stamina, brain function, skin turgor (wrinkles)  and cardiovascular health all decrease dramatically in response to lack of the hormonal messengers necessary to assure these functions are at optimal levels. By replacing the hormones that your body would make if it could, your symptoms can be minimized and more importantly, your core health functions can be kept operational through the latter half of your life when the “slow slide” downhill would otherwise be inevitable.

To get started, usually simple saliva or blood tests are checked to see the current levels in your body and if any imbalances exist.  The process of replacement is indeed just that – a process.  Your body did not get where it is overnight, and there will certainly be an adjustment period to reintroducing the hormones.  At times, many of the symptoms are remarkably improved in a few weeks, though often several months are needed for more optimum results.


Hormones are as important for men as they are for women, and only recently are they beginning to be talked about in most circles. Compared with women, men's sexual hormones are relatively steady throughout one's lifetime.  However, every year after the age of 40 or so, a man may loose on average 1-2% of his testosterone. At first, the symptoms of loss may be very subtle.  Am I not quite as sharp as I once was?  Is my energy less because I am getting   older or depressed?  Why don't I have the zest for life that I used to?  Why is my middle expanding?  Symptoms of declining testosterone may  include weaker muscle and less stamina, the inability to make muscle like you used to with exercise, joint pain, low energy,  irritability, depression, sleeping difficulties, less joy in your life, and of course less sexual interest and weaker performance. Weight gain and changes of body composition such as more fat and less muscle are often seen as well.

What is “Low T”?
Testosterone levels can easily be measured by blood, saliva or urine.  However, the levels of optimum testosterone for each man are really dependent on what his levels were when he was younger.   The range for “normal” testosterone levels is large and it is really the change from your baseline that is felt in the way of symptoms.  Other factors such as estradiol levels also play a role in symptoms as well.

Testosterone replacement for Low T is usually fairly easily accomplished and is quickly appreciated.  Methods of replacement include using creams or gels, injectable testosterone or pellets which are inserted in the office every 4-5 months and just dissolve slowly giving your body the needed levels of testosterone.  For men, testosterone is your “LIFE FORCE” and most men clearly feel more like themselves again with adequate replacement.  A simple blood or saliva test and evaluation is all that is usually needed to make the diagnosis and get you started on your way back to living the life you always wanted.

A great informational book on men’s hormones is “The Testosterone Syndrome” by Eugene Shippen, MD.  Very readable and short, and illuminates the health benefits to the brain, heart, prostate and rest of the body.

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