What is a bio-identical hormone?
A bio-identical hormone has the same chemical and molecular structure as the equivalent naturally occurring hormone produced in the body.
This means that bio-identical hormones fit their hormone receptor sites perfectly, so that messages are translated properly, and therefore the effects are more consistent with the normal biochemistry of the body.
Bio-identical hormones can be prescribed in a few licensed products with standardised doses, for example utrogestan (bio-identical progesterone). This is known as body-identical hormone replacement therapy to avoid confusion with bio-identical HRT.
Non-bio-identical conventional HRT includes conjungated oestrogens and synthetic progestogens, which are structurally different from the hormones produced in the body.
Bio-identical hormone replacement therapy is prescribed specifically for each patient and so is individualised. By using individual doses it is therefore unlicensed. It is prescribed often in lower doses than conventional HRT treatment and licensed bio-identical hormone therapy, and with an option of different modes of delivery (e.g transdermal cream, lozenge or capsule) that are best tolerated by the patient.
There are also bio-identical hormone treatments which are not available as a licensed medication on the NHS, for example in women testosterone can be prescribed, which can help with vaginal dryness and low libido, and also DHEA can be given to men and women.
Where appropriate, patients may be prescribed a combination of licensed and unlicensed bio-identical hormone medicine to ensure that they have the most appropriate treatment to fit their exact need.
Combined with a thorough consultation and appropriate tests, this type of treatment gives the patient the most appropriate options to their needs. Dr Hodgkinson will make you aware of all options available to you, and you will be able to make a decision about the best treatment for you.
How long has bio-identical hormone therapy been around?
It was discovered in the 1940s. Popular and widely used in the USA for many years, it is now becoming increasingly used in the UK. Bio-identical hormone therapy (BHRT) was pioneered in the UK by Dr Marion Gluck, a world leading expert in bio-identical hormone therapy with over 20 years’ specialist experience. She has successfully treated thousands of patients, and trained many medical professionals to deliver her ethos and promote the life changing effects of bio-identical hormones. Dr Hodgkinson received her training at the renowned Marion Gluck Academy.
Where do bio-identical hormones come from?
Bio-identical hormones are converted from wild yams or soya beans, and then made into micronized powder form. They are then made into transdermal form (applied onto the skin as a cream) or oral forms (taken by mouth).
Which conditions can be treated with bio-identical hormone replacement therapy?
BHRT can be used for treatment of hormonal conditions such as premenstrual syndrome, painful or heavy periods, endometriosis, post-natal depression, peri-menopause, menopause, acne, polycystic ovarian syndrome (PCOS) and most other hormonal imbalances in women, and in men for symptoms of andropause (low testosterone and DHEA).
Many symptoms can be attributed to changes in hormones, and if imbalances are found can be treated with BHRT to help restore the balance. Examples of these symptoms include anxiety and depression, headaches, low sex drive, urinary symptoms such as recurrent urinary tract infections, insomnia, lethargy and poor concentration.
Which hormones can be prescribed?
Oestrogen, progesterone, testosterone, DHEA, pregnenolone and melatonin can be prescribed.
The medicine can be administered to the skin as a cream, or orally as lozenges or capsules.
It can be applied to different areas of the body such as forearms, genitals or face e.g estradiol face cream which helps with collagen formation and hydration of the skin, so reduces the effects of ageing.
The treatment is individualised to you, offering an alternative to the ‘one size fits all’ approach of standard medication. You will be given a bespoke prescription. Treatments can be compounded by the pharmacy (where active ingredients in precise measured doses are mixed together) as prescribed by Dr Hodgkinson, to specifically treat your needs.
What are the side effects of taking bio-identical hormones?
There are no side effects if the hormones are given in doses that are appropriate to the patient needs, because you are replacing what is part of our normal physiology. However for example, if there are high levels of oestrogen this can cause breast tenderness and bleeding, and if there are high levels of progesterone this can cause tiredness and depression. To reduce these side effects, you will be started on the lowest possible dosages.
How long does it take for the medication to work?
Usually results are seen within 3-6 weeks, but often treatment can be surprisingly immediate. Most patients will see significant improvements after 6 weeks. If a hormonal imbalance is severe it can take 3-4 months to experience the desired effect.
Patients will be reviewed 6 to 8 weeks after starting treatment. If the symptoms have improved and been resolved at that point, then you will be reviewed 3 to 4 months later, and if results are still stable reviews are recommended every 6 months after that.
Sometimes adjustments to the medication are made at the review. Follow up appointments are usually made 6 to 8 weeks after any changes to medication.
Do I have to be on this treatment for life?
No, bio-identical HRT is tailored to each patient. The decision on whether to stay on or stop treatment can be made between you and Dr Hodgkinson. If you are experiencing the benefits of being on the medication and you have noticed great improvement in the quality of your life then there is no reason for you to stop the treatment.
Are there any conditions where bio-identical hormone replacement therapy is not suitable?
Dr Hodgkinson is unable to use bio-identical HRT if any of the following apply to you:
Undiagnosed abnormal vaginal bleeding
Active thromboembolic disorder or acute-phase myocardial infarction
Suspected or active breast or endometrial cancer
Active liver disease with abnormal liver function tests
Porphyria cutanea tarda
*Hormone receptor positive breast, endometrial or ovarian cancer.
*If you have a history of non-receptor positive breast, ovarian or endometrial cancer, a discussion would need to be made with your oncologist, gynaecologist or breast surgeon before being able to start any hormone treatment.
You will not be able to be started on any systemic medications if you are over 65, but it may be suitable to be prescribed localised medications such as estriol cream for vaginal symptoms.
Active testicular or prostate cancer
Poorly controlled heart failure
Untreated obstructive sleep apnoea
Patients seeking fertility or trying to conceive
Unexplained raised prostate specific antigen
Under 40 years old
Will I receive any advice on lifestyle and supplements?
A healthy lifestyle is hugely important in supporting your hormones. During the consultation Dr Hodgkinson will take a thorough history of your lifestyle including diet, sleep, emotional stress, exercise and relaxation, and will focus on these areas in advising you on how to improve your health and wellbeing.
She will also advise on any supplements to help support your hormones.
Why didn’t my doctor tell me about this treatment before?
A growing number of doctors are now using bio-identical HRT, however many doctors are not familiar with it, and hormonal imbalances may not be recognised as a form of disease. Major pharmaceutical companies market artificial hormones that they can patent and make a lot of profit from, and so the resources from these companies have enabled conventional HRT to be a standard prescription. As BHRT cannot be sold off the shelf it remains off their radar.
How much will the medication cost me?
A private prescription for the required daily hormone doses of bio-identical HRT will usually cost between £1-£3 per day. Still less than a cup of coffee!
If you are prescribed body-identical HRT you will usually be given a private prescription for up to 3 months of medication. Repeat prescriptions can be obtained from your NHS GP at the usual NHS prescription costs.
Where do I get the medication from?
BHRT is only available on private prescription. Each prescription is individually made up to your exact dosage requirements as per Dr Hodgkinson’s request. Hampshire Health and Hormones uses the Specialist Pharmacy who make and dispense the medication.
The Specialist Pharmacy is registered, regulated and complies with the standards of the General Pharmaceutical Council (GPhC). Its rigorously trained technicians work only with suppliers operating whose pharmaceutical raw materials and GMP standards are recognised by the EU, using regulatory approved manufacturing equipment and software.
If you are prescribed body-identical HRT Dr Hodgkinson can give you a private prescription for up to 3 months supply of medication. If you are happy and would like to stay on the medication, you can choose to obtain repeat prescriptions from your GP or from Hampshire Health and Hormones.