Hormone replacement therapy (HRT) has been available for both men and women for many decades, evolving significantly over time. The concept behind HRT is that as humans age, hormone production naturally declines. This not only leads to uncomfortable symptoms but also increases susceptibility to age-related diseases. There are notable differences between men and women in this regard. Men’s hormonal health is largely driven by testosterone, while women have a more complex interplay of sex hormones—primarily estrogen, progesterone, and testosterone.
Early approaches to hormone replacement relied on synthetic hormones that were not bioidentical. Bioidentical hormones, by contrast, have the exact same chemical and molecular structure as the hormones naturally produced by the human body. Beyond these chemical distinctions, bioidentical and synthetic hormones can affect the body in different ways, each with its own risk profile. As mentioned, bioidentical hormones have the exact chemical structure as those produced in the body. Typically, these hormones are derived from plants, such as yams or soy. The three main hormones involved are estrogen, progesterone, and testosterone.
Synthetic hormones date back to the mid-1900s, when the pharmaceutical company, Ayerth, introduced Premarin. This drug was made by extracting estrogenic compounds—known as conjugated equine estrogens (CEE)—from the urine of pregnant mares and formulating them into a pill. Premarin proved effective in controlling menopausal symptoms such as night sweats and hot flashes. It was later combined with a synthetic form of progesterone, or progestin, called Provera. Provera (medroxyprogesterone acetate) mimics some of the effects of natural progesterone but is associated with significant side effects, including an increased risk of blood clots and breast cancer.
A lesser-known fact is that oral contraceptives—widely used by young women—also contain synthetic hormones that carry similar risks of blood clots and breast cancer. In addition, oral contraceptives suppress the ovaries’ production of testosterone, leaving many women deficient in this vital hormone from a young age.
Modern bioidentical hormone replacement therapy avoids synthetic hormones, which are associated with significant side effects and unfavorable risk profiles. Bioidentical hormones integrate seamlessly with the body’s hormone receptors, organs, and tissues, making them both safe and effective. Because they are chemically identical to the body’s own natural hormones, they do not cause unusual risks, side effects, or drug interactions.
17β-estradiol is the chemical form of the most active natural estrogen in a woman’s body. Estrone and estriol are also produced by the ovaries, but they are far less biologically active than 17β-estradiol. This hormone can be administered in a variety of ways, including oral, transdermal, transvaginal, sublingual, or injectable forms. Estradiol offers significant benefits for women’s health, protecting the brain, bones, and cardiovascular system. However, without proper balance with progesterone, estradiol can also cause side effects. While it effectively relieves hot flashes and night sweats, it may stimulate growth of the uterine lining, leading to cramping, bleeding, and bloating. It can also contribute to mood swings and water retention when not balanced with optimal progesterone levels. Progesterone not only enhances estradiol’s positive long-term health effects but also mitigates its potential side effects. Achieving this delicate hormonal balance requires expertise, precision, and experience—qualities that set the providers at Spartan Medical Associates in Charlotte North Carolina apart from other practices.
Testosterone is an important hormone for both men and women. Humans are testosterone driven creatures as this hormone is responsible for driving lean body mass, muscle mass, sexual function, libido, energy and cognition. You may be surprised to know that women have more testosterone in their body than estradiol. Testosterone can be administered in a variety of forms including oral, transdermal, sublingual and injection. Both men and women need optimal testosterone levels as they age to stave off disease and improve quality of life.
One of the core principles at Spartan Medical Associates is the understanding that both women and men need optimal levels of hormones for long-term health. In women, the hormone deficiencies of menopause contribute to numerous chronic health problems, increasing the risk of osteoporosis, cardiovascular disease, dementia, heart attack, stroke, obesity, and diabetes. Similarly, men with low testosterone face a higher risk of cardiovascular disease, heart attack, stroke, osteoporosis, sarcopenia, low muscle mass, frailty, and bone fractures. While bioidentical hormone replacement therapy (BHRT) is highly effective at relieving symptoms and improving quality of life in both men and women, the primary reason for pursuing this therapy is the long-term health benefits. Preventing and minimizing the damaging effects of hormone deficiency as we age is central to our approach—and we will show you the supporting data.
At Spartan Medical Associates in Charlotte, North Carolina, we avoid synthetic hormones whenever possible, using bioidentical hormones for their favorable safety profile and positive effects. We tailor therapy to each person’s overall health and risk profile, focusing on improving quality of life, reducing symptoms, and achieving long-term health outcomes.
We assess more than just hormones, taking a deep dive into your metabolic health by evaluating inflammatory markers, vitamin levels, insulin resistance, and cardiovascular risk. Our approach combines hormone replacement therapy with nutrition, exercise, and optimization of biomarkers such as vitamins and inflammation markers. This comprehensive strategy is the foundation of healthy aging and effective disease prevention.
