FREQUENTLY ASKED QUESTIONS
Bioidentical hormones are derived from a plant source. A substance called a “sterol” is extracted from a plant, usually soy or yam, and changed in the lab to estradiol , progesterone, and sometimes testosterone. These hormones are chemically identical to the hormones we produce in our bodies.
Very few studies have been done comparing bioidentical hormones with synthetic, however, one recent study suggests that the bioidentical progesterone (used with estrogen) may be safer for the breast than the synthetic. I prefer the bioidentical hormones for a few reasons. First, I can prescribe the amount I think a client needs to relieve symptoms and keep the dose as low as possible. In the past this has not been possible with synthetics. It was a “one size fits all” dosing philosophy. Another reason I prefer the bioidenticals is because they can be measured in blood (or saliva). When I prescribe bioidenticals hormones I like to occasionally check hormone levels to make sure the person is not taking too much. In the past twelve years of prescribing the bioidenticals I have observed minimal negative side effects. Women (and men) feel better.
Bioidentical hormones are available from compounding pharmacies that make the exact prescription that your doctor recommends; it is a “customized” product just for you. There are a few bioidentical products available from regular pharmacies. Examples are Vivelle Dot patch, estradiol tablets, and Prometrium (the only bioidentical “progesterone” available).
The controversy around bioidentical hormones made by the compounding pharmacists is that the final “customized” product is not FDA regulated.
How could it be? Those bought from a regular pharmacy, i.e., Vivelle Dot patch are FDA regulated.
So, it is important to find a reputable compounding pharmacist. Physicians who use compounding pharmacists know who they are.
Women feel better when using bioidentical hormones and repeat blood levels show improvement as well.
Menopause is a time in a women’s life that marks the end of her reproductive life. It formally begins one year after the last menstrual period.This usually occurs in the early 50’s but can occur sooner. Hot flashes, memory loss, fatigue, sleep disturbance, weight gain, mood swings, dryness, reduced sex drive, increased heart disease risk, and bone loss coincide with the rapid loss of estrogen production in the ovaries. About five percent of women do not have noticeable symptoms and experience an easy transition; however, most women have some symptoms that can last years. Over the life of a woman estrogen is a key factor in the vitality of many organs and rapid loss of this important hormone just prior to and during menopause is an issue that needs to be addressed.
First, read the question on “what are compounded bioidentical hormones” to familiarize yourself with what they are. The pellet therapy uses bioidentical hormone, usually estradiol and/or testosterone, prepared in a small tablet the size of a grain of rice. This pellet is then surgically implanted in the fat pad to the rear of your hip. The procedure is simple and requires a small incision which usually does not require stitching. As in any surgical procedure side effects can be bleeding, bruising, tenderness, and infection at the incision site. These side effects are rare when the sterile technique is used. The hormone is released over time into the blood stream. Hormone blood testing is done prior to the procedure and at time periods after the procedure. Pellets usually last 3-6 months. A person with a fast metabolism will deplete the hormone sooner. Pellet therapy is effective for only a small “select” group of patients. It is not for everyone. In fact, only 5% of my hormone patients are using the pellets. I recommend an initial trial of daily, topical, bioidentical hormone therapy in the form of creams, drops, or lozenges. Daily application keeps levels more consistent. If daily dosing does not relieve symptoms I then recommend the pellets. Pellets release hormones such that the level in the blood “peaks” and then “troughs.” This means that the level starts low, gets high, then tapers down again over time. Estradiol and testosterone peak (and trough) at different rates. Testosterone wears off much faster than estrogen.
Patients enjoy the convenience of pellets. Insurance does not cover pellet therapy. Pellets surgically implanted are not easily removed. Testosterone can help energy and sex drive but could also cause hair loss, anxiety, and interrupted sleep. The estrogen in the pellets can improve mood, increase vaginal moisture, improve sleep, and diminish hot flashes. Too much estrogen causes breast tenderness, weight gain, headaches, and vaginal bleeding. Bleeding can occur in women who still have a uterus.
Office hours vary. Call the office at 480-488-0575. The Office Manager is generally in the office from 8:00 am – 4:00 pm Monday through Thursday. (an hour off for lunch)
Questions can be sent to Dr. Ingalls through your portal. Expect a 24-48 hour response (usually sooner). You can also call the office. If responses are complex you will be asked to make an appointment.
No, patients can use the portal to communicate.
For any billing questions call Kim at KD’s Billing Service at 928-302-3430.