Careful discussions regarding your reasons for wanting Bio-Identical Hormone Replacement Therapy are very important. You must also make sure that this treatment can deliver what you want. The duration of the treatment is also important. Any potential risks from hormone supplementation increase with the length of treatment. Taking the current medical advice for conventional HRT - the lowest dose for the shortest period of time – may be advisable to apply to BHRT too. There is currently limited data to confirm that long-term use of bio-identical hormones is any different, so caution may be pertinent. Your practitioner should be able to answer all these questions.
A medical history should be taken to make sure that there are no reasons why you shouldn’t undertake treatment. You will be asked to sign a consent form which means that you have understood the potential benefits and risks associated with the treatment programme and any associated tests.
Photographs (if there is an anti-ageing solution or alleviation of visible medical symptoms being sought), and possibly questionnaires to establish mood or symptom rating scores may also be taken by the practitioner for comparison later.
The initial consultation will lead to a blood, urine or saliva test and some cells may be taken from the inside of your cheek, with a swab, to check telomere length, which can be analysed to assess internal-ageing. Your DNA strands are protected by a cap called a telomere. There is a lot of research which indicates that these telomeres shorten as you get older and your DNA may then start to deteriorate. Telomere length can be used to measure your internal age. These tests may be offered as part of a general health check rather than for any specified symptoms.
The next consultation will take you through all the indicators that have been examined and measured by the tests. These may include hormone levels such as oestrogen, progesterone, testosterone as a comparison to your chronological age; thyroid and adrenal hormones; cholesterol levels; vascular health; telomere length etc. It would seem to be common sense that before embarking on any hormone replacement therapy you should begin by establishing if there is any deficiency that matches up with the symptoms that you are describing. The tests performed and the indicators measured may vary from one clinic to another so it’s important to get a thorough evaluation.
The clinician can tell you what these test results indicate and prescribe BHRT accordingly. This prescription will be individualised for your body. Hormones must be prescribed, as they are regulated as medicines, but other dietary supplements which may be recommended alongside might be available over-the-counter from a pharmacist. It is worth asking about this as it could make a huge difference to the price that you pay for the overall treatment programme.
BHRT may be taken orally, as a tablet or lozenge, or topically as a cream or patch which may be delivered through the skin or through the genital region.