Frequently Asked Questions

My doctor says my hormone levels are “normal,” so why don’t I feel good?

”Normal” levels on lab tests are the average ranges for someone of your general age. However, normal is not the same as “optimal.” At Ellithia Healthcare our goal is to help our patients feel optimal, not just average.

What is BHRT?

BHRT stands for Bioidentical Hormone Replacement Therapy. Bioidentical hormones have the same chemical structures as the naturally occurring hormones produced in the body.

What are the benefits of BHRT?

BHRT can be helpful for symptoms of perimenopause, menopause, and andropause (also known as “male menopause”). BHRT can also offer preventive benefits related to cardiovascular disease, bone loss, mood issues, and memory.

Who needs BHRT?

Many people can benefit from the use of hormones for quality of life and wellness, including women going through peri-menopause/menopause, women with difficult menstrual cycles, men over 40 years old, and anyone having thyroid issues such as Hashimoto’s thyroiditis, hypothyroidism, etc.

What are the risks/side effects of BHRT?

BHRT is safe when guided by an expert clinician—one who is a regulated healthcare provider and prescriber (for example a Nurse Practitioner). Some people may not be able to use BHRT, for example, those living with breast or ovarian/uterine cancer and some other medical problems.

Will taking estradiol increase my risk of heart attack or breast cancer?

When prescribed for women who have been appropriately assessed by a regulated healthcare provider, estradiol can actually prevent both breast cancer and cardiovascular disease (including heart attack).

What is the difference between synthetic hormones and bioidentical hormones?

Some bioidentical hormones are derived from diosgenin, which is sourced from yams. Others are created from animal sources. Both of these are identical in structure to hormones that occur naturally in the human body. Synthetic hormones, on the other hand, have a chemical structure that may be similar to, but not exactly the same as, the hormones produced by the body. These chemical differences mean that synthetic hormones act differently in the body and can produce different effects.

How are bioidentical hormones given?

Most hormones are taken orally. since orally administered hormones are metabolized in the liver and provide effects that improve sleep, mood, and cardiovascular protection. Other hormones are applied to the skin. In the United States (and eventually in Canada), hormones can also be introduced via pellets, which are small products inserted under the skin that sidestep the need to take hormones orally.

What is the difference between synthetic hormones and bioidentical hormones?

Some bioidentical hormones are derived from diosgenin, which is sourced from yams. Others are created from animal sources. Both of these are identical in structure to hormones that occur naturally in the human body. Synthetic hormones, on the other hand, have a chemical structure that may be similar to, but not exactly the same as, the hormones produced by the body. These chemical differences mean that synthetic hormones act differently in the body and can produce different effects.

Do my health care benefits cover BHRT?

It depends on your benefit plan. Most often, the prescriptions themselves are covered through insurance. However, unless your benefit plan includes a “Health Spending Account,” the cost of your appointments will likely be out of pocket. Please contact your benefits provider for specific details.

BHRT or HRT?

Some people use the terms BHRT (Bioidentical Hormone Replacement Therapy) and HRT (Hormone Replacement Therapy) interchangeably. Others may use the term HRT to refer only to synthetic hormones. At Ellithia, you will be prescribed bioidentical hormones unless there is an indication to use something different. Every person is assessed individually to ensure the prescribed products are the ones best suited to your needs.

Can men benefit from BHRT?

Absolutely! Men generally respond to BHRT quickly and get great results specific to energy, libido, sexual performance, mood, and exercise response. At Ellithia, our focus is to ensure that your long-term health and wellness, as well as your immediate symptoms, drive your care.

What is estradiol?

Estradiol is a hormone that occurs naturally in the body but declines in concentration with age. Estradiol is essential to healthy bones, helps prevent cardiovascular disease, and also helps with energy and mood. Estradiol must be taken orally for best effect. Estradiol should NEVER be prescribed without progesterone!

What is progesterone?

Progesterone is a hormone that occurs naturally in the body but declines in concentration with age. Progesterone is essential for healthy tissue, and it protects blood vessels, the endometrial (uterine) lining, and breast tissue. Progesterone is useful for mood and sleep. It is also essential to balance estradiol. Progesterone must be taken orally for best effect.

What is testosterone?

Testosterone is a hormone that occurs naturally in the body (yes, even in a woman’s body) but declines in concentration with age. Testosterone helps to maintain lean muscle and prevent the age-related weight gain that happens even with a healthy lifestyle. Testosterone is considered the “vitality hormone,” as it gives women and men that zest for life and also supports a healthy libido.

What is thyroid?

Thyroid hormones are a group of hormones that are produced naturally in the body. With age, and sometimes as a result of other health problems, thyroid hormones become less effective. Thyroid deficiency can present as fatigue, memory problems (or “brain fog”), brittle hair and nails, constipation, sleep problems, and mood changes, to name a few. Thyroid can be replaced and optimized by synthetic hormones, but is most effectively replaced by bioidentical hormones.

What is DHEA?

DHEA is a hormone that occurs naturally in the body but declines in concentration with age. DHEA helps to maintain a healthy cholesterol level, and improve energy and mood. DHEA is also the natural oppositional hormone to cortisol (the stress hormone). If cortisol levels are high in the body, people are at higher risk of diabetes and metabolic syndrome. By increasing DHEA concentration in the body, cortisol levels can often be lowered. DHEA is also useful for treating vaginal atrophy (dryness).

What is menopause?

Menopause is defined as that time when a woman no longer has a menstrual cycle and her “egg reserve” is depleted (that is, she can no longer achieve a pregnancy). Most women will go through menopause between the ages of 45 and 55 years of age. Women also go through surgical menopause after their ovaries have been removed.

What is perimenopause?

Perimenopause is the time when a woman’s “egg reserve” begins to decrease; our bodies respond to this by altering the production of FSH (follicle-stimulating hormone), LH (luteinizing hormone), estradiol, progesterone, DHEA, and testosterone. This period is normal but often the most difficult, as hormones can be volatile and may produce significant symptoms, including heavy menses, hot flushes, night sweats, low libido, and mood changes. Perimenopause can occur between the ages of 30 and 50+.

What is andropause?

Andropause is a term used to describe the hormonal transition that men go through whereby production of testosterone decreases. This is a normal transition, but it can mean decreases in energy and/or libido, changes in sexual performance, weight gain, and mood changes.

How is Ellithia Healthcare different from other BHRT clinics?

At Ellithia, all of your appointments will be with your prescriber—a Nurse Practitioner (NP). All of our NPs have advanced degrees (Master’s or PhD degrees) and have completed extensive training in the inclusion of hormones in health care and wellness. Your care will be guided by your goals and will include a holistic review of your previous health history and current concerns. Moreover, Ellithia’s practitioners are accessible anywhere in Alberta and British Columbia, as our clinic offers virtual health care.

My physician says taking hormones is bad. Why doesn’t my family physician prescribe hormones?

Unfortunately, not all primary care providers or specialist physicians have received education about the benefits offered by hormones. Hormones are not risky for the vast majority of people. In fact, most people can benefit significantly from the use of hormones if they are prescribed by a knowledgeable regulated healthcare professional, such as a Nurse Practitioner.

This excellent paper provides an overview of the literature that has negatively impacted women’s health because of the lack of knowledge, expertise and care related to HRT for menopause: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780820/

The New England Journal of Medicine open access to the paper Hormone therapy and the profession of coronary-artery atherosclerosis in postmenopausal women (2003) offers the opportunity to understand the role that 17B estradiol can play in reducing atherosclerosis progression in women at menopause:  https://www.nejm.org/doi/10.1056/NEJMoa030830

The North American Menopause Society provides a report/summary of the KEEPS Study (Kronos Early Estrogen Prevention Study) which demonstrates the safety of estrogen and progesterone as well as its positive effects on symptoms of menopause as well as bone density: https://www.menopause.org/annual-meetings/2012-meeting/keeps-report

The New England Journal of Medicine provides open access to paper entitled Vascular effects of early versus late postmenopausal treatment with estradiol (2016).   article: https://www.nejm.org/doi/full/10.1056/NEJMoa1505241

How long will it take until BHRT starts working?

The benefits of taking hormones can be seen as quickly as within a few weeks, but this depends upon what hormones have been prescribed for you and the symptoms or concerns for which you are using the hormones. At Ellithia, we recommend you commit to taking the prescribed hormones for three months before making a decision about whether they are beneficial for you.

When do I stop taking BHRT?

Many men and women will use BHRT for the rest of their lives, as it offers benefits to the cardiovascular system, bone health, and memory. Others may choose to use hormones until they are no longer experiencing the symptoms of (peri)menopause or andropause. This is a very individual decision—and one we look forward to supporting you in making!

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