BHRT – the Doctor and Lab Work

Bioidentical Hormone Replacement Therapy means your doctor prescribes hormones that are identical in molecular configuration to the hormones your body produces. Therefore they act more precisely and normally to induce the desired reactions in the cells and tissues of your body than the hormones patented as drugs.

Find a Physician Skilled in Bioidentical Hormone Replacement Therapy

First of all you must find a physician or health care provider who is very skilled in evaluating and prescribing Bioidentical Hormone Replacement Therapy (BHRT). He/she will know how to test your hormone levels and then prescribe for your specific needs. That’s the beauty of (BHRT). It’s fine tuned for your uniquely-you body.

Women’s International Pharmacy can help you find a practitioner if you want to fill out their form at this link:

http://www.womensinternational.com/request_referral.html

You may also be able to find a practitioner from the resources on my web site:

https://www.drjomd.com/resources/find-a-doctor/

The Exam and Lab work:

Your doctor will review your medical history, examine you and then order lab tests for the current levels of hormones in your body.

Still cycling

If you’re still menstruating, the doctor will have you collect lab samples at various points in your cycle. As you know estrogen and progesterone rise and fall in an orchestrated pattern throughout the month. This collection process takes longer and is a bit cumbersome but well worth the effort to get some relief from your symptoms.

I used to say that someone should put me in a box and close the lid in my premenstrual phase because I felt so bitchy. Hopefully I didn’t show it too much! If only I had known about BHRT then my misery could have been abated.

Irregular periods

If you’ve started through the change and cycles are irregular, your doctor will work with you to determine the best times for collecting your specimens for testing for hormone levels. The timing of collection of these specimens can be a bit tricky.

If you’re thinking about seeing a doctor about BHRT, start gathering some information right now that you can take to your first doctor’s appointment. On a calendar record each time you have some menstrual flow, how many days it lasted, and how heavy the flow was. You may find that your periods are not as irregular as you think, but that they have stretched to five or six or more weeks apart.

Taking your basal body temperature may also provide more information about your irregular cycle and thus help you and your doctor more quickly determine when to collect your lab specimens if you have this information in hand at your first visit to the doctor. Try to track your basal body temperature for a couple of months.

During a normal regular menstrual cycle a woman’s basal body temperature is lower in the first half of the cycle and then pops up about 1 degree at ovulation time when progesterone kicks in. Since 1 degree’s difference is so slight you have to be very carefull in how you take your temperature.

Guidelines for taking your basal body temperature:

Take your temperature the same time every day, preferably before you get out of bed in the morning.

Don’t move around eat, drink, or do anything else before you take your temperature.

Use the same orifice to take your temperature each time, under your tongue, in the rectum or vagina . It doesn’t matter which orifice you choose but it is very important to use the same one.

Same with a digital thermometer – use the same orifice each time. Some digital thermometers use the ear canal.

Record your temperature on paper immediately. Charting a graph can be helpful. Look for a “fertility chart”.

Occasionally a temperature reading may not fit the pattern – record it anyway, but don’t worry about it.

Periods have stopped

Of course specimen collection gets easy if your cycles have stopped. You usually only need to collect one specimen and then start treatment.  After a few months your doctor will run the test again. Once your hormone levels reach the optimal levels most doctors check your levels once a year at the time of your annual exam.

Finding a Good Laboratory

If your doctor is new to saliva lab testing for hormone levels, consider sharing this link with your practitioner:

http://www.labrix.com/SalivaryHormoneTesting

And review the information on this Labrix.com page to help you understand why testing saliva for hormone levels measures the free (unbound) hormone levels. Only these “free”  portions of the hormones  can effectively lock into the receptor sites on the cells to give them the important messages for proper cell functioning. Saliva testing for hormone levels is very different (and better) than blood testing and the two cannot be compared.

Be sure to read the tab “Accuracy of Labrix Testing” on the above Labrix page. It helps you understand how hormones fluctuate from minute to minute.

Hormones Fluctuate in a Symphony

Keep in mind that hormones carry messages to your cells and that the amount of each individual hormone in your blood and tissues fluctuates all the time as they help your body adjust to whatever is going on at that moment in your environment, emotions, energy level, etc. Hopefully they work together in a beautiful symphony.

But when we get “out of tune” BHRT can bring us back to a concert our family and friends will enjoy.

The sex hormones estrogen, progesterone and testosterone have an intimate interaction with the adrenal hormones. So your doctor may want to order adrenal hormone levels too as well as thyroid hormone levels.

Once your practitioner has all the information about your exam, history and lab work collected he/she can make a wise decision about how much of each different hormone to prescribe for your uniquely – you situation.

Next article: The Prescription

Blessings,

Dr. Jo