Specializing in Women's Wellness   

Hormone Therapy

B-HRT Therapy

Bio-identical hormone replacement therapy is not an easy or cookie cutter area of care. I am constantly reminded how different every woman is, as evidenced by the need to streamline her care and hormone requirements to her specific symptoms and physiology. While this area of women's health is challenging, it is rewarding to me as a healthcare provider to offer women some insight, choices, and relief during the transitional phases of perimenopause and menopause.

While the structure of synthetic hormones differs from those produced in the human body, the term “bio-identical” denotes hormones that are chemically synthesized to be identical to the natural hormones of the body: estrone, estradiol, estriol, progesterone, testosterone, cortisol, and DHEA, to name just a few. While the amount of these hormones which our bodies produce or obtain from outside sources is an essential piece of information, it is also imperative that these hormones function “in balance”. Many of the annoying symptoms of menopause and perimenopause occur because of the imbalance that exists during these phases of a woman’s life. With the use of supplemental doses of bio-identical hormones, individualized to the specific needs of each individual patient, these transitional times in a woman’s life can be changed forever from a time of dread and discomfort to a time of good health and youthful exuberance.


Pregnenolone, made from cholesterol, is the intermediary compound from which DHEA, progesterone, estrogens, cortisol, and testosterone are created. In other words, pregnenolone gives the gland involved in the production of a specific hormone, the building blocks it needs. Pregnenolone improves memory, increases brain cell activity, may relieve the symptoms of rheumatoid arthritis, and facilitates learning.

Estrogen actually refers to an entire class of hormones. They include Estrone (E1), Estradiol (E2), and Estriol (E3).

Estrone, widespread throughout the body, converts to estradiol in the peripheral tissues and back again to estrone. The ability to make estrogens in the skin, muscle and fat cells explains the increase of breast and endometrial cancer in heavier women.

Estradiol, formed from developing ovarian follicles, is the primary sex hormone of childbearing women. It is responsible for female characteristics and normal sexual function. It is important to women’s heart and bone health as well as optimal brain function.

Estriol, converted from estradiol and estrone by the body, is considered the weakest estrogen. Also made by the placenta, this rise in estriol during pregnancy, which never returns to pre-pregnant levels, is felt to offer some protection against breast cancer.

Progesterone is produced as ovulation occurs and the egg is released from the ovary. A small amount is made by the adrenal glands. If ovulation is diminished, it is easy to understand why estrogen dominance becomes so common. Progesterone balances estrogen, thus decreasing the risk of endometrial and breast cancer. It has a sedative effect and, therefore, is a natural calmer; it helps the thyroid to function more efficiently, decreases insulin resistance, is a natural diuretic, and helps to build bone.

Testosterone is made mostly in the peripheral tissues with a small amount being made by the ovaries and adrenal glands. It increases libido and arousal, inhibits fat accumulation while building muscle, facilitates sleep, adds to a sense of well-being and vitality and helps build stronger bone.

Cortisol, the stress hormone, is secreted by the adrenal glands. It helps us deal with stress from every possible source, ranging from injury and disease to work and relationship problems. Cortisol causes an increase in metabolism with a resultant rise in blood pressure, blood sugar, heart rate, and energy level. It responds in a circadian rhythm pattern thus allowing us to adapt to stress.

DHEA is the most abundant hormone made by the adrenal glands and works in a close relationship with cortisol. It is well known that chronic stress leads to an increase in cortisol levels and over time may result in a gradual depletion of DHEA. DHEA tames stress, fights cancer, enhances libido, restores memory, rejuvenates the immune system and reduces body fat. It is vital in women of all ages as a major source of testosterone and estrogen production.

Melatonin, secreted by the pineal body in the brain, plays a dominant role in our wake/sleep cycles. Known as the “hormone of darkness” because it is secreted in higher levels in the dark hours, its levels vary in a daily cycle corresponding to the circadian rhythm. Another role of melatonin is as a pervasive antioxidant.



Saliva hormone testing measures the amounts of various hormones in your saliva instead of in your blood or urine. Saliva hormone levels are more indicative of the amount of hormone inside the cells where hormone reactions take place. Saliva testing is simple, reliable, and more cost effective than blood tests.