Bioidentical Hormone Replacement Therapy

Frequently Asked Questions

Who should consider hormone replacement therapy?

Bioidentical hormone replacement therapy (BHRT) is a treatment that can be beneficial for every woman who is experiencing perimenopausal symptoms or who is in menopause. These symptoms can include night sweats, hot flashes, and mood changes, all of which can significantly affect a woman’s quality of life. BHRT can help alleviate these symptoms, providing relief and allowing women to maintain their daily routines and activities.
Moreover, BHRT offers numerous health benefits beyond symptom relief. Research has suggested that BHRT may reduce the risk of cardiovascular disease, osteoporosis, and cancer. In her book, A New Prescription for Women’s Health, Bernadine Healy, a renowned cardiologist and former director of the National Institutes of Health, emphasized the potential of BHRT in reducing the risks women face as they age. Heart disease, stroke, osteoporosis, and Alzheimer’s disease are common concerns for women, and BHRT has the potential to address and minimize these risks.
Considering these potential benefits, it can be concluded that BHRT is a smart option for women who desire to live a healthy and vibrant life. By managing perimenopausal symptoms and reducing risks associated with aging, BHRT empowers women to navigate this phase of life with confidence and improved well-being. It is essential for women to consult with their healthcare providers and discuss the potential benefits and risks of BHRT to determine if it is an appropriate treatment option for them.

What kinds of hormones do you prescribe?

By using a holistic approach, I can prescribe bioidentical progesterone, estradiol, and testosterone to offer numerous benefits for patients like you seeking hormone replacement therapy (HRT). This approach focuses on treating the body as a whole, acknowledging the interconnectedness of various bodily systems and aiming to optimize overall wellness.

One of the key advantages of utilizing bioidentical hormones is that they are structurally identical to the hormones naturally produced in the body. This similarity allows for better integration with the body’s existing hormone receptors and may result in fewer side effects compared to synthetic hormone alternatives. Bioidentical hormones are derived from plant sources and undergo a process that replicates the molecular structure of your hormones, making them safer and more effective for hormone replacement.
Additionally, offering the option of static dosing or rhythmic dosing allows for tailored treatment plans to suit your individual needs. Static dosing involves a consistent dose of hormones, which can be convenient if you prefer a predictable regimen. On the other hand, rhythmic dosing mimics the natural hormonal fluctuations throughout your menstrual cycle and can provide additional benefits like improved mood, libido, and energy levels. This dynamic dosing approach acknowledges the cyclical nature of hormone production in the body and may offer a more personalized and effective therapy option for you.
The availability of different types of bioidentical hormone replacement therapy, such as the Wiley Protocol ©, further adds to the flexibility and customization of my treatment options. This specific protocol encompasses a rhythmic dosing method that imitates the cyclical nature of hormones in premenopausal women. It aims to provide you with hormone levels that replicate those of a younger, fertile woman.
Overall, the holistic approach combined with the prescription of bioidentical progesterone, estradiol, and testosterone offers you a more natural and personalized solution for your hormone imbalances. By considering tje individual needs, mimicking your natural hormone cycles, and utilizing bioidentical hormones, you can experience improved symptom relief, enhanced well-being, and a heightened sense of overall health.

Do you just address hormone imbalance?
 What other kinds of health issues do you address?

I look at total body and mind functioning.  For example, for every woman I see, I always draw labs looking at adrenal, liver and thyroid function as well as sex hormones.  Depending on symptoms, we may also do food sensitivity testing, a stool test or an organic acids test.  If there are potentially genetic polymorphisms, I may also recommend genetic testing through 23 and me.  I will prescribe thyroid medications if needed.  And of course, I look at lifestyle issues which may be impacting well-being such as diet, stress and emotional issues.

What are the risks and benefits of hormone replacement therapy?

Bioidentical hormone replacement therapy (BHRT) offers both risks and benefits for individuals seeking hormonal balance. On the positive side, BHRT can effectively alleviate symptoms of hormone imbalance such as hot flashes, fatigue, and mood swings. By using hormones that are chemically identical to those naturally produced by the body, BHRT tends to have fewer side effects compared to traditional hormone replacement therapy (HRT). It also allows for personalized dosing, where an expert hormone specialist, like myself, can tailor treatment plans to address each patient’s specific needs. Moreover, BHRT has shown promising results in reducing the risk of osteoporosis and heart diseases in postmenopausal women.
However, like any medical treatment, BHRT does come with some risks. Possible side effects can include breast tenderness, bloating, and irritability, especially during the initial adjustment period. Additionally, the long-term effects of BHRT are still being studied, making it important for me to closely follow up on my patients throughout the treatment process. Nevertheless, as a hormone specialist, I am dedicated to providing the best care-ensuring that all my clients are in good hands. I guide each client through the treatment, monitor their progress, and address any concerns or complications that may arise, maximizing the benefits and minimizing the risks associated with BHRT. Check out my personalized services.

How does hormone replacement therapy help slow the aging process?

It may reduce cardiovascular disease (CVD)
Did you know that cardiovascular disease (CVD) is the leading cause of death in women? This fact often goes unnoticed as breast cancer tends to receive more media attention. According to the American Heart Association, CVD claims the lives of as many women each year as cancer, chronic lower respiratory disease, and diabetes combined.
Studies indicate that hypertension is more prevalent in men than women up until the age of 55, at which point this trend reverses. Interestingly, menopause, which typically occurs around age 50, is associated with an increased risk of CVD.
The theory behind hormone replacement therapy (HRT) suggests that it may reduce the risk of cardiovascular disease due to the protective influence of estrogen on the heart and blood vessels. Estrogen receptors in the heart are downregulated during menopause, leading to increased inflammation and cell death. Moreover, estrogen supports blood vessel health and can prevent the slowing down of metabolism that contributes to visceral fat, inflammation, and heart disease.
While the American Heart Association does not specifically recommend HRT for cardiovascular benefits, the current research on this topic is inconclusive and perplexing. Many of the studies showing uncertain benefits are based on the use of FDA-approved treatments utilizing synthetic estrogen and progestin, which differ from the estrogens identical to our natural hormones. A single-center study presented at the American College of Cardiology in 2017, comprising 4,200 women, found that those who used hormone replacement therapy to alleviate menopausal symptoms had a lower risk of mortality and exhibited lower levels of atherosclerosis, or plaque buildup in the heart’s arteries, compared to non-users. Another study involving 5,000 women at Queen Mary University of London also demonstrated a lower risk of heart failure after menopause among HRT users.
It may reduce the risk of cancer
 To gain a comprehensive understanding of the association between Hormone Replacement Therapy (HRT) and cancer, it is crucial to delve into its historical context. The 2002 Women’s Health Initiative (WHI) study played a significant role in curtailing the use of HRT, attributing an increased incidence of breast cancer to the utilization of Premarin and Provera. However, it is worth noting that this outcome was not statistically significant, as highlighted by subsequent updates to the same cohort in 2006. Bluming and Tavris (2018), authors of the book Estrogen Matters, shed light on the fact that while the authors of the initial study observed a slight elevation in risk by manipulating their data, this practice is deemed unacceptable. Nevertheless, the cumulative risk remains statistically insignificant. It is also imperative to acknowledge that these investigations exclusively employed Premarin (derived from mare’s urine) and Progestin (synthetic progesterone), failing to mirror the composition of bioidentical hormone replacement therapy – the same hormones naturally produced by the human body, which I recommend in my practice.
Furthermore, a study conducted by Fournier in 2005 revealed a 10% reduction in breast cancer risk among a sizable cohort of women utilizing bioidentical estrogen and progesterone. Interestingly, the same study indicated an elevated risk of breast cancer associated with the use of progestins (synthetic progesterone). This finding underscores the potential role of progestin in breast cancer risk, while substantiating the safety of bioidentical hormones. 
It may reduce bone loss
I would like to bring to your attention the well-documented correlation between menopause and bone loss. It is worth noting that the majority of cases involving hip fractures, osteopenia, and osteoporosis occur after menopause. In fact, women tend to lose about two-thirds of their bone density after reaching this stage, with the most significant loss occurring within the first three years.
To maintain healthy bone density, it is crucial for estrogen and progesterone to work synergistically. Estrogen plays a vital role in fortifying bones by stimulating the production of osteoblasts, which contribute to bone formation. On the other hand, progesterone aids in bone reabsorption. After menopause, the levels of estrogen and progesterone decrease significantly, as ovulation ceases to take place, which is the primary mechanism responsible for generating substantial amounts of these hormones.
Given these findings, it strongly suggests that bioidentical hormone replacement therapy could be an effective approach in preventing bone loss, especially if initiated in close proximity to the onset of menopause.

What is functional medicine?

Functional medicine is an innovative approach to disease that adopts a comprehensive biologic systems perspective, taking into account all aspects of the body such as systems, lifestyle, lab work, symptoms, and medical history. Through this holistic lens, the underlying cause of disease is thoroughly examined and addressed, ultimately restoring the body and mind to a state of equilibrium known as homeostasis. As a result of treating the root cause, the initial symptoms dissipate.
In contrast, modern medicine typically approaches diseases by analyzing and treating each bodily system in isolation, such as the cardiovascular, digestive, dermatological, or endocrine systems. This fragmented approach often fails to identify the root cause of the symptoms and merely focuses on symptom management. Consequently, once the treatment is discontinued, the original symptoms tend to resurface, and the overall health condition may even deteriorate due to potential side effects of the treatment. This can result in a reliance on multiple medications (polypharmacy) and exacerbation of the disease process.
In my practice, I take a comprehensive approach to prescribing Bioidentical Hormone Replacement Therapy (BHRT), carefully considering the entire body system. By ensuring that all systems are balanced and functioning optimally, I aim to maximize the benefits and wellbeing experienced by women receiving this treatment, ultimately enabling them to feel their best.

Is there such a thing as affordable Hormone Replacement Therapy?

Maintaining hormonal balance with BHRT typically incurs a monthly treatment cost ranging from $200 to $500. It is important to note that the price may fluctuate depending on the unique requirements of your personalized treatment plan.
Optional supplementation may be recommended, thereby incurring additional costs. Rest assured, however, that I am dedicated to delivering the most cost-effective care without compromising on quality. Gain an overview of my comprehensive services.
Realizing the Long-Term Benefits:
Countless individuals who have undergone BHRT have reported significant long-term benefits, emphasizing the value and return on investment of this treatment modality. Rebalancing hormonal levels can result in improved overall well-being, increased energy, enhanced cognitive function, and relief from distressing symptoms. Embarking on this transformative journey is an investment in your long-term health, happiness, and quality of life.
Affordable Payment Options:
As holistic healthcare is often not covered by insurance providers, I have designed a payment system that accepts credit card payments only. However, to make the treatment more accessible, I offer flexible payment plans that accommodate various budgets. By spreading out the cost over manageable installments, you can prioritize your hormonal health without straining your finances. Moreover, many patients qualify for reimbursement from their flexible spending accounts, further easing the financial burden associated with visits and supplements.


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Suzanne Elkind, CNM, APRN is a highly-skilled practitioner renowned for her expertise in hormone therapy. With extensive experience serving women across the New England region, including Maine, Massachusetts, Connecticut, Rhode Island, New Hampshire, and Vermont, Suzanne offers exceptional holistic services.
As a licensed advanced practice nurse and certified through The School of Applied Functional Medicine, she is uniquely equipped to provide personalized treatment plans tailored to alleviate menopausal symptoms.
Whether you seek relief from hot flashes, mood swings, or disrupted sleep, Suzanne’s comprehensive approach ensures optimal well-being.
To inquire or schedule a complimentary consultation, kindly complete the contact form.
For urgent matters, please don’t hesitate to call 617-710-4564 or email us.
Experience the transformational care that Suzanne Elkind, CNM, APRN delivers to enhance your hormonal health!
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