Orange County Hormone Replacement Done Right

Hormones can be prescribed in many different types of formulations, some of which are better than others. For estrogen, MDTW favors using skin and vaginal formulations instead of oral formulations. For progesterone, MDTW favors oral capsules. For testosterone in women, MDTW favors topical skin creams or in-office injections.  Your provider will customize a plan that’s best for you based on your needs and preferences.

Often benefits will be felt within the first week, but it can take several weeks to months to feel the full effect of hormone replacement.

Medication is shipped directly to your home at no cost to you and typically arrives in 7-14 days.  We maintain an office supply of testosterone, semaglutide, and tirzepatide, and can administer and dispense these medications from the office.

Testosterone is an important hormone for women also. Women actually make more testosterone in their bodies than estrogen. The testosterone/estrogen split in women is about 55/45, while in men it is 95/5. Symptoms of low testosterone in women include low libido, fatigue, loss of focus, anxiety, depression, muscle pain, mood swings, memory loss, migraines, weight gain, and belly fat. Testosterone decreases in women before estrogen, typically during their 30’s. Birth control pills also cause testosterone deficiency by suppressing the function of the ovaries, which make 95% of a woman’s testosterone.

Bioidentical hormones are molecularly identical to the hormones your body makes. This means they are indistinguishable in your body from your natural hormones, and function in exactly the same way.

The risk for breast cancer is slightly increased with synthetic hormones, especially synthetic progesterone. The risk is for about 1 in 1000 women to get breast cancer who wouldn’t otherwise get it. This makes breast cancer a rare complication of HRT. The risk with bioidentical hormones may be less. Why would a hormone the body naturally makes cause cancer? If HRT is started within 10 years of menopause, the benefits far outweigh the risks for most women.

If HRT is started within 10 years of menopause, the benefits far outweigh the risks for most women. Benefits include a lower risk of all cause mortality, heart disease, osteoporosis and bone fractures, and dementia. The risks include a slight increase in breast cancer (1 in 1000 women) with synthetic hormones, and no increase to a slight increase (likely < 1 in 1000 women) with bioidentical hormones. If HRT is started more than 10 years after menopause, the risk reward ratio is not as clear.

We strongly believe so. We believe bioidentical hormones, which are molecularly identical to and function exactly like your body’s natural hormones, are preferable to synthetic hormones, which are altered from the natural hormones your body makes. The problem with synthetic hormones is they function differently, sometimes very differently, than your body’s natural hormones. The reason pharmaceutical companies make synthetic hormones, of course, is so they can obtain patent protection to guard their ability to make profits. They can’t patent substances naturally made in the body, and therefore can’t make money from them.

This is a controversial topic, because the benefits are most pronounced when HRT is started within 10 years of menopause.

Traditional healthcare diagnoses and treats disease, and perimenopause and menopause aren’t considered diseases. 80% of gynecologists say they are untrained in menopause. Managing perimenopause and menopause is not considered important in medical education and training. Furthermore, many doctors wrongly believe that the risks of HRT outweigh the benefits for most women. The fact is, if HRT is begun within 10 years of menopause, the benefits far outweigh the risks in most women, including a decrease in mortality, heart disease, osteoporosis, and dementia.

FDA approved medications are medications, in specific formulations and dosages, that have been proven to be safe and effective for a specific medical problem. Compounded medications are made from the same active ingredients (e.g. estradiol, testosterone cypionate, semaglutide, etc.), but are compounded (mixed) with other ingredients to create a product suitable or more beneficial for individual patients. For example, testosterone cypionate is often compounded with DHEA, a precursor compound for testosterone. Estradiol is often compounded into creams and other topical formulations.

Compounding pharmacies provide medication mixtures for individual patients. They buy pharmaceutical grade medications from drug manufacturers (same as pharmaceutical companies) and compound (mix with other ingredients) them into products suitable for individual patients. An example of a compounded product is a bioidentical hormone compounded into a cream for topical use.

We use only large, US-licensed compounding pharmacies that buy their pharmaceuticals from FDA registered manufacturing facilities, and provide certificates of analysis to prove the integrity of the pharmaceuticals they use.

Because pharmaceutical companies, which sell their products to traditional pharmacies, generally don’t make bioidentical hormone products. Why? Because they can’t patent them (because they are naturally occurring in the body), and therefore can’t make money from them. The niche that compounding pharmacies have is that they provide medication tailored for individual patients. They buy the pharmaceutical grade medication from drug manufacturers, like pharmaceutical companies do, and then prepare a compounded product suitable for individual patients. An example is estrogen cream. They buy pharmaceutical grade bioidentical estrogen, and then compound (mix with other ingredients) it into a cream for individual patient use.

No, MD Total Wellness does not accept insurance for medical services and treatments. We accept all major credit/debit cards as well as payments from HSA or FSA accounts. Our transparent pricing includes all medications, your follow-up office visits, unlimited messaging with providers, and in-office testosterone testing.

We value in-person visits with our patients; however, we understand that it’s not always easy to come into the office for regular appointments. Telemedicine visits are offered for follow-up appointments and are conducted face-to-face using a secure audio/visual platform. We cannot provide Telehealth care to patients outside of California or Arizona.

No. This is not our area of expertise, however, upon request, we can refer patients to a trusted, local provider who specializes in gender-affirming hormone therapy.