Bioidentical Hormone Therapy Orange County

Bioidentical hormone therapy is by far the best treatment we have for symptoms of perimenopause and menopause. Bioidentical hormone therapy addresses the root cause of menopause transition symptoms, which include hot flashes and night sweats, vaginal dryness and atrophy, brain fog, irritability, low libido, difficulty achieving orgasm, joint pain, mood changes, heart palpitations, and migraine headaches. Additionally, bioidentical hormone replacement decreases the risk of chronic disease (heart disease, osteoporosis, dementia), and is the best anti-aging intervention we have.

Yes! Bioidentical hormones are molecularly the same as the hormones your body normally makes, and therefore function exactly the same as your normal hormones. Pharmaceutical companies make altered version of hormones (so they can patent them), but they don’t work in the same way as your body’s normal hormones. Mother Nature has provided us with the ideal hormones, and pharmaceutical companies, unsurprisingly, have not been able to improve upon them.

Our healthcare system focuses on the diagnosis and treatment of disease using pharmaceuticals. Perimenopause and menopause aren’t diseases, and the best treatments aren’t pharmaceuticals. 80% of gynecologists say they are untrained in menopause. Furthermore, many doctors wrongly believe that the risks of HRT outweigh the benefits because of old studies utilizing synthetic hormones, not bioidentical hormones. The fact is, if bioidentical hormone therapy 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.

If HRT is started within 10 years of menopause, the benefits far outweigh the risks in most women. Benefits include a lower risk of all-cause mortality, heart disease, osteoporosis, and dementia. If HRT is started more than 10 years after menopause, the risk reward ratio is not as clearcut. Oral estrogen (which we don’t use) does increase the risk for blood clots, and synthetic progesterone (which we don’t use) does increase the risk for breast cancer.

Yes, hormone therapy can improve quality of life and provide anti-aging benefits when started at an older age, but the maximal medical benefits (prolong life, decrease risk for heart disease, osteoporosis, and dementia) occur when hormone replacement is started within 10 years of menopause. A qualified clinician can assess your specific situation to help you determine if hormone therapy would be appropriate.

Studies have never shown that bioidentical hormones increase the risk of breast cancer. It makes sense. Why would a hormone the body normally makes cause breast cancer? Medroxyprogesterone acetate, a synthetic progesterone, on the other hand, does slightly increase the risk for breast cancer, and is the reason for why hormone replacement fell out of favor in the early 2000s. Pharmaceutical companies can’t patent naturally occurring hormones, so their approach is to alter natural hormones so they can patent and “own” them. The risk with medroxyprogesterone acetate is for about 1 in 1000 women to get breast cancer who wouldn’t otherwise get it.

Testosterone is an important hormone for women also. Women actually make more testosterone in their bodies than estrogen. 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.

Hormones can be prescribed in many different types of formulations, some of which are better than others. Oral estrogen increases the risk for blood clots, whereas topical formulations, pellets, and vaginal formulations don’t. Progesterone is best given as an oral medication. Testosterone is best given as an oral formulation or injectable formulation. 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 therapy.

Yes, we accept blood tests done within 6 months of evaluation and treatment.  Lab work previously obtained is not required for your initial consultation but may be helpful if it was conducted in the past 3-6 months. Labs may be requested prior to initiating hormone replacement therapy and are routinely obtained as part of ongoing monitoring and follow-up.

Compounding pharmacies buy pharmaceutical grade medications from drug manufacturers (same as pharmaceutical companies) and sell them in a wider variety of formulations (mixtures of medications, dosages, forms of delivery like topical, vaginal, sublingual) than what is available from pharmaceutical companies.

Compounding pharmacies offer a wider variety of bioidentical hormone formulations than pharmaceutical companies, which makes it easier to tailor medication plans for individual patients. There are FDA approved bioidentical hormone formulations (micronized progesterone, estradiol patches), but the formulations and dosages are limited. In general, pharmaceutical companies prioritize medications that they can patent, and they can’t patent naturally occurring compounds. We use both FDA approved and compounded bioidentical hormones.

No. FDA-approved medications are specific drug formulations and dosages that have been demonstrated to be safe and effective in studies performed by pharmaceutical companies for specific medical issues. Compounded drugs contain the same active drug ingredients as in the FDA-approved medications, but are compounded into various formulations (e.g. creams, topical, combinations of medications, etc.), and dosages, that haven’t gone through the studies required for FDA approval.

FDA-approved medications are medications, in specific formulations and dosages, that have been proven to be safe and effective for a specific medical problem in studies sponsored by pharmaceutical companies. Compounded medications are made from the same active ingredients (e.g. estradiol, testosterone, semaglutide, etc.), but are compounded (mixed) with other ingredients, and available in a wider variety of dosages, to create a product suitable or more beneficial for individual patients. This makes compounded medications more customizable for individual patients.

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.

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.

We favor in-person, face-to-face appointments for better, more effective care, but we do offer telehealth appointments for convenience when necessary.

No, MD Total Wellness does not accept insurance. We accept all major credit/debit cards as well as payments from HSA or FSA accounts. Our affordable, pay-as-you-go monthly pricing includes personalized care with board-certified clinicians, medication, and in-office blood testing.