Bioidentical means structurally identical
The molecule is the one your body makes. That matters — for safety, for efficacy, and for how the body responds.
✦ Aging Well
Considered,monitored,well-done.
Bioidentical hormones, prescribed and monitored properly, are one of the most effective tools for aging well. Used carelessly, they cause problems.
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✦ The pattern
“The conversation isn't 'hormones, yes or no.' It's 'which hormone, what dose, how monitored, and is this still the right tool a year from now?'”
Hormone replacement has been controversial, oversold and undersold in different decades. The current evidence — when read carefully and applied carefully — supports its use for the right person, in the right window, at the right dose.
I prescribe bioidentical estradiol, progesterone, testosterone and DHEA where the labs and the case agree. I monitor closely. And I'm honest about what hormones can and can't do.
✦ Worth knowing
Three things to hold onto.
The window matters
For women, starting hormone therapy within ten years of menopause carries the best risk-benefit profile. Starting much later changes the conversation.
Monitoring is non-negotiable
Quarterly labs in the first year, then twice yearly. Dose adjustments based on symptoms and numbers together. This isn't a set-and-forget tool.
✦ The work
How I think about hormone replacement.
01
Who I'd consider it for
Women in perimenopause or within ten years of menopause with quality-of-life symptoms, bone concerns or cardiovascular risk profile. Men with measurably low free testosterone and clear symptoms after optimization of sleep, body composition and stress. Older adults with documented DHEA deficiency in some cases. The conversation is always individual.
02
How I prescribe
Estradiol typically as transdermal cream or patch. Progesterone oral at night. Testosterone for men as cream or injection. DHEA when warranted. Doses adjusted carefully to a target lab and symptom profile, not maxed out.
03
Where I'd say no
Active or recent hormone-sensitive cancers, certain clotting disorders, uncontrolled cardiovascular disease in the acute phase. Other relative contraindications I'd discuss carefully — sometimes the right answer is yes with adjustments, sometimes no.
✦ How I'd work with youConsidered.
Considered.
Tested.
Re-tested.
Baseline labs and full conversation before starting. Re-test at 6 and 12 weeks. Then quarterly for the first year, twice yearly thereafter. Yearly re-evaluation of whether this is still the right tool.
Therapies I'd likely use
✦ Common questions
You're probably wondering.
Is hormone replacement safe?
For the right person, in the right window, at the right dose — yes, current evidence is reassuring. For the wrong person, or done sloppily, it's not. That's why the work-up and monitoring matter.
Can I start hormones in my 70s?
Sometimes. The benefit-risk profile changes with time since menopause for women and with overall cardiovascular health for both sexes. Worth a careful conversation rather than a yes or no.
Do I need to be on this for life?
Not necessarily. Some people stay on indefinitely. Others taper after a number of good years. We revisit the question annually.
✦ Next step
Ready to talk it through?
Book a free 15-minute discovery call. I'll listen, you'll ask questions, and we'll decide together if this is the right fit.
Aging Well · Hormone Replacement