How Can Bioidentical Hormone Replacement Treatment Help You? 

Whether you’ve lived in Myrtle Beach all of your life or retired to the area to enjoy the beach, golf or a more relaxed lifestyle you can’t enjoy everything our area has to offer if you’re feeling old and tired. At Inlet Physical Medicine we help people, every day, optimize their help and feel young. So…

Stop accepting the idea that feeling old is a consequence of your age. You can experience the restoration of energy, vitality, and potential that you felt was lost in your 20s and 30s. Bioidentical hormones are designed to mimic the hormones your body naturally produces.

The Basics of Bioidentical Hormone Replacement Treatment (BHRT):

Natural hormone production starts to decline as we age. The loss of hormones leads to age-related changes that popular opinion say is unavoidable. That leaves us dreaming about our lost “glory days”.  The loss of hormones is not only caused by age, but can be linked to nutrient deficiencies, a lack of adequate sleep, and high amounts of emotional stress. Living in today’s world exposes you to high levels of stress that attack your hormone supply and age you prematurely.

Aging diminishes your capacity for cellular protein synthesis.

What does that mean? It means that aging has a huge negative impact on the health of your cells and how they function. Not only does aging impact your cells it causes a decline in immune function, an increase in fat mass, a loss of muscle mass and strength, and a decrease in bone mineral density (Biomedicina, 2000).

Furthermore, age-related disability is synonymous with weakness, impaired mobility, balance, and poor endurance (Biomedicina, 2000). Finally, as you age you become physically frail and lose more and more muscle strength. The consequences can lead to falls, fractures, impairment in activities of daily living, and loss of independence (Biomedicina, 2000).

Not All Hormones Are Created Equal

It is important to understand the difference between hormones because all hormones are not made the same.

Many people, including doctors, are confused about the differences between bioidentical versus synthetic hormones. Bioidentical hormones are hormones designed with the same chemical structure as those manufactured and metabolized by the body.

Synthetic hormones are made with a different chemical structure compared to the hormones naturally produced by the human body. The key point to note is that synthetic hormones are chemically altered, which have been shown to cause harm and side effects.

Many studies have shown that natural, bioidentical hormones produce better outcomes with fewer side effects compared to synthetic hormones.  As a result, we only use bioidentical hormones in our office to treat patients. The bioidentical hormones offer a decreased risk of breast cancer and improved compliance compared to synthetic hormones.

Finally, bioidentical hormones offer synergistic osteoporosis and cardiovascular protection that is not available with synthetic hormones.

References: Biomedicina. 2000 Jan;3(1):6-7

The Truth About Aging According to Dr. Seuss (wink, wink)

I believe The Cat in the Hat sums up aging quite accurately in this poem below.

The Cat in The Hat on Aging

I cannot see

I cannot pee

I cannot chew

I cannot screw

Oh, my God, what can I do?

My memory shrinks

My hearing stinks

No sense of smell

I look like hell

My mood is bad – – can you tell?

My body’s drooping

Have trouble pooping

The Golden Years have come at last

The Golden Years can kiss my ass.

What are symptoms associated with hormonal changes?

Weight Gain:  Visceral fat is making you sick and old.

Hormone depletion can cause weight gain, especially around the abdominal area. In women, a sudden increase in weight gain often occurs following menopause. Therefore, when women lose estrogen they gain weight.  There is powerful evidence that visceral fat tissue has a direct effect on age-associated insulin resistance (Vitiello, 1999).

Also, the increase in visceral fat tissue in older persons is associated with decreases in serum levels of estrogen, testosterone, and growth hormone (Vitiello, 1999). As a result, optimizing the lower levels of hormones that decrease with age may better control visceral fat deposition, consequently leading to decreased insulin resistance and development of diabetes and atherosclerosis (Vitiello, 1999).

References: Vitiello, MV. Effective treatments for age-related sleep disturbances. Geriatrics. 1999 Nov;54(11):47-52.

Low Energy and Lack of Motivation

Low hormone levels can leave you feeling exhausted. Did you need an afternoon nap in your 20s or 30s? Feeling tired is not the result of a deficiency in caffeine. Is your energy gas light on? Fuel up on hormones and watch your engine run like it did when you were younger.

Often people with declining hormones will report a lack of motivation. They no longer have the desire to exercise or motivate themselves to do the things they once enjoyed.

Looking Old

Low hormones can cause decreased collagen and elasticity of the skin. This, in turn, leads to sagging skin and the development of wrinkles.  

Decreased Sexual Desire

Low testosterone can lead to decreased sexual desire in both men and women, which can lead to psychological issues of stress and depression or relationship problems.  It has been long established the role low testosterone has regarding sexual dysfunction in men.

However, recent evidence has shown that women both premenopausal and postmenopausal suffer from low testosterone. As a result, these women will encounter decreased sexual desire, decreased energy levels, decreased muscle strength, decreased vaginal lubrication, decreased genital (vaginal and clitoral) arousal, decreased vaginal and clitoral orgasmic ability, and decreased energy and sexual desire.

References: Guay, AT. Advances in the management of androgen deficiency in women. Med Asp Hum Sex. 2001;1:32-38

Menopausal Symptoms in Women

Are you suffering from hot flashes, irritability, or mood swings?

Are you carrying around extra weight, especially around the waist? Do you find it difficult to lose weight despite exercise or diet?

Is intimacy painful?

Are you struggling with anxiety or depression?

Do you suffer from insomnia?

These are all symptoms of hormone imbalance associated with menopause. Are you struggling to find an understanding doctor that has been trained to prescribe and monitor your hormones?

Estrogen deficiency causes
  • Urogenital atrophy
  • Incontinence
  • Sagging skin and breasts
  • Increased skin wrinkles on your face
  • Fatigue
  • Depression
  • Mood Swings
  • Decreased libido secondary to vaginal atrophy

According to Freeman 2010, “The transition to menopause and the resulting changes in hormone regulation has been strongly associated with the development of depressed mood among women with no history of depression.”   Restoring hormones such as Estrogen, Progesterone, Thyroid, DHEA, and Testosterone to optimal levels can eliminate the symptoms associated with menopause.

References: Freeman EW, Associations of depression with the transition to menopause. Menopause. 2010 Jul;17(4):823-827

Sleep Disturbance

Low hormones can cause you to have trouble falling asleep or staying asleep. The importance of sleep, especially quality Deep Wave and REM phase sleep has been well established. One of the main benefits of deep sleep cycles is the elimination of free radicals, which cause oxidative stress and cell damage. Melatonin production decreases with age.  

Mood Changes

Low hormones can cause irritability, anxiety, and even depression. Recent data shows that 1 in 10 Americans now takes an antidepressant medication. Medications used to treat anxiety and depression have a vast amount of side effects that negatively affect the body.

According to Almeida et al. (2008) “A free testosterone concentration in the lowest quintile was linked with a higher prevalence of depression.”  The therapeutic utilization of hormones has been well established in the field of Psychiatry. For example, Seidman (2000) outlined the benefits of using Estradiol and Progesterone to treat depression in post-menopausal women. Additionally, the use of Dehydroepiandrosterone (DHEA) and Thyroid hormones have been shown to positively affect mood disorders (Seidman, 2000).

References:  Almeida OP, Yeap BB, et al. Low free testosterone concentration as a potentially treatable cause of depressive symptoms in older men. Arch Gen Psychiatry. 2008 Mar;65(3):283-289 Seidman SN. The therapeutic uses of hormones in psychiatry. Psychiatric Annals. 2000;30(2):1-76

Brain Fog

Low hormones have been shown to cause poor concentration and memory loss.

Male Menopause is Under-diagnosed and Under-treated

Low Testosterone Symptoms and Effects

Endocrine symptoms that occur in andropause include: erectile dysfunction, reduced erectile quality, diminished nocturnal erections, increase in abdominal and visceral adipose tissues (Ginsberg, 2008). The physical symptoms manifest as fatigue, decreased vigor, and diminished strength, reduced muscle mass, reduction of lean muscle mass, and decreased in bone mineral density (Ginsberg, 2008).

The sexual symptoms include: decreased libido diminished sexual activity diminished the quality of erection and weakness in ejaculation, and limited quality of orgasm (Ginsberg, 2008).

Psychological symptoms include mood changes, impaired concentration, diminished motivation, reduced memory, the decline in libido, and depression.

Finally, low testosterone levels in men can contribute to the development of co-morbid conditions, such as myocardial infarction, coronary atherosclerosis, type 2 diabetes, obesity, hypertension, and osteoporosis (Ginsberg, 2008). Low levels of testosterone have been linked to aortic atherosclerosis and a predictive marker of cardiovascular disease.  Low serum testosterone is associated with an increased risk of mortality in older men (Laughlin, 2008).

References: Ginsberg TB, Cavalieri TA. Androgen deficiency in the aging male: The beginning, the middle, and the ongoing. Clinical Geriatrics. 2008 April:25-28 Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocrinol Metab. 2008 Jan;93(1):68-75

Is Your Hypothyroidism UNDER-treated?

Symptoms of Hypothyroidism: fatigue, weight gain, depression, fibromyalgia/muscle & joint aches and pains, hair loss or coarse/dry hair, and infertility. A normal TSH level in the presence of symptoms related hypothyroidism could indicate an issue at the cellular level. As a result, optimizing T3 in addition to using T4 could be the answer for the millions of Thyroid patients suffering from under-treated hypothyroidism.    

Benefits of Bioidentical Hormones:

Decreasing Fat Mass and Obesity

According to Mayes (2004), hormone replacement therapy in postmenopausal women and testosterone replacement therapy in older men appear to reduce the degree of central obesity. Estrogen replacement therapy has been shown to be a possible treatment for abdominal fat by reducing high cortisol levels (OHSU Researchers, 2005).

Also, the use of DHEA has been shown to reduce the accumulation of abdominal visceral fat and protect against insulin resistance (Villareal & Holloszy, 2004). Testosterone treatment was shown to decrease visceral fat mass by increasing insulin sensitivity, decreasing fasting blood glucose, cholesterol, and triglycerides, and decreasing diastolic blood pressure (Marin, 2005)

References: OHSU Researchers Uncover Cause, Possible Treatments for Abdominal Fat in Postmenopausal Women. Oregon Health & Science University. 2005 June 11. Marin P. Testosterone and regional fat distribution. Obesity Res.1995 Nov;3(4):6095S-612S. Mayes, JS, Watson GH. Direct effects of sex steroid hormones on adipose tissues and obesity. Obes Rev. 2004 Nov;5(4):197-216. Villareal, DT, Holloszy JO. Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial. JAMA. 2004 Nov 10;292(18):2243-2248

DHEA: Helping your heart, bones, mood, and your waistline

DHEA (dehydroepiandrosterone) has been shown to be important for preventative medicine. In addition to living longer, healthier, and happier the benefits of DHEA include:

  • Reducing cardiovascular risks by decreasing visceral fat
  • Stimulating the immune system, activates T-cells (anti-cancer properties)
  • Restoring sexual vitalityImproves mood
  • Decreasing cholesterol and body fat
  • Improving memory
  • Reducing the risk of Alzheimer’s
  • Increasing energy
  • Aiding as an antidepressant
  • Acting as a precursor to other hormones
  • Preventing diabetes
  • A possible anti-aging hormone.

Decreased serum dehydroepiandrosterone (DHEA) concentrations may be associated with an increased risk of cardiovascular disease (CVD) (Fukul et al., 2005).  Low levels of serum DHEA was found to be significantly lower in the group of patients suffering from coronary heart disease, osteoporosis, and depression (Kedziora-Kornatowska, Beszczynska-Oles, Kornatowski, Szadujkis-Szadurski, 2007).

Also, low DHEA concentrations are associated with the development of obesity (Fukul et al., 2005). Appropriate use of DHEA treatment can reduce body weight, improve insulin sensitivity, and provide a beneficial effect against the development of atherosclerosis (Fukul et al., 2005).  DHEA was found to be an effective treatment for midlife-onset major and minor depression (Schmidt, 2005).

According to Davis et al. (2008) “Higher levels of DHEA in women have been found to be associated with a better cognitive function, concentration, and working memory.” According to Villareal & Holloszy, 2004, “DHEA replacement has a role in the prevention and treatment of the metabolic syndrome associated with abdominal obesity.”

References: Fukul M, Kitagawa Y, Nakamura N, et al. Serum dehydroepiandrosterone sulfate concentration and carotid atherosclerosis in men with type 2 diabetes. Atherosclerosis. 2005 Aug;1(2):339-344  Kedziora-Kornatowska K, Beszczynska-Oles R, Kornatowski T, Szadujkis-Szadurski L. The analysis of dehydroepiandrosterone sulfate concentration in elderly age women depending on coexisting disease states. Adv Med Sci. 2007;52(1):126-130. Schmidt PJ, Daly RC, Bloch M, et al. Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression. Arch Gen Psychiatry. 2005 Feb;62(2):154-162. Viillareal DT, Holloszy JO. Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized and controlled trial. JAMA.2004 Nov10;292(18):2243-2248


It makes life fun again. It makes life healthy again. It makes you feel better and benefits your health in so many ways. It is important for men and women

Benefits of testosterone in Men:  
  • Testosterone enhances well being
  • Decreases Cholesterol
  • Promotes lean muscle mass
  • Improves Healing
  • Improves bone density
  • Improves libido and sexual performance
  • Improves Skin Tone and Collagen
  • Memory enhancer
  • Improves cognition
  • Protects against chronic diseases
  • It prevents and treats depression
  • Increases endurance
  • Improves athletic performance
  • Lowers insulin resistance
  • Increases beneficial lipoproteins
  • Decreases all harmful cardiovascular risk markers, and raises all good markers
  • Improves healing in diabetic and immunocompromised patients
Benefits of testosterone in Women:
  • Improved well being
  • Improved energy
  • Improved strength and endurance
  • Improved body composition
  • Improved bone density
  • Improved sexual function
  • Increased clitoral sensitivity and orgasmic ability
  • Decreased visceral fat and subcutaneous fat
  • Maintains muscle mass, thus maintaining metabolism. Both prevent diabetes and heart disease
  • Increases collagen
  • Increases skin thickness
  • Improves texture
  • Decreases wrinkles
  • Decreases fat deposition and cellulite

Testosterone replacement has been shown to reduce cardiovascular risk.  According to a study by Kapoor, Goodwin, & Channer, 2006, Testosterone replacement improves insulin resistance, glycemic control, cholesterol, and reduces accumulation of visceral fat.

Moreover, data suggests testosterone therapy has a positive effect on bones, muscles, erythropoiesis and anemia, libido, mood, cognition, fasting blood glucose, glycated hemoglobin, insulin resistance, visceral adiposity, and quality of life (Rice, 2008).  In a Systematic Review and Meta-Analysis on Testosterone and depression, the conclusion was that testosterone replacement has an antidepressant effect in depressed patients, especially those with hypogonadism (Zarrouf et al., 2009). Higher Testosterone levels have been associated with better cognitive performance in men (Muller et al., 2005)

References: Kapoor, D, Goodwin E, channer KS. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolemia in hypogondal men with type 2 diabetes. EurJ Endocrinol. 2006Jun;154(6):899-906. Muller MAleman A, Grobbee, DE, et al. Endogeneous sex hormone levels and cognitive function in aging men: Is there an optimal level? Neurology 2005 Mar8;64(5):866-871. Rice D, Brannigan RE, Campbell RK, et al. Men’s health, low testosterone, and diabetes: individualized treatment and a multidisciplinary approach. Diabetes Educ. 2008 Nov-Dec;34(5):97S-112S. Zarrouff FA, Artz S Griffith J, et al. Testosterone and depression: Systematic review and meta-analysis. J Psychiatr Pract. 2009 Jul;15(4):289-305


In a number of scientific and medical studies estrogen prolongs quality of life by decreasing the diseases of aging. Estrogen has been shown to have a positive impact in fighting: 

  • Heart disease
  • Strokes
  • Colon cancer
  • Osteoporosis
  • Urinary tract infections
  • Alzheimer’s disease and dementia
  • Macular degeneration
  • Improves balance and coordination, which prevents falls and fractures
  • Neurologic and cerebral benefits
  • Vascular benefits

⃰ It is important to know the difference between Bioidentical Estrogen compared to Synthetic Estrogen. They are not the same! Estradiol is not Premarin.

Gambrell 2004 cited 45 years of clinical research and practice concluded, “The benefits of estrogen other than alleviating symptoms are preventing: Genital atrophy, Osteoporosis, Cardiovascular disease, Alzheimer’s disease, Psychogenic manifestations, Colorectal cancer, Macular degeneration of the retina, and Cataracts.”  

References; Gambrell RD. Menopause. In: Rakel RE, Bope ET, eds. Conn’s Current Therapy 2004. Philadelphia, PA:WB Saunders; 200


No woman should be without progesterone. Treatment is readily available and the benefits are numerous:

  • Reduces symptoms of PMS
  • Decreases a headache and bloating associated with menstruation
  • Reduces symptoms of menopause & perimenopause
  • Protects against uterine and breast carcinoma.
  • Protects against osteoporosis
  • Vaginal bleeding
  • Protects against fibrocystic disease, ovarian cysts, and coronary artery disease
  • Important in the treatment of Polycystic Ovary Syndrome.
  • Helps overall wellbeing
  • Helps promote restful sleep
  • Reduces night sweats.
  • Treats postpartum depression
  • Helps treat cycle migraines

⃰⃰ It is important to know the difference between Bioidentical Progesterone compared to Synthetic Progestins. They are not the same! Progesterone is not Provera. Natural Progesterone protects whereas Provera increases risks of cancer, osteoporosis, and heart disease.


The benefits of melatonin go far beyond providing you with a high quality of sleep, Melatonin has also been shown to do the following:

  • Promotes stage IV sleep & REM sleep.
  • Improves depth and quality of sleep
  • Mood Enhancer
  • Lower blood pressure
  • Decreases migraine headaches
  • Decreases cluster headaches
  • Reduces the urge to urinate at night because it increases stage IV sleep
  • Improved immune system