Hormonechick

Allow me to first preface this discussion by saying, HRT for women is more controversial than with our male counterparts. That is largely because there are more reasons why a woman would decide to seek treatment. Women who have had a total hysterectomy may seek treatment to help them return to their previous baseline, which is actually not much different from all other women who still have their uteri intact. We all want to feel and look our best, that’s a given. The health and beauty industries are thriving due to our shared desire to live our best life. For total transparency in this discussion, I have developed my own nuances of how I prefer to treat my HRT patients. My preferences have been born from the way I learned from my HRT mentor, Dr. Justin Saya, and the volume of patients I have treated over the years. To be clear, I am referring to all hormone replacement as HRT, rather than make the distinction of saying Bio-Identical Hormone Replacement Therapy (bHRT) because that is a whole separate discussion that is best saved for a later time. All in all, the good news is that women have options, and patients have a plethora of information made available to them. In today’s market, patients have a voice and for medical providers to be successful they must listen to their patients concerns and take their chosen preferences seriously. 

Hormone Replacement Therapy (HRT)/ Testosterone Replacement Therapy (TRT)

HRT/ TRT are the most commonly used methods to restoring hormones [Testosterone (T), Estradiol (E2), and Progesterone (P)] back to more youthful levels. These are the methods that I utilize when treating patients. There are many ways to replace deficient hormones that include: injections, transdermal creams and gels, pellets, patches, and troches, to name a few. I typically recommend injections over creams, and that is mostly due to a couple of reasons, 1. I live in Florida and it is hot and we sweat down here, and 2. I like to have more control of the amount of hormone that is getting into my patient’s system. Topical applications, like creams and gels, are just less reliable because of the sweat factor, I have no way of knowing an individual patient’s ability to absorb these products, and I have seen some faux pas with cream placement (we can discuss this another time), but let me just say placement does matter, especially with women. Creams and gels also carry the risk of cross transmission to children and grandchildren in the home. Last but not least, I would like to give my insight on pellets. Please do not write to me if you are a die-hard pellet fan, I know there are so many patients who absolutely LOVE their pellets, and furthermore, HRT providers love them too for many reasons, some of which are financially motivated. I am a trained pellet HRT provider, but I am not a huge fan of the lab ups and downs, the cost, the potential for scaring from the placement, and some of the most common undesirable effects that go along with the highs and lows experienced by patients. 

The Wiley Protocol (TWP)

Let us begin with the most controversial method of Female HRT, which was devised by T. S. Wiley. This method is interesting because it is targeted towards post-menopausal (meno) women and promises to restore youthfulness back to a woman’s pre-meno monthly hormonal cycle by using rhythmic doses of hormones. The medical community basically got their panties in a bunch largely due to the fact that Ms. Wiley does not have a medical background, in fact, she is an author who writes about common female complaints. There are loads of patients who swear by TWP, and let’s not mess with the preferences of women in their 70’s who are still getting a monthly visit from their beloved “Aunt Flow.” I feel it is important to say that this is not my preferred treatment method for a number of reasons, but mostly, I just do not prescribe patients very large doses of E2.

The Menopause Method (TMM)

I first heard about TMM from a dear friend I made when I went digging around the online hormone group communities, her name is Carolyne Shapiro. She is a gem in the HRT world because she has a history of cancer and regained her life back with the assistance of TMM. The founding physician of TMM is Dr. Daved Rosensweet. Carolyne sings his praises and I am pleased to see cancer survivors overcome all that a diagnosis like that entails and still have the same access to hormone treatment. The basis of TMM includes various forms of Estrogen and P that are compounded in organic, all-natural oils that are transdermally applied a couple of times throughout the day. I like the idea of this method, but I have no working knowledge of it, besides the feedback that Carolyne has offered me. Upon researching TMM, I found that Dr. Rosensweet is located in Sarasota, Florida, which is only an hour away from my home in Tampa. I will also mention that Carolyne lives in Southern California, so there are available treatment options to other cancer survivors regardless of location. 

Article written by: Christee Bond, MSN, APRN, NP-C

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