Bioidentical Hormone Therapy in NYC

Dr Steven R. Goldstein MD is considered one of the nation’s top doctors in gynecology an expert on hormone replacement therapy in general. Regarding bioidentical hormone therapy in NYC, Dr. Goldstein does not recommend the use of compounded bioidentical hormones and explains why below.

Dr Goldstein is a Certified Menopause Practitioner and a past President of the International Menopause Society as well as past President of the North American Menopause Society. This combination of Dr. Goldstein’s being a menopause specialist and an expert on hormone replacement therapy makes him uniquely qualified, and the best gynecologist to work with menopausal patients or those approaching menopause.

Dr. Goldstein is co author of the book “The Estrogen Alternative” and is the Recipient of the Thomas A. Clarkson award for many outstanding contributions to menopause related clinical or basic science research

Regarding bioidentical hormones, Dr. Goldstein recognizes that each woman’s needs for hormone replacement therapy are different, thus each woman’s HRT plan needs to be personalized to her needs. This is not the case with compounded bioidentical hormones.

Bioidentical hormone therapy, sometimes called BHRT, is really a misnomer. It is misleading. It’s really unfortunate there are so many patients who believe that this is a safer way to get hormone therapy. Many of the doctors who promote this are also involved in the anti-aging movement. Ponce de León left Spain six hundred years ago looking for the fountain of youth. We are still looking. The key is “healthy aging” not anti-aging.

The problem with most BHRT is that it is compounded or made up by a pharmacist with the guise that it will be special for you, sometimes doing salivary testing for your levels of hormone. Hormone replacement therapy, however, unlike thyroid disease, is not based on levels of hormones, it is based on symptoms. Doses are varied until symptoms are relieved.

Medications that are pharmaceutically manufactured are regulated by the FDA. In other words, when a medication is commercially produced by a pharmaceutical company the FDA has oversight of its manufacture. Clinical trials showing safety and efficacy have been completed. Moreover, the workers at those facilities wear protective gear that look like space suits and you could probably eat off the floor.

Your only assurance, with something that is compounded is that the pharmacist who made it is licensed in the state in which it is made. In fact, More Magazine ran an article several years ago, where they sent ten hormone preparations that were compounded to an independent laboratory. Not one of them had exactly the thing or the amount it was supposed to have.

The Bioidentical movement doesn’t come with any package insert and it is not any safer than traditional hormone replacement.

It is very sad that all of us who are leaders in the menopause field and familiar with female hormone replacement therapy have had a handful of patients who have developed uterine cancers using compounded hormones because there wasn’t enough progesterone to protect the uterus.

Here is the difference between traditional hormone replacement therapy and compounded Bioidentical Hormone Replacement Therapy (BHRT)

* Some pharmaceutically made HRT utilized “bioidentical” estrogen and progesterone, which, if important to patients, is preferable to compounded formulations. Discuss with Dr. Goldstein whether this might be better (or not) for you.

Click on the link below for the hormone therapy that Dr. Goldstein recommends.

See more on female hormone replacement therapy here

Finally, if you still feel that you want “bioidentical hormones,” that is, exactly the hormone that is produced by the ovaries before menopause, these can be prescribed pharmaceutically and quality controlled. Pharmaceutically made hormone therapy can be individualized patient by patient. It is certainly not “one size fits all.”

If you are experiencing the symptoms of menopause or feel you need hormone replacement therapy, schedule a visit with Dr Goldstein to go over your care and determine the best option for you. Remember, HRT is not “one size fits all”