Dr. Nadini Verma is a board certified OB/GYN who serves the greater Los Angeles, California area, including Santa Monica and many of the surrounding communities. She specializes in bioidentical hormone replacement to treat many of the problems associated with menopause and infertility.
Bioidentical Hormone Replacement Q & A
What are bioidentical hormones?
Bioidentical hormones are identical to the hormones your body produces. They mimic your own hormones and function in your body the exact same way your hormones do. These hormones are plant-based, but because of the similarity with natural hormones, your body perceives them the same way. This allows for a natural integration into your body’s physiology. Bioidentical hormones are available commercially as well as from compounding pharmacies. These hormones are used to replace what your body no longer makes as you go through menopause. The most popular method of administration of these hormones is by use of a cream, gel, or patch on the skin (i.e. transdermally). If estrogen is taken as a pill, it is first processed through the liver. This stimulates protein associated with clotting factors, which increase the risk of heart disease, stroke and blood clots. When delivered by transdermal routes such as creams or gels, estrogen is not processed first by the liver and does not have these effects. Although estrogen is the main component of Hormone Replacement Therapy and relieves most symptoms, natural progesterone is also added to alleviate anxiety and promote better sleep. Estrogen can be dispensed as Estradiol, Estriol, or Bi-Est. Besides Estrogen and Progesterone, women may need other hormones like DHEA, Pregnenolone, and Testosterone.
What are hormone pellets?
The use of subcutaneous (under the skin) pellets of biodentical hormones offer a uniform, continued release of the hormones. By placing the pellets under the skin, the hormones can be dispensed in a steady amount over a period of time. Pellets obviate the need for daily application of hormone creams and other types of hormone replacement therapy. While other types of HRT may fluctuate in potency, pellets always provide the same, consistent dosage. A single treatment can last three to four months. Pellets are ideal for patients with busy active lifestyles, patients who may forget to use their creams or simply for the sake of convenience.
Dr Verma specializes in pellet therapy and if necessary can discuss this option at your appointment.
Is hormone replacement safe?
In young postmenopausal women, Hormone replacement therapy (HRT) is a safe and an effective tool to alleviate moderate to severe menopausal symptoms and to prevent long-term degenerative diseases such as osteoporotic fractures, cardiovascular disease, diabetes mellitus and, possibly cognitive impairment. Dr. Verma is very conscious of common patient concerns, such as the increased possibility of breast cancer linked with Hormone Replacement therapy as well as controversies regarding compounded hormones. All of your concerns regarding these issues can be addressed at your appointment.
What is the protocol for hormone therapy?
Dr. Verma will carefully consider your medical and family history, genetic factors, and review your baseline lab tests to select the hormones for your specific needs. Hormone replacement therapy typically takes 1-3 weeks to optimize and restore your hormonal balance to regular levels.. An effective and safe hormone replacement program will always involve ongoing monitoring to ensure that dosage levels remain appropriate. To that end, you will have lab testing and follow-up visits with Dr. Verma every 3-6 months.