Bioidentical Hormones

What are they used for?

  • perimenopause: to help with sleep issues, hot flashes, moodiness, brain fog.
  • postmenopause: to help with bone health, longevity and feeling young
  • younger women: to help with premenstrual symptoms, uterine fibromas, PCOS
  • men: for low testosterone

What is ‘bioIdentical’?

Bioidentical means that the hormone has exactly the same chemical structure as your own hormone, or body identical.
The female hormones used in bioidentical hormone therapy – estradiol, estriol and progesterone – are plant-derived hormones (from Wild Yam or Soybeans). Testosterone is usually made from soybeans.

In contrast, non-bioidentical hormones, are chemically different from the ones in your body.

Compounded hormones

The hormones I prescribe are ‘compounded’ by a pharmacy in Portugal. So they locally made on a small scale. The creams and capsules are custom made from the raw materials (progesterone, estrogen, testosterone powder).

BHRT CONSULTATIONS – what to expect

  • Initial Consultation (60 minutes; book here; only clients in Portugal; international not possible)
    • Medical History: past illnesses, symptoms, current medications, supplements, and allergies.
    • Symptom Assessment: We will discuss your peri-menopausal symptoms in detail, their severity, and how they impact your daily life.
      Before the first appointment I will ask you to:
      1. fill in a general health & lifestyle intake
      2. fill in a hormone symptom questionnaire
      3. do blood testing (can also be done after the first consultation)
    • Hormone prescription: if appropriate, we will start with the initial hormone cream. Usually Bi-est 80:20 cream and with progesterone, sometimes progesterone only in early menopause). This is made by a compounding pharmacy.
      Titration: You will receive instructions how much to take and titrate up you dose according to symptom relief.
    • Supplements: advice on which supplements to take, as to support healthy metabolism.
  • Second consultation (after 1 month, 30 minutes; book here)
    • review of the follow up symptoms questionnaire
    • Evaluate need for testosterone
    • Dose adjustment and new prescription
    • Ordering of the hormone level test for review in the 3rd appointment
  • Third consultation (after another month)
    • If you have reached a stable dose, this is usually the last consultation until the follow up 1 year later.
    • Hormone dosing adjustments according to the hormone test results
    • Once stable, we meet every 12 months for hormone level testing and adjustments
    • PS. sometimes an extra consultation is needed 1 month after the 35d, if dosing is not optimal yet.
  • Yearly consultations
    • hormone level test before the consultation
    • Hormone dosing adjustments according to the hormone test results

COSTS

  • Consultation
    • first: 120eur
    • follow up consultation at 1 and 2 months: 60eur each
    • follow up consultation at 1 year: 120eur
  • initial blood testing 250-350eur (or less if ordered by the doctor from the Centro de Saude or with insurance)
  • compounded hormone creams/capsules:
    • progesterone: ~15€/month,
    • estrogen (bi-est) cream: ~40-65€/month
    • testosterone cream ~15€/month.
  • hormone level urine test
    • between after 2-4 months of hormone use: ~350eur
    • yearly: ~350eur