
Bioidentical Hormone Replacement Therapy
BHRT, which is short for Bio-Identical Hormone Therapy, is a treatment that uses natural hormones to improve your health and wellbeing. It is a therapy used to restore your hormone levels to the normal healthy levels you had in your 20's, but have declined as a result of aging and other reasons. BHRT pellets are made up of the same estrogen and testosterone that's naturally occurring in your body, created from plant-based ingredients. Once the pellets are placed into the subcutaneous fat, then immediately begin releasing a continuous amount of hormones into your bloodstream to restore balance. The procedure typically takes 10-15 minutes and you are able to go back to normal activities within a week.

What causes low hormones in women?
The most common cause of low hormones in women is menopause. As a woman ages, there is decreased secretion of estrogen, progesterone, and testosterone from the pituitary gland, adrenal glands, and ovaries. Menopause typically occurs between the ages of 45 and 55 years old and results in the abrupt decline of these hormones, which are essential for the mental and physical well-being of women. There are other causes of low hormones, including premature ovarian failure, excessive exercise or extreme dieting, eating disorders, autoimmune conditions, and surgical removal of the ovaries.
What are the symptoms of low hormones?
The symptoms of low hormones can vary depending on the person and be differentiated based on the hormone involved:
Low estrogen symptoms:
- Hot flashes
- Night sweats
- Changes in or cessation of menstruation
- Vaginal dryness or pain during intercourse
- Difficulty sleeping and insomnia
- Changes in mood
- Increased risk of depression and anxiety
- Bladder problems such as difficulty urinating, increased need to urinate, and bladder incontinence
Low testosterone symptoms:
- Decreased sexual desire and libido
- Difficulty reaching orgasm
- Fatigue
- Lack of concentration
- Muscle weakness
- Weight gain
- Thinning hair
- Increased incidence of cardiovascular disease
- Loss of bone mineral density
- Cognitive decline and increased risk of cognitive disorders such as Alzheimer’s disease
What are the benefits of hormone supplementation in women?
There are numerous benefits of testosterone supplementation in women, which have been proven in high quality clinical trials over the last several decades:
- Improved libido and desire: the same effect we see in men
- Protective against depression and anxiety: women with low testosterone had a significantly higher rate of depression and anxiety compared to women who were on testosterone supplementation
- Protective against breast cancer: women with low testosterone had a significantly higher incidence of breast cancer compared to women who were on testosterone supplementation
- Patients on testosterone therapy for 12 months experience a 5-8% increase in bone mineral density
- Decreased migraines caused by low testosterone
- Increased lean muscle mass
- Decreased body fat
- Decreased triglycerides, low-density lipoproteins (LDLs), and cholesterol
- Decreased risk of cardiovascular events like heart attack: the same effect we see in men
- Both testosterone and estrogen have a neuroprotective role against cognitive decline and cognitive disorders
These are the benefits of estrogen supplementation in women:
- Improvement in hot flashes and night sweats
- Improvement in insomnia
- Decreased vaginal dryness and pain during intercourse
- Decreased migraines caused by low estrogen
- Improved mood and decreased irritability
Dr. Itri discusses the benefits of testosterone supplementation in women
What are Bio-Identical Hormone Pellets?
Bio-Identical Hormone pellets are the size of a grain of rice (or smaller) and are made of the same testosterone and estrogen that occur in your body, not the synthetic forms of estrogen and testosterone that are in other preparations. One of the benefits of the bio-identical form is that the synthetic forms can have side effects such as increased risk of deep vein thrombosis and pulmonary embolism with oral estrogens and allergic reaction to injectable testosterones. Another benefit of the pellets is that patients experience slow, controlled release over months rather than the daily and weekly variation that come with the other routes of administration. The resulting blood level of hormone is also much more predictable with the pellets, peaking at 4-6 weeks after pellet placing and slowly decreasing over 3-4 months.
Why does my regular doctor tell me not to do hormone replacement with bio-identical pellets?
If you’ve gone to your primary care or gynecology doctor and asked about hormone replacement therapy (HRT), this is likely the response you received:
“I don’t believe in hormone supplementation for women”
“There’s no data to support hormone supplementation in women”
“Our organization doesn’t advocate for hormone supplementation in women”
If you’ve told your gynecology doctor that you have a low libido and desire, it’s likely they told you:
“You should see a sex therapist”
These are the most common responses we hear from female patients who come to us to ask about HRT and hormone supplementation.
Part of the problem is that these physicians do not differentiate between the types of hormone preparations such as creams, pills, injections, and bio-identical pellets. For example, oral estrogen supplementation significantly increased the risk of thromboembolic events (deep vein thrombosis and pulmonary embolism) because it is a synthetic preparation that is ingested, whereas bio-identical estrogen is identical to the estrogen your body produces and has been shown to NOT increase the risk of thromboembolic events. Pellets are the preferred method at Studio R Aesthetics because they do not cause the same problems as the other preparations.
Another part of the problem is research studies such as the Women’s Health Initiative (WHI) study, which showed a higher risk for breast cancer, stroke, cardiovascular disease, and thromboembolic events with combined treatment of ONLY synthetic estrogens and progestin (not testosterone or bio-identical hormone pellets). Since this study, there have been numerous clinical studies evaluating bio-identical hormone pellets, which have been shown to reduce the risk of breast cancer, stroke, and cardiovascular disease in women undergoing hormone supplementation compared to women who were low hormone and not supplemented.
What is the process for undergoing hormone supplementation?
- Call us at (434) 260-1667 to schedule a consultation with one of our physicians or click the Book Now button below
- Complete medical intake forms using our online portal
- Meet with one of our physicians to review your medical history, symptoms and health concerns, as well as discuss the benefits of hormone supplementation and treatment options.
- We use the SottoPelle algorithm for dosing, which incorporates your symptoms and lab results to determine the optimal dose of hormones to bring you back to normal healthy levels
- Pellets are placed in the office; the procedure takes 10-15 minutes.
- You will start the feel the benefits of the hormones 3-4 weeks after pellet placement
- Labs are obtained 5-6 weeks after pellet placement to ensure optimal levels. If you continue to have symptoms despite increased hormone levels, our physicians can place additional pellets.
- Pellets typically last 3-4 months and repeat labs are obtained 14-16 weeks after the initial pellet placement to guide subsequent doses.

Women's Hormone Replacement
Starting At $450
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