FREQUENTLY ASKED QUESTIONS

How do I begin? What does an HRT program involve?

STEP 1: Send us your contact information in the convenient Free Consultation submission box on the home page and one of our Clinical Assistants will contact you at your convenience.

STEP 2: We will discuss the principles of bio-identical hormone replacement therapy, advanced preventative medicine and Age Management and ask you to complete a questionnaire with your symptoms, your medical history and discuss making an appointment for a physical exam and blood tests. If you are already an HRT patient elsewhere, we may accept you as a transfer patient however you will need to complete our patient information materials. In the meanwhile, please continue to take your medications normally.

STEP 3: Once blood work and physical exams are performed, results generally arrive within a few days, following which you will receive a phone call to review your findings and discuss your treatment plan.

STEP 4: Within one or two days, you will receive your custom treatment plan medications directly from a specialty compounding pharmacy. Compounding pharmacies are specialty pharmacies that are not open to the general public, rather specially trained pharmacists prepare medication for patients to the individual specification of the physician and dispense these medications directly to you.  Our office does not dispense medications nor can medications be delivered to the office for pickup.

STEP 5: If you are a new patient, we may need to recheck your blood tests in two to four months to fine tune your treatment plan and thereafter we will repeat your blood work once or twice yearly as well as your physical yearly. We are always happy to discuss the effects of the medications, your results, and adjust dosages accordingly.

What are the costs involved?
The fee and costs for the initial consultation, physical, laboratory tests and medications vary from patient to patient. One of our Clinical Assistants will be happy to review these with you.

Does your office accept health insurance?
We do not accept insurance for payment however, in some cases you may have your primary care physician perform lab tests that we will accept in lieu of performing the tests in our office or laboratory service. Your Clinical Assistant will review which laboratory tests our medical staff require.

Will my insurance cover the cost of prescriptions?
Unfortunately, insurance companies typically do not cover the cost of care or medications for Age Management or Advanced Preventative Medicine.

Will my insurance cover the cost of lab tests?
Unfortunately, as with medications, insurance carriers do not view Age Management Medicine a part of their contracted health care coverage and so do not reimburse for the laboratory testing we require. Occasionally however,  if performed by your primary care physician as a part of a yearly physical or for some other medical condition, your insurance plan may cover the cost of lab tests. Rest assured though that because we are aware there is little or no coverage for laboratory tests, we have negotiated preferential rates so in many cases our in house lab tests fees are very affordable.

Can I use my own pharmacy?
Bio-identical hormone replacement therapy prescribing is custom-tailored to the individual and medications are compounded into creams, tablets, lozenges, capsules or injectables by specially trained pharmacists. In addition, quality control and specific dosing in hormone replacement therapy is critical and if a patient obtains their hormones or supplements from pharmacies other than from those we know and trust, we cannot be sure of the highest and best quality of care and results .

How are the hormones administered? How often?
Typically, like diabetics who administer their own insulin, bioidentical hormone replacement is also self-administered usually once or twice per day via transdermal creams or gels (estrogen, progesterone, testosterone), oral capsules (progesterone, DHEA, pregnenolone, melatonin), or injections (hGH, HCG and testosterone). We provide educational materials and in ofice training and advice to all of our patients.

What are the hormones made from?
Our bio-identical estradiol, progesterone and testosterone are derived from natural products then the molecules are modified to exact replicas or bio-identical duplicates of naturally produced hormones. HCG is human-derived, and hGH is produced using recombinant DNA technology. 

What are the side-effects?
Side-effects are often minimal and manageable when restoring hormones to physiological levels. Some patients report breast tenderness or swollen joints treated by reducing the dosage until symptoms resolve, then gradually resuming. None of our patients have reported long-term side effects.

How long do I need to stay on the program?
You should continue treatment as long as you wish to see results. Most patients we have treated continue on our program.

What happens if I stop the program? Will my body stop producing hormones on its own?
Will my hormone levels decrease? Will I lose my gains?
In general, hormone replacement will results in decreased production by the body however, the body tends to restore hormones to pre-treatment levels if treatment is stopped. If your own hormone production was low before treatment, it will most likely return to the same levels after treatment. As a result, most of the physical changes enabled by the program will gradually revert.

Will my testes shrink on testosterone replacement therapy?
We currently restore testosterone using transdermal testosterone cream and HCG, human chorionic gonadotropin. Using the cream, the testes will likely slow production of testosterone in response to (perceived) high levels. This condition also may result in a minor shrinking of the testes. HCG which emulates luteinizing hormone, stimulating the testes to produce their own testosterone, preserves function and size.

What are hormones?
Hormone, secretory substance carried from one gland or organ of the body via the bloodstream to more or less specific tissues, where it exerts some influence upon the metabolism of the target tissue. Normally, various hormones are produced and secreted by the endocrine glands (see endocrine system), including the pituitary, thyroid, parathyroids, adrenals, ovaries, testes, pancreatic islets, certain portions of the gastrointestinal tract, and the placenta, among the mammalian species. As lack of any one of them may cause serious disorders, many hormones are now produced synthetically and used in treatment where a deficiency exists. The hormones of the anterior pituitary include thyrotropin, adrenocorticotropic hormone, the gonadotropic hormones, and growth hormone; the posterior pituitary secretes antidiuretic hormone, prolactin, and oxytocin. The thyroids secrete thyroxine and calcitonin, and the parathyroids secrete parathyroid hormone. The adrenal medulla secretes epinephrine and norepinephrine while the cortex of the same gland releases aldosterone, corticosterone, cortisol, and cortisone. The ovaries primarily secrete estrogen and progesterone and the testes testosterone. The adrenal cortex, ovaries, and testes in fact produce at least small amounts of all of the steroid hormones. The islets of Langerhans in the pancreas secrete insulin, glucagon, and somatostatin. The kidneys also produce erythropoietin, which produces erythrocytes (red blood cells). The passage of chyme (see digestive system) from the stomach to the duodenum causes the latter to release secretin, which stimulates the flow of pancreatic juice. The duodenum can also be stimulated by the presence of fats in the chyme to secrete cholecystokinin, a hormone that stimulates the gall bladder to contract and release bile. There is evidence that the upper intestine secretes pancreatozymin, which enhances the amount of digestive enzymes in the pancreatic juice. In addition, the pyloric region of the stomach secretes gastrin, a hormone that increases the secretion of hydrochloric acid into the stomach. The placenta has been shown to secrete progesterone and chorionic gonadotropin. There is evidence that it even contains a substance similar to growth hormone. Insects have a unique hormonal system that includes ecdysone, a steroid that influences molting and metamorphosis, and juvenile hormone, needed for early development. Plants, too, have a hormonal system, which includes the auxins, the gibberellins, the cytokinins, and substances associated with the formation of flowers, tubers, bulbs, and buds. Ethylene is said to function as a hormone in plants, acting to hasten the ripening of fruits.

Please contact us for a full evaluation.  We look forward to hearing from you.