HRT Guide for Women | Bioidentical Hormone Replacement Therapy


When it comes to hormone replacement therapy (HRT) for women, there is a definite lack of education in the community about exactly what is it and how women can benefit from this type of treatment. This is one of the reasons why health for middle-aged people is spiraling out of control. Ladies, you don’t need to be tired all the time and live in a fog. You can get your energy back, build lean muscle, drop body fat and live a dynamic life! When it comes to overall fitness, there are 3 main areas you should be concerned about:

  1. Optimal Hormone Levels – The first step is to get your hormones checked! If your local doctor won’t do it, then search for an anti-aging clinic in your area and set up an appointment. They will discuss all of the options available and if you decide to get started on a program, they will do a comprehensive blood panel to check several different key hormones. Many times, your health insurance will cover the cost of the blood labs and maybe even the medicine so check with them to make sure.
  2. A Clean Diet – Eating a healthy diet is critical to your success when you are on HRT. If you keep eating unhealthy food while you are taking HRT, the results will not be nearly as good as if you focus on adhering to a nutrient dense whole food diet with lean protein, clean carbs and healthy fats.
  3. An Exercise Program –  Just like your diet, the type of exercise plan you choose to do while on HRT will have a major impact on your overall results. Make sure to include resistance training with weights to build lean muscle, along with cardio exercise to burn excess body fat. It’s also important to include core exercises into your routine in order to target the vital muscles in your abdominals and lower back.

My goal in writing this article is that I want to help women of all ages understand how they get back to how they looked and felt when they were in their 20’s and 30’s. It’s time for you to decide if you want to let age dictate your health as you get older or if you want to take control and do something about it. Remember, we are talking about optimizing your own body’s natural hormones so you can look and feel better. It’s no different from someone who is a diabetic and needs insulin in order to control this important hormone. You may also have sub-optimal hormones that play critical roles in your body (testosterone, estrogen, progesterone, thyroid) and the goal with HRT is to bring these levels back up to the high-normal range so you can feel and look your best!

Questions To Ask Yourself
Are you no longer seeing the results you’d like with your fitness plan? Do you continue to put on unwanted body fat while suffering from bouts of low energy and a decreased sex drive along with experiencing all the other menopausal symptoms? Well, it’s probably time to look into hormone replacement therapy!

What Exactly is Hormone Replacement Therapy (HRT)?
This type of therapy uses female hormones (estrogen and progesterone) to treat common symptoms of menopause and aging. Along with estrogen and progesterone, other key hormones (testosterone and thyroid) are sometimes used with HRT if these levels are currently low. The overall goal is to bring all of these levels up to the high-normal range that you used to have when you were younger. There are a few different types of HRT therapy that are used:

  • Estrogen Only HRT – this type of therapy only contains estrogen.
  • Combination HRT – this contains both estrogen and progesterone. Along with these two hormones, an anti-aging doctor may also prescribe small doses of testosterone if you are currently low on this important muscle building hormone. They may also prescribe thyroid medication if those levels are out of whack also.

What is The Difference Between Bio-Identical and Synthetic Hormones?
Bioidentical hormones are derived from naturally occurring plant-based sources, such as soy or yams. They are molecularly identical to the hormones that your body produces naturally which allows them to be more effective on more biological pathways. The great thing is that each dose of bioidentical hormones is individually tailored (custom-compounded) for your own specific needs. This is very important since every woman is different and there is no “one-size-fits-all” treatment when it comes to optimally balancing hormones.

Synthetic hormones are derived from animal sources which are created and patented by pharmaceutical companies. They are not structurally created the same way as human endogenous hormones (inside the body) which can lead to more side effects. The dosage of synthetic hormones also varies only by milligrams which is dictated by your anti-aging doctor so it’s more difficult to tailor a custom program to meet your needs.

The Important Role of These Key Hormones:

  • Estrogen – This is the primary female sex hormone that plays a very important role in a women’s reproductive cycle as well as sexual desire (low levels of estrogen can lead to vaginal dryness which can be very painful during intercourse). In addition, estrogen regulates the menstrual cycle, reproductive tract, urinary track, heart and blood vessels and even impacts the brain. It’s also an important factor for healthy skin and strong bones. Women entering into their menopause years often get an inconsistent production of estrogen which can cause imbalances and issues with other hormones such as progesterone. The effects of this can cause weight gain, mood swings, hot flashes, decreased libido and increased risk of osteoporosis.
  • Progesterone – This hormone is produced in the ovaries and prepares the body for pregnancy and regulates the menstrual cycle.
  • Thyroid – Plays a major role in the body’s everyday functions by secreting hormones that control metabolism. Your metabolism determines the rate that cells produce. Your thyroid also determines what nutrients are absorbed and used for energy by the body. Your thyroid impacts every organ and system within the body.
  • Testosterone – Small amounts of testosterone are produced by women (a fraction compared to men) and it plays a very important role in women for a number of reasons. Women produce testosterone in the ovaries and the adrenal glands. The ovaries function to help produce testosterone even after menopause. Testosterone helps maintain lean muscle and bone mass. Building muscle helps to increase the metabolism and burn more calories. Testosterone is also a key factor in the overall sex drive for women. Low testosterone in women can lead to bone density problems, low energy, lack of mental focus (brain fog) and low sex drive along with weight gain and cardiovascular issues.

HRT Treatment Methods:

  • Pellet Therapy – Pellets include doses of different hormones that are put into a tablet shaped like a cylinder which gets implanted underneath the skin of the hip, where it then slowly dissolves and releases the hormones into the blood stream over the course of 3-5 months (depends on the rate at which your body metabolizes the pellet). The pellets use bio-identical hormones as part of the therapy. The anti-aging clinic you visit will usually take saliva, blood and urine samples to check your current hormone levels and get a baseline to be used for monitoring your on-going therapy. Your anti-aging doctor will customize your HRT plan and create your pellet using these results and they will determine what is best for you based on your current health and medical history.
  • Pills – Taking hormones in oral form. This is a less popular method compared to pellets and creams.
  • Patches – This is placed directly on the skin. This is usually recommended over pills. The downside of the patch is that it can cause skin irritations and you need to continually administer the medication.
  • Creams and Gels – The cream or gel is rubbed into the skin which makes it very convenient to many patients. It provides a slow release of the hormones into the blood stream. The downside is that the cream needs to be applied routinely and can easily spread to other family members by touching the skin where the cream was applied.

What’s Your Best Option?
It totally depends on you! The best thing to do is ask about all the options when you visit your anti-aging clinic. I’m a firm believer that you get what you pay for and investing into your health now will save you lots of money down the road. You and your anti-aging doctor are going to have to make the final decision on which type of therapy is best. The easiest type to manage would be the pellet therapy where bio-identical hormones are inserted under the skin which provides a slow and consistent release of hormones. You do it once and then you don’t have to worry about it for 3-5 months! There is no daily or weekly administration like you would have with creams, patches and pills.

How Much Does HRT Cost?
The cost involved with hormone replacement therapy varies per patient based on the required lab testing to check your current levels, your eligibility of insurance coverage, the necessary follow-up appointments, different prescriptions, and any type of nutritional supplements you may want to add to your therapy plan. The initial costs of HRT will be higher than the monthly average of on-going therapy, as the initial lab panels (blood, saliva, urine) are the most comprehensive which covers many different health markers in order to get a thorough assessment and proper identification of your body’s hormone levels to find the root cause of your symptoms. The initial consultation with your anti-aging clinic will usually consist of a 60-90 minute consultation to review your overall symptoms, medical history and current lifestyle along with a full physical. The breakdown of costs include:

  • Doctor Consultation – This initial consultation can cost anywhere from $100 to $250. This is sometimes included for free if you choose to sign-up for an annual program.
  • Blood Labs – This varies between $150 to $300 depending on the amount of labs needed. Your health insurance plan will often cover the entire cost of blood labs so be sure to check with them first.
  • Pellet Therapy – The price varies with different anti-aging clinics so it’s important to call around to get detailed pricing from several clinics before going into to meet with them. For women who require an average schedule of pellets (every four months), the price ranges from $1,500 to $1,800 per year ($500 to $600 per pellet insertion) which breaks down to $125 to $150 per month.
  • Medication (progesterone, thyroid, etc) – Insurance usually covers the majority of this cost also, so it comes down to your health insurance plan. The cost might range from $25 to $50 per month.
  • Additional Supplements: This cost can widely range depending on the clinic and the available products they offer. You could spend $50 to $100 month for additional supplements.

Why HRT is Important for Quality of Life?
As a certified personal trainer, I see women every single day in the gym that fall into this category who unnecessarily starve themselves with terrible fad diets while doing tons exercise (usually the wrong type) and they can never seem to make any progress. I really believe that most women who are over 40 years old are missing the boat on one of the most vital pieces of optimal health as they age. You might be saying, “If hormone replacement therapy is so important then my doctor would have told me about this.” The reason that most medical doctors are not discussing HRT with their middle-aged patients is usually because it is out of their scope of medical expertise and many physicians will just say, “That’s the price of getting old.” I’m not saying that HRT is going to stop the aging process, but I can say that with the advancements in medical science, we can definitely slow done the aging process. The good news is that there are specialized anti-aging doctors that are medical experts and they will be able to correct this for you with a variety of treatment methods.

I spoke with a several ladies the other day at the retirement community where I live about this very topic. These ladies were clearly overweight and exhibited many of the key signs of having unbalanced hormones. One of the ladies even mentioned that her doctor had done a test a few years back and her testosterone levels were near zero! Her doctor still did not recommend looking into any type of HRT therapy! This is the same lady that two years earlier went on a starvation diet and hired a personal trainer to get her in shape. Well, she did lose 25 pounds, but why did she gain the weight back shortly after? Without the proper hormone levels, the body’s metabolism slows down and is not capable of developing the needed lean muscle to help burn calories and body fat. This is the reason why HRT is so important!

Health Issues Associated with Unbalanced Hormone Levels
The average female who is over 35 years old usually suffers from some form of hormone imbalance. Most women are oblivious to the impact of hormones on their daily life and overall health. They ignore the symptoms and suffer the consequences through poor quality of life and often incur more health issues than women who are properly balanced. Here are some of the health issues related with having sub-optimal hormone levels:

  • Alzheimer’s Disease
  • Chronic viral infections
  • Allergies
  • Chronic fatigue syndrome
  • Migraines
  • Autoimmune disease
  • Cancer
  • Cardiovascular disease
  • Insomnia
  • Hypoglycemia
  • Type-2 diabetes
  • Osteoporosis
  • Irritable bowel disease
  • Celiac disease

Symptoms of Having Unbalanced Hormones:

  • Low libido
  • Mood swings
  • Depression
  • Increased weight
  • Lack of energy
  • Memory loss

Is Hormone Replacement Therapy Safe?
HRT is very safe when prescribed and monitored under the supervision of a qualified anti-aging doctor. The failure to not address your unbalanced hormones increases your risk of costly health issues. Your anti-aging physician will obviously review your medical history as well as your lab results to find the treatment that is best for you. Most of the HRT clinics will do blood work every 4-6 months to ensure you are in good health and on track with the right doses. It might be a good idea to talk to other women who are currently using HRT therapy to get their input and recommendations also. This is an absolute game changer when it comes to your life and appearance and it’s clearly a proactive and preventative health measure you can take right now.

What Type of Results Can You Expect When Using HRT?

  • Lose weight
  • Development of lean muscle
  • More energy
  • Better sleep
  • Increased libido and sex drive
  • Positive attitude and improved mental clarity

Now that we’ve covered the most important steps for turning back the clock by optimizing your hormones with HRT, I need to briefly discuss two other very important components when using hormone replacement therapy. Balancing your hormones is the first step for achieving your dream physique. The two other important components include:

  • Your Diet – Eating a clean diet is vital for achieving optimal fat loss and building lean muscle mass. Make sure to eat clean starchy carbs (brown rice, quinoa, sweet potatoes, old-fashioned oatmeal), lean protein (chicken breast, egg whites, lean steak, fish), lots of veggies (broccoli, mushrooms, zucchini, etc), fresh fruits and healthy fats (avocado, nuts, olive oil, flaxseed).
  • Your Exercise Plan – A balanced workout plan involving weight training, core exercises and cardio workouts are critical for building lean muscle and losing body fat. I mention weights first because developing muscle will be your best friend when it comes to achieving a lean physique.

How Long Will It Take To See Results from HRT?
It usually takes most women just a few weeks before they start feeling and seeing results after starting hormone replacement therapy. If you include a strict exercise program and healthy nutrition plan into your overall program, you should see considerable results with your overall body composition (muscle gain and fat loss) within 3 months (90 days). The key is to make sure and visit your anti-aging doctor for follow-up consultations every 3-5 months (blood labs, etc) to make sure your hormone levels are at their high-normal range and your HRT program is completely dialed in for your specific needs. Best of luck to all the women out there and I really hope this article has shed some light on this very important topic.

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About Author

Timothy Roach

My name is Timothy Roach and I'm a Certified Master Trainer, Certified Personal Trainer and I'm certified in sports nutrition. I'm also an accomplished amateur bodybuilder and have competed in 16 bodybuilding competitions. See my profile page for more information!


    • ShapeFit

      Hi Nancy – HRT for women has been very popular for many years and has helped women regain their strength, muscle tone and mental clarity. It’s a common prescribed medication at anti-aging clinics all over the country to help women live a vibrant life. As long as you get a complete checkup by an anti-aging doctor when first starting out and then follow their strict 3-6 month follow up visits to do blood labs and keep a close eye on all of your hormone and metabolic levels, then most women see great results from HRT therapy.

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