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Ask the Doctor: What Conditions Can Be Treated with BHRT?


Bioidentical hormones Last week, I wrote to you about bioidentical hormone replacement therapy (BHRT), a more natural method of treating hormonal imbalances that utilizes forms of hormones that are molecularly identical to what the body naturally produces. Here are some of the conditions that can be treated with BHRT.


Classically defined as the time period in a woman’s life that occurs one year after her last menstrual period. Symptoms commonly include hot flashes, night sweats, insomnia, irritability, mood changes, thinning hair, vaginal dryness, decreased libido, bone loss and urinary tract infections. Treating menopausal symptoms is the most common application of bioidentical hormone replacement therapy. It offers effective relief with a great safety record.


This refers to the state preceding menopause when a woman might be having menopausal symptoms but is still have regular or irregular menstrual periods. Symptoms typically include night sweats, hot flashes, irritability, increased menstrual bleeding, menstrual irregularities, headaches, insomnia and decreased libido.  BHRT can greatly help ease the symptoms associated with peri-menopause and ease the transition into menopause.


Premenstural syndrome symptoms occur due to the dramatic shift in hormone balance that occurs just prior to the onset of menses. It is considered normal to have some shift in physical and mental state as a result of this dramatic shift, but some women can experience more extreme symptoms. Having a greater severity of symptoms or a longer duration of symptoms can mean that hormone balance is off and the transition of hormonal states needs to be supported and regulated. Bio-identical hormones, particularly progesterone, can play a critical role in supporting a woman’s body through the hormonal shifts associated with monthly menstrual cycles.


Often referred to as “male menopause”, this condition occurs when testosterone levels significantly drop in a male typically after the age of 50. Symptoms include; low libido, erectile dysfunction, fatigue, muscle wasting, cognitive declines and depression. Bio-identical hormone replacement using testosterone can effectively reverse this condition and help many men retain their health and vigor as they age. There has been some concern regarding the use of testosterone therapy as it relates to prostate cancer, but new research is suggesting that testosterone therapy does not increase prostate cancer risk.[1]


Hypothyroidism is a very common condition predominantly diagnosed in women but also relatively common in men. Many different treatment options are available, most of which use hormone replacement strategies that utilize a form of hormone identical to what our body produces. However, many people do not react well to some of these synthetically manufactured thyroid hormone substitutes. An alternative is using a thyroid medication derived from the thyroid tissue of an animal. These preparations contain thyroid hormones in ratios similar to what our body naturally produces and are derived from a totally natural source without any synthetic laboratory manufacturing.  Many people benefit from the use of these naturally derived hormones vs. the synthetic counterparts.

Adrenal Fatigue

This is a condition largely unrecognized by the Western medical community. It refers to functional decline in the ability of the adrenal glands to produce an adequate response to stress. The hormone cortisol is the primary adrenal hormone and plays several roles in our body’s function. Its main job is to help our body and brain deal with stress by triggering the release of stored sugar into the bloodstream for increased cellular activity. What most people don’t realize is that our body has a natural daily rhythm of cortisol output where levels spike in the morning upon waking and steadily decline throughout the day to reach their lowest level at night before bed. This is the body’s natural way to support energy during the daytime when energy demands are the greatest and to spare energy expenditure at night when our body’s rest.

Adrenal fatigue results when the adrenal system falters in its ability to release cortisol levels in appropriate amounts throughout the normal circadian cycle. Typical blood cortisol tests are poor at picking this information up and are the reason this condition is largely ignored. Salivary testing is a more accurate way of assessing how much cortisol is available to the cells and is the most helpful at diagnosing adrenal fatigue. Typical symptoms include; fatigue, inability to handle stress, insomnia, hypoglycemia, low blood pressure, salt cravings and many other common health concerns. Bio-identical hormone replacement with low dose adrenal hormones can significantly improve how someone with adrenal fatigue feels and support the gland in recovery.

Weight Loss Difficulty

Weight loss is related to many different factors. Hormonal factors are one of the most important. It is estimated that a menopausal woman will have to engage in 3x the amount of exercise just to maintain pre-menopause weight![2] For men, low testosterone levels can significantly contribute to a decrease in muscle mass and an increase fat tissue. BHRT can help to safely restore optimal hormone levels and support an ideal body mass index and weight loss.

[1] Feneley MR, Carruthers MD. Is Testosterone Treatment Good for the Prostate? Study of Safety during Long-Term Treatment. J Sex Med. Aug 2012;9(8):2138–2149.

[2] Lee IM, Djoussé L, Sesso HD, Wang L, Buring JE.  Physical activity and weight gain prevention. JAMA. 2010 Mar 24;303(12):1173-9.

Dr. Passero completed four years of post-graduate medical education at the National College of Naturopathic Medicine in Portland, Oregon after receiving a Bachelor’s Degree in Environmental Biology from the University of Colorado. Dr. Passero has trained with some of the nation’s leading doctors in the field of natural medicine. In his practice, Dr. Passero focuses on restoring harmony to both the body and mind using advanced protocols that incorporate herbal therapy, homeopathy, vitamin therapy and nutritional programs. Through education and guidance patients are able to unlock the natural healing power contained within each one of us. For more information, visit his website, Green Healing Wellness, or follow him on Facebook.

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