Sunday, December 25, 2011

What is the best delivery system for Bioidentical Hormones?

What’s the best delivery system for bioidenticals?

Generally, I try and put the hormones directly into the bloodstream without having to go through the stomach, intestine, and liver first. This is more physiologic (like normal human physiology) and does not cause adverse effects on clotting factors thus avoiding increasing one’s risk of stroke, heart attack, and venous blood clots.

There are five ways to do that:
1. Subdermal -- under the skin as with Pellets
2. Trans-dermal (through the skin as with patches, gels, or creams),
3. Vaginal suppositories or gel
4. Sublingual (under the tongue), or
5. Intramuscular injection (as with testosterone cypionate which is not quite bioidentical).

I prescribe compounded transdermal creams of female and male hormones quite frequently. With creams, it’s easy to change dosing and can be tailored just for you. It allows for more physiologic cycling if desired. However, it is more inconvenient and more costly, and the benefits might not exceed the costs for some people.

I use highly experienced compounding pharmacies who have excellent reputations amongst doctors like myself to make up these prescriptions for you.

Oral Prometrium or other progestin must be taken about 2 weeks a month or six days a week if you have your uterus still.

I hardly use sublinguals. They have to be dosed twice a day and allowed to dissolve under the tongue.

I’m using injectable hormones only for males, and it is called testosterone cypionate. I recommend injecting it once a week to reduce the peaks and valleys in blood levels.

I do not prescribe HGH (human growth hormone) in my practice at this time. It’s very expensive and its use is controversial.

For an excellent article on bioidentical hormones out of Harvard, go to

Call my office in Lombard (630) 627-3700 to set up an appointment or email me at


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