- Pam Rathbone, WHCNP -

Women's Health Care Nurse Practitioner at

Aura Integrative Health, in Lake Oswego, Oregon

Bioidentical Hormone Replacement Therapy

Pam Rathbone WHCNP, specializes in Bioidentical Hormone Replacement Therapy (BHRT).

Bioidentical hormones are derived from plant sources and are termed “bioidentical”

because they have been shown to be structurally identical to our body’s own hormones, and they are said to be metabolized the same way your body metabolizes your own hormones. This hormone therapy is not a "one size fits all". . . it is individualized to meet the specific needs for each person.  It can be compounded or it can be prescribed utilizing products purchased at any pharmacy. 


The compounds can be formulated as topical creams, vaginal suppositories, oral capsule/troches, or estradiol &/or testosterone pellets which are implanted under the skin. These are identified as doing the best at mimicking a woman's own hormone levels.  Most women report they feel "normal" when they use this route of administration. 


You are encouraged to do your due diligence and a thorough investigation. . . find a provider that you believe is experienced in prescribing bioidentical hormones.  You want to feel confident that your hormones are well balanced and managed appropriately.  If this is accomplished you can enjoy health and wellness.

About Bioidentical Replacement Therapy

Bioidentical Hormone Replacement Therapy (BHRT) can involve the following hormones:

  • Estrogen
  • estradiol
  • estriol * estrone (however, I "prefer" not to use this hormone)
  • Progesterone
  • Testosterone
  • Dehydroepiandrosterone - (DHEA)

Functions of Progesterone in Women

  • Regulation of blood sugar
  • Builds bone
  • Conversion of fat to energy
  • Regulates thyroid activity
  • Natural antidepressant
  • Calming effect
  • Important for fertility and is pro-gestational
  • Promotes calming effect through GABA (neurotransmitter in the brain) activation
  • Fluid balance
  • Neuroprotective – promotes myelination
  • Anti-inflammatory – relaxes smooth muscle
  • Balances estrogen, counters proliferative effects of estrogen
  • Natural Progesterone Decreases Breast Cancer Risk
  • Research identifies: synthetic “progestins” increase Breast Cancer risk

Functions of Estrogen in Women

  • Increases HDL and decreases LDL and triglycerides
  • Maintains bone structure
  • Increases serotonin
  • Decreases fatigue
  • Works as an antioxidant
  • Maintains memory
  • Helps absorption of calcium, magnesium and zinc
  • Decreases arterial plaque
  • Reduces cataracts
  • Helps prevents Alzheimer’s disease
  • Maintains skin collagen
  • Maintains elasticity of the arteries
  • Increases blood flow
  • Improves sleep

Function of Testosterone in the Body

  • Testosterone is needed for sense of well being
  • Bone density
  • Body composition
  • Muscle mass and strength (especially upper body)
  • Sex drive
  • Maintains memory
  • Helps prevent skin from sagging
  • Decreases excess body fat
  • Elevates nor-epinephrine in the brain (tricyclic effect)
  • Sexual sensitivity (clitoral and nipple)
  • Testosterone is lower in perimenopause and menopause

Testosterone in Women – Studies/Research

  • Literature reviewing evaluation the safety of testosterone supplementation
  • “the predominant data shows that low dose T use is safe in regards to reduced breast cancer incidence in women treated with subcutaneous (pellets
  • Six month trial in elderly women with CHF. Testosterone therapy in women
  • Improvement in sexual desire, arousal, orgasm frequency, pleasure and in women the breast and endometrium with experimental data suggesting a decrease in estrogen induced breast epithelial proliferation, and no adverse cardiovascular effects.”
  • testosterone, or testosterone with anastrozole: a prospective, observational study. Glaser,et al with chronic heart failure: a pilot double-blind, randomized, placebo-controlled study.Iellamo F, et al. J Am Coll Cardiol. 2010 Oct 12;56( 16 sexual satisfaction and reduced personal distress in women using exogenous testosterone. Testosterone for peri and postmenopausal women.

Function of DHEA in the Body

  • Decreases cholesterol
  • Decreases formation of fatty deposits
  • Prevents blood clots
  • Increases bone growth
  • Promotes weight loss
  • Increases brain function
  • Increases body mass
  • Reduces oxidative stress and lipid peroxidation
  • Reduces inflammation
  • Activates immune system function

Benefits of DHEA supplementation

  • Increase muscle strength and lean body mass
  • Activate immune function
  • Increase quality of life
  • Improve sleep
  • Increase feeling of wellness
  • Decrease joint soreness
  • Increase sensitivity of insulin
  • Decrease triglycerides
  • Decreases the damaging effects of stress
  • Helps elevate growth hormone levels

DHEA and Osteoporosis

DHEA 50 mg/d or placebo for 12 months improved hip BMD in older adults and spine BMD in older women.

DHEA – more studies needed...

A randomized trial of oral DHEA treatment for sexual function, well-being, and menopausal symptoms in postmenopausal women with low libido. Improvements in arousal, lubrication, sensation and orgasm with vaginal DHEA administration on libido and sexual dysfunction in postmenopausal women. No negative effect on lipid profile, insulin. Keeping in mind, the body is a complex mix of many hormones. . .If you feel like you have limited energy, low sex drive or weight gain you may be experiencing a hormone imbalance. BHRT can restore lost libido, poor zest for life, or persistent fatigue. There are also many other factors within the endocrine system that can contribute to an imbalance of hormones. Some of these conditions include:

  • Thyroid Dysfunction
  • Adrenal Dysfunction ( Adrenal Fatigue)
  • Metabolic Syndrome
  • Sexual Dysfunction
Careful anaylsis of high-quality scientific studies reveal that real human hormones, in well-balanced physiologic doses, are actually protective of health and well being.

Take a look at the following articles related to BHRT:

"The Bioidentical Hormone Debate...." by Kent Holtorf, published in the prestigious Journal of Postgraduate Medicine in 2009.