Bioidentical hormone replacement therapy (BHRT)
A physiological approach to hormonal aging in menopause and andropause
The Linus Pauling Prevention Center (LPPC) offers individual and medical approaches to hormonal changes associated with aging. One of the spearheads of this is the use of bioidentical hormone replacement therapy (BHRT) in menopausal women and andropausal men, always within a clinically supervised, evidence-based and personalized framework.
What is bioidentical hormone replacement therapy?
BHRT uses hormones that are molecularly identical to the endogenous hormones produced by the human body itself. Unlike synthetic or modified hormones, bioidentical hormones are better recognized by the body’s hormonal receptors and have a more physiological profile of action and metabolism.
Examples:
– Estradiol (E2) and progesterone in women
– Testosterone in men
– If indicated: Melatonin, DHEA, pregnenolone, melatonin, thyroid hormones (T3/T4)
Menopause: restoration of estrogen balance
After menopause, the production of estradiol and progesterone drops dramatically. This can lead to symptoms such as:
– Hot flashes, night sweats
– Sleep disturbances and mood swings
– Cognitive decline
– Vaginal dryness and libido loss
– Bone breakdown and increased cardiovascular risk
With BHRT, we aim for physiological substitution, administering low, measured doses of bioidentical estradiol and progesterone – preferably transdermally or vaginally, depending on indication and risk profile. The goal is to increase quality of life and protect long-term health, not mere symptom control.
Andropause: focus on testosterone and vitality
In men, starting in middle age, we see a gradual decline in free and total testosterone, often accompanied by:
– Decreased libido and erectile dysfunction
– Muscle loss and increase in fat mass
– Fatigue, somberness, decrease in drive
– Cognitive slowing and irritability
A correct diagnosis requires thorough hormonal analysis, including SHBG, LH, FSH, DHEA, cortisol and thyroid function. In case of a clear deficiency and relevant symptoms, substitution with bioidentical testosterone (e.g. gel, cream or injection) can be considered, with regular medical follow-up.
Medical protocol within the LPPC
Within the LPPC, we employ a carefully constructed protocol for BHRT that relies on:
1. Hormonal and metabolic diagnostics (blood tests, possibly saliva or urine in complex cases)
2. Risk stratification (family history, imaging in women at mammography risk or men at prostate risk)
3. Start with low dose – physiologically tailored
4. Regular monitoring of efficacy and safety (symptoms, blood values, biomarkers)
5. Combination with lifestyle interventions (nutrition, exercise, stress management, orthomolecular support)
BHRT in the context of healthy aging
Bioidentical hormones are used within the LPPC not merely symptomatically but as part of a broader aging strategy. The approach focuses on:
– Functional vitality and quality of life
– Bone health and cognitive protection
– Cardiovascular balance
– Prevention of sarcopenia and metabolic syndrome
Treatment goals are always determined in consultation with the patient, respecting individual wishes, medical context and ethical considerations.