Two common questions we get all the time is: how much does BHRT cost? And will my insurance cover it?
If I had a dollar for every time, I have been asked this question I might have a pair of those fancy Christian Louboutin heels. It’s okay because I can't stand heels anyway, but the cost of Bioidentical Hormones is undoubtedly a significant concern.
People have budgets, so they need to know if their BHRT is going to cost them a car payment, nothing or something in between. Considering BHRT can be an ongoing monthly prescription, these are valid questions.
I have been prescribing BHRT since 2004. In that time, the cost of BHRT and insurance coverage has changed a lot. Since BHRT has increased in popularity, some compounding pharmacies have started charging more and more.
Injectable growth hormone is a perfect example. Per month growth hormone has gone from the price of a fancy dinner to more than a round-trip airline ticket to Hawaii. Also, we are well aware of the breakdown and many changes to our healthcare system. This change made what used to be almost 100% coverage of BHRT to pretty much 0%.
I work with a few compounding pharmacies, and I am very particular which pharmacies those are. Price is an essential factor, but quality and safety is the main priority. BHRT is not a supplement or vitamin. BHRT are prescription medications. That means you do not want to take something that you might be questioning quality over price.
Compounded thyroid medication is a good example. If the T3 (Liothyronine) dosage is altered by the smallest of micrograms, a patient can end up in the emergency room with a heart arrhythmia.
So what are you going to pay for BHRT? Unfortunately, this is a loaded question without a definite answer. It depends on how many BHRT prescriptions you are taking. As well as what dosage and the type you need for your specific health goals.
To be incredibly broad (sorry) each prescription is going to cost between $30 to $70. With the average cost of a prescription being right around $50.
Sorry to break this to you, but insurance is most likely not going to cover any of it. Some insurances might cover a portion of the prescription, but usually not the full cost.
Conventional hormone replacement can be covered by insurance, but these hormones cannot be tailored to the individual and have some unwanted side effects. This is why patients do well on custom BHRT, but unfortunately, there is going to be an out of pocket pricing. I understand this episode may seem vague and might leave you frustrated. But honestly, this is the best I can tell you. And I am sure the cost and insurance coverage will continue to change.
If you have concerns, questions or even your personal story, please post in the comment box below or email us at [email protected]
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Traditionally when one thinks of Bioidentical Hormone Replacement Therapy (BHRT), they immediately think of menopause. That hormone therapy is used to treat menopausal symptoms such as hot flashes and night sweats. But in the last 10-15 years, hormone replacement has become more than a fix for hot flashes. But did you know that you can use BHRT for memory, energy and even libido? Did you know that men and women of all ages use BHRT? There are many other conditions that BHRT can treat. Below are a few conditions that BHRT can address that you may not know about.
Hypothyroid:
When people think of hypothyroid medication, you may think of Synthroid or the porcine thyroid (Armour/Nature Throid). However, Compounded Thyroid, which is a combination of Levothyroxine and Liothyronine, is an excellent option to treat hypothyroid.
PMS:
Using bioidentical progesterone helps to alleviate some of the symptoms related to PMS. You can use progesterone in many different dosage forms depending on the situation. From creams to capsules, to troches to vaginal suppositories. You can use bioidentical progesterone all month long or just part of the month or even a few days of a woman's cycle for PMS symptoms.
PCOS:
The conventional approach to PCOS is to prescribe birth control pills. However, this is such a limited treatment approach, and there are some potential side effects associated with birth control. But with BHRT you can individualize the doses of BHRT to the patient. This can help with PCOS symptoms but also help with the long-term effects of PCOS on the body such as the androgenic effects and fertility.
Perimenopause:
My patients in perimenopause describe it as feeling like they have PMS symptoms all month long. Plus, it is not healthy to use birth control pills in a perimenopausal female. Bioidentical hormones can be used effectively and safely to help women with perimenopausal symptoms. The symptoms range from irritability to trouble sleeping. From low libido to hair loss and acne. Bioidentical hormones can even help with perimenopausal weight gain.
Low Testosterone aka Low T :
Men can use Bioidentical Testosterone to address Low T. Conventionally low testosterone is treated with injections and gels, which can be expensive and cause some unwanted side effects. Besides, conventional testosterone cannot be tailored to the patient. Whether it is personal symptoms or family health history, hormone replacement therapy needs to meet the needs of the patient. Conventional this can be difficult to do. But with BHRT you can design the testosterone to the patient.
Adrenal Dysfunctions/Adrenal Fatigue/ Adrenal Insufficiency:
There is more to Bioidentical Hormone options besides just the reproductive hormones. You can use BHRT to treat Adrenal Fatigue. BHRT for adrenal fatigue can include pregnenolone, DHEA, and hydrocortisone. These hormones can also come in creams, sublingual, capsules, and tablets.
Menopause:
This is what everyone thinks of when they hear Bioidentical Hormone Replacement Therapy (BHRT). The great aspect of BHRT is you can make any dose you want depending on the particular patient's symptoms. For women in menopause, there are many different symptoms and goals for each person.
For some women, their goals are to reduce hot flashes and night sweats. Other goals for women in menopause are low libido, vaginal dryness, and pain with intercourse. Others, it's dry skin and tonicity. Other women help with preserving bone density. With BHRT you can custom design the doses for the goals of the person.
As you can see Bioidentical Hormones Replacement Therapy can be helpful for more than just menopause. BHRT can be prescribed for men and women of all ages. There are exceptions to who is and is not a candidate for BHRT, but that is another episode in itself.
Develo

As I have always stated before, us ladies are a symphony of hormones. If one hormone is out of tune, it is quite apparent. However, sometimes it is hard to hear what instrument (hormone) is out of tune because when one hormone is out of balance, others seem to follow suit. So remember, it is not a good idea to fixate on one hormone being out of balance. It's about balancing them as a whole.
Patients tell me all the time, they have estrogen dominance.' They read on the internet, and their symptoms fit estrogen dominance.' Yes, their symptoms do fit estrogen-dominance, but It does not mean their estrogen is the only hormone that is off.
I am going to go through some common estrogen dominance symptoms' that you might find on the internet. And I will explain what other hormones might be at work here besides estrogen. Later in another episode, I will delve into more detail, causation, and treatment to balance our hormones.
PMS:
“My PMS is off the chain 7-10 days before my period! . This is actually because the progesterone is too low compared to the estrogen level. It is not that estrogen is too-high, but because the progesterone failed to peak after ovulation or it dived too quickly before your period.
Fibrocystic breast tissue:
If your estrogen is high, it can cause dense breast tissue and fibrocystic breasts. Estrogen likes to grow things. So if estrogen is not balanced or is high, the breast tissue will thicken and can become fibrocystic. Also, caffeine can exacerbate or lead to fibrocystic breast tissue.
This is because the progesterone level is to low for the amount of estrogen. Your estrogen levels might be “normal,” but because the progesterone is lacking it cannot hold back the estrogen. So estrogen will continue to grow that uterine lining.
Headaches:
This again is because the progesterone is too low for the amount of estrogen. A drop in progesterone can cause hormonal headaches starting at 14 days before your period. If you have headaches the last half of your cycle, your progesterone might be too low.
Breast swelling and tenderness:
Estrogen can cause water weight. Our breast tissue is very sensitive to estrogen. So if your estrogen is high, it can cause water retention in the breast tissue, making them feel full, heavy and, tender.
Weight gain in the belly:
Female hormones can contribute to weight gain, but not by themselves. It happens via the connection that estrogen/progesterone has with insulin and cortisol. High levels of cortisol and insulin will cause fat to accumulate around the mid-section. When the progesterone is low, or estrogen is high, that can cause insulin and cortisol to elevate. This will make you gain weight and also make it hard to lose.
Mood swings:
Feeling grumpy, snarky, irritable, weep, or sad. When the progesterone to estrogen balance is off, it can definitely affect our moods. If progesterone is low, that causes irritability. When you feel like everything it aggravating and you are quick to anger. That is low progesterone. If you feel weepy and nostalgic, that is high estrogen.
Decreased sex drive:
I think this is because the progesterone is too low and it makes us irritable. And us ladies do not want to have sex if we are angry or aggravated. High levels of estrogen do not drop the sex drive. Low levels of estrogen drop the sex drive. That is why sex flies out the window when we enter perimenopause or menopause.
Fibroids/polyps/exacerbated endometriosis:
Again, estrogen likes to grow stuff. If estrogen is high, it can also grow fibroids and polyps. It does seem to aggravate endometriosis.
Cold hands/feet, hair loss, foggy thinking, memory loss:
If you have any of these symptoms, then we want to look at your thyroid. Thyroid comes into play with estr

You know you have heavy periods when .

When you have tampons everywhere. In every single purse, the glove box of your car. In the glove box of your friend's and spouse's car. In the kitchen drawers, all bathrooms, in your jacket pockets, even your grocery bags.
You never wear white.
You don't own white underwear because at some point they will no longer be white.
You know exactly when and how much ibuprofen you can take.
You have a whole bunch of the light tampons because you never use them from the box.
You laugh at the purple Tampax lites.  Because seriously, what magical woman actually uses them? And we hate her.
You time everything around your period. How long can I stay in the meeting? How long is that exercise class? How long is that road trip and what are the stops on the way?
You always get your period right before or during vacation.
You devote an entire bathroom cabinet to super-heavy-plus tampons and those huge, bulky overnight pads.
If you have heavy periods, aka menorrhagia, then you know quite literally what a pain it can be.  From the pain of cramping to always knowing where is the closest bathroom.  

For the most part, heavy periods are benign, just bothersome. (But if you have heavy periods make sure to discuss with your doctor so that you do not become anemic and test for underlying diseases/disorders.)
But what causes heavy periods?  Below are some of the more common reasons women may develop heavy periods.

Estrogen-Progesterone Imbalance:

Having an elevated level of estrogen or lower progesterone can cause heavy periods.  Estrogen is the best hormone in the world. Estrogens keeps your skin youthful and hydrated.
Your own estrogen is good for your heart, bones, brain, hair, sleep, and libido to name a few.  But she can be a runaway train if not balanced.  Estrogen likes to grow-things.  Estrogen grows our breast tissues and uterine lining. If there is an imbalance of lower progesterone to estrogen, she will grow the uterine lining so thick that you practically hemorrhage once a month.  It is important to have your hormones checked and balanced if you have heavy periods.

Low thyroid function:

Hypothyroid can also contribute to heavy periods.  The thyroid also helps to rein in estrogen's negative effects. If your thyroid is low, the estrogen will grow that uterine lining very thick.  So that you will have heavy periods and also commonly spot through the cycle.  It will also cause the period to last for what seems like FOREVER. If you have heavy periods, mid-cycle spotting, long periods, talk to your doctor about testing your thyroid.

With all of the recent changes in health insurance, blood testing is more expensive than ever.  Below are few questions and situations we get from our patients and thought it would be good to discuss.  Do any of the following sound familiar? My Doctor Won’t Order Thyroid Function Test, What Should I Do? We see […]

Which thyroid medication is best?  This is a question we get from patients quite often.  Conventionally for hypothyroidism, there is one medication prescribed. Regardless of your gender, family/personal history, symptoms, goals. If you need thyroid replacement, you will get Synthroid. If you have had your thyroid gland radiated, now it is hypothyroid. If you have […]

Hashimoto Thyroiditis is an autoimmune process where your immune system will attack your thyroid gland. This attack will eventually cause the thyroid function to drop. Inevitably, Hashimoto’s disease causes hypothyroid. There are two primary blood antibodies to test for Hashimoto’s disease. Thyroid Peroxidase Antibody (TPO) Thyroglobulin Antibody (TgAb). If you have one or both of these […]

The most common test for thyroid is the TSH, which stands for Thyroid Stimulating Hormone. Unfortunately, this is also the only test most conventional doctors use to screen for thyroid disease.   If the TSH is elevated (above 4.5 mIU/L), you are hypothyroid, and if the number is low (below 0.45 ng/dL), you are hyperthyroid. […]

“My doctor will only test my TSH level for my thyroid. He/She says my thyroid is normal based on my TSH level, but I feel I have a thyroid problem! I hear this all the time with my new patients. They have been to their internist, their primary care, and even endocrinologists, but they get […]