Bioidentical Hormone Replacement Therapy (BHRT)

What "bioidentical" means

Bioidentical hormones have the same molecular structure as the hormones your ovaries produce. Estradiol and micronized progesterone are the most common, and many bioidentical products are FDA-approved and regulated for consistent dosing — including estradiol patches, gels and sprays, oral micronized progesterone, and vaginal estradiol.

Custom compounded hormones also exist, but they are not FDA-approved and dosing can vary. JennWell favors regulated, evidence-based bioidentical options and discusses compounded products transparently when they come up.

Who may benefit

Hormone therapy is the most effective treatment for hot flashes and night sweats. It can also improve sleep, mood swings, joint aches, vaginal dryness and sexual comfort, and it helps prevent bone loss. Women who are in perimenopause or within about ten years of their final period, and generally under age 60, tend to see the most favorable balance of benefit to risk.

• Moderate to severe hot flashes or night sweats
• Sleep disruption tied to vasomotor symptoms
• Early or surgical menopause
• Bone loss risk
• Vaginal dryness and painful intercourse

Your BHRT consultation

Your visit includes a symptom review, personal and family history of breast cancer, blood clots, stroke, heart disease and liver disease, blood pressure, and an up-to-date breast and cervical screening plan. Labs may be ordered to check overall health, though menopause itself is diagnosed primarily by symptoms and age.

If you have a uterus, estrogen is always paired with progesterone to protect the uterine lining. Transdermal estrogen (patch, gel or spray) is often preferred because it bypasses the liver and carries a lower clot risk than oral estrogen.

Monitoring and adjustments

Most women notice improvement in hot flashes within two to four weeks, with fuller benefit by three months. Follow-up visits assess symptom relief, bleeding patterns, breast tenderness and blood pressure, and dosing is adjusted to the lowest dose that achieves your goals. Annual reviews revisit benefits and risks as you age.

Understanding the risks honestly

Older headlines from the Women's Health Initiative frightened many women away from hormones. Later analyses clarified that age and timing matter greatly, and that transdermal estradiol with micronized progesterone appears to have a more favorable profile. Hormone therapy is not right for everyone — including women with a history of certain breast cancers or blood clots — and non-hormonal options are always discussed.

Preparing for your visit

Coming prepared helps you get the most from an appointment about hormone therapy. Write down your symptoms, how often they occur, and how they affect sleep and work. Gather your family history of breast cancer, blood clots, stroke and heart disease, and the dates of your last mammogram and Pap test. If you have tried hormones before, note the product, dose and how you felt.

JennWell Women's Health is located at 11844 Standing Stone Dr., Suite 200 in Gretna, inside Skilled Touch Health and Healing, and welcomes women from Elkhorn, West Omaha, Millard, Papillion, La Vista, Bennington, Lincoln and across Eastern Nebraska. To schedule, call (402) 800-8595 or request an appointment online. If you are unsure whether this service is right for you, a consultation is a no-pressure place to start the conversation and learn your options.