HRT FAQ - Part II

Do hormones for men differ than hormones for women?

The answer to this is yes and no. Men and women produce the same sex hormones. Yes, men make estrogen and progesterone just like women. The difference is that men and women produced different levels of these hormones. Men predominantly produce testosterone and often when placed on testosterone replacement therapy (TRT), they will convert some of that into the estrogen they need. Likewise, women can do the same with estrogen and converting it to the testosterone they need. This can also be facilitated by DHEA which is produced by the adrenal glands. Sometimes, though, women will need to be on TRT along with their other sex hormones. Of course, the dosing is just a fraction of what a male dose would be.  Both men and women, should also have thyroid and insulin levels evaluated. These are basic hormones and play a role in how a patient feels as well as their health outcomes long term. Often hormone therapy is thought to just include the sex hormones but really an approach should focus on sex hormones, adrenal glands, thyroid function, and insulin resistance.

What are the best forms available for BHRT?

This is a loaded question. There are many options available for patients including pills, creams, pellets, injections, etc. For some patients, depending on how their body processes hormones and other chronic diseases they may have, they may do better with a certain form over another. I.E. Insulin resistance increases conversion of testosterone to estrogen in men and the opposite in women. This appears to occur more with testosterone injectables in men over cream. Therefore, a diabetic who starts TRT may benefit more from a cream over an injection. Which format is very patient dependent and that is why it is important to have a hormone provider who can work individually with patients vs using a “cookie cutter” type protocol.