Hormone Optimization Therapy

Why do our hormones need to be balanced?

Hormones are the messengers of our endocrine system. Our glands secrete these biochemicals directly into our bloodstream – through which they travel to their target sites: every cell, tissue, organ, and body system. Once they arrive, hormones deliver commands to our cells, which then perform our growth, musculature, bone density, metabolism, and sexual functions.

Like orchestra musicians performing under the conductor’s command to play louder or softer, faster or slower, hormones must be released by a gland at the optimum rate and duration to stimulate harmonious health.

Even a small over or under production of a hormone can cause havoc in your body.

That’s why regenerative medicine practitioners customize each treatment, tuning in to your unique, and often subtle requirements before beginning hormone optimization to tap into your body’s regenerative powers.

Dr. James Robles is a highly experienced regenerative medicine practitioner.

He is one of the only a handful of doctors who’s earned 14 certifications at some of the world’s most progressive institutions—including World Link Medical certifications in hormone optimization therapy, and is currently pending Metabolic Institute certification in anti-aging regenerative medicine.

Dr. Robles is most proud of the innumerable patients who thank him daily for reviving their energy levels, boosting their immune system, fortifying their bone density, and rejuvenating their libido.

He has thoroughly trained his in-house physical therapists, nutritionists, phlebotomists, and imaging technicians to utilize his integrative, holistic evidence-based methods to:

  • restore your physical and mental balance to minimize or prevent future damage
  • rejuvenate your sexual enjoyment by replenishing dwindling hormone levels
  • regenerate your energy by powering up your body's intrinsic healing abilities

What causes hormone imbalances?

As biochemicals, hormones react to one another, as well as to outside chemicals – like those in the foods and beverages you ingest, in the air you inhale, and in the substances you apply to your skin and organs. These chemical interactions may prevent cells from getting their “go” signal from your hormones.

Hormone fluctuations may be influenced by various factors throughout your lifecycle:

  • natural aging at genetically influenced rates
  • environmental and lifestyle stress
  • toxic exposures
  • poor diet
  • unhealthy sleep patterns

What are the signs of low testosterone?

As men age, their bodies naturally make less testosterone. In fact, by the time men are in their mid-forties, their testosterone levels can be down by 40%. Lifestyle factors such as excessive stress, weight gain, and lack of exercise can lower their levels even further – impacting stamina, sex drive, virility, and bone strength, and potentially leading to chronic fatigue, erectile dysfunction, and even heart disease. A study published in Circulation Journal demonstrated that low testosterone may be a predictive marker for those at high risk of cardiovascular disease.

As women age, testosterone may affect their ovarian function causing irregular periods, stimulating facial hair growth, destabilizing bone strength, and diminishing libido.

Both men’s and women’s sex organ functions require an optimal balance of estrogen and testosterone, which varies for each individual, depending on age, genetics, diet, and lifestyle, as well as various environmental and health factors. Some signs of low testosterone are the same in men and women. Others vary.

Warning signs of testosterone imbalance in men include:

  • low libido
  • erectile dysfunction
  • infertility
  • low sperm count
  • loss of body hair
  • poor concentration and memory
  • depression
  • insomnia
  • decreased energy, motivation, or self-confidence
  • reduced physical performance and muscle mass
  • increased body fat

Warning signs testosterone imbalance in women include:

  • irregular or absent periods
  • excess body or facial hair
  • depression
  • acne or oily skin
  • increased muscle mass
  • decreased breast size
  • deepening voice
  • chronic fatigue
  • low libido

Unlike in women, whose estrogen production halts completely during menopause, men’s hormone production declines at a much slower rate. However, the testes’ function may undergo changes as early as age 45 or as late as age 70.

What are the signs of low estrogen?

Women of all ages can develop low estrogen levels, and the condition may be genetically inherited. During menopause low estrogen levels can make women dangerously susceptible to bone density loss. Common signs of low estrogen include:

  • fatigue
  • depression
  • mood swings
  • hot flashes
  • breast tenderness
  • decreasing bone density
  • diminished concentration
  • irregular or absent periods
  • headaches or accentuation of pre-existing migraines
  • diminishing vaginal lubrication leading to painful sex
  • thinning urethra leading to frequent urinary tract infections

If you have these symptoms, speak with Dr. Robles to diagnose or rule out any other underlying medical conditions before discussing testosterone supplementation.

Menopause

Estrogen depletion usually leads to the end of a woman’s menstrual cycles – menopause – and may cause the following:

  • dry skin
  • weight gain
  • hot flashes
  • night sweats
  • mood changes
  • thinning hair
  • vaginal dryness
  • decreased libido
  • slowed metabolism
  • decreased fertility
  • irregular periods or period cessation
  • loss of breast fullness and elasticity
  • osteoporosis: degradation of bone density
  • urinary incontinence: vaginal tissues lose elasticity, causing frequent urinary urges
  • cardiovascular disease: spiking cholesterol and blood pressure may increase heart disease risks

It’s makes a lot of sense to monitor hormone levels throughout your lifespan and take action early to address imbalances before they affect your health and quality of life.

How can I get my baseline hormone levels tested?

To make sure you achieve accurate hormone levels, Dr. Robles will have to learn everything about your medical history, diet, lifestyle, sleep patterns, and medications. A genital exam may help diagnose or rule out any possible underlying medical conditions that could be causing your symptoms. Then he will decide to do one of the following:

Blood test

This is a simple outpatient procedure. Dr. Robles’ phlebotomist will draw a blood sample from your arm and send it to a lab for hormone level baseline analysis.

Functional medicine specialists observe and treat the gray states in between “normal” and “failing” blood test results, addressing the root causes behind your ever-evolving symptoms.

Your hormone levels are not static. They change throughout your life stages, and even throughout the hours of your day, so they may need to be monitored throughout your therapy.

As the Harvard Medical website explains, determining if a man is truly testosterone deficient is far from simple. Why? Sex hormones in the bloodstream are 95-99% bound to carrier proteins, and in this form are unavailable to target tissues. Dr. Robles will be monitoring your levels during hormone replacement therapy, so he can adjust your treatment accordingly.

Urine test

Low hormone levels may prompt Dr. Robles to recommend other tests to help pinpoint a diagnosis, such as the follicle-stimulating hormone (FSH) test, which is an FDA approved urine test. FSH manages the menstrual cycle in women and prompts the production of sperm in men.

How can Bioidentical Hormone Replacement Therapy Improve My Health?

There’s more than one way to conduct a harmonious symphony. Likewise, there is no one-size-fits-all solution to hormonal harmony. The type and duration of your treatment will depend on the intensity of your symptoms and conditions, your diet and your ability/willingness to alter it, your lifestyle and your ability/willingness to alter it enough to practice time-consuming treatments, and your patience level.

World Link

Gradual treatments produce slower, more subtle results than fast-working, high-potency pharmaceutical treatments. This solution requires patience.

BHRT is derived from plant material like yams or soybeans and is molecularly identical to our body’s endogenous (produced within your organism) hormones. It treats those dwindling hormones differently than chemical-based hormone replacement.

This form of therapy allows hormone levels to be monitored more precisely and adjusted with each patient’s fluctuating needs. It’s a customized solution that Dr. Robles modifies throughout the life of your therapy.

His team is very sensitive to the synergy between hormones. For example, when the adrenal glands’ supply of cortisol-producing cholesterol and pregnenolone fluctuates dramatically, it affects progesterone, estrogen, testosterone, and dehydroepiandrosterone (DHEA) levels.

Your treatment starts with small doses that slowly increase over time. Throughout your treatment, Dr. Robles will monitor and adjust your hormone levels. Monitoring with quick, convenient saliva testing may help prevent dangerous hormone overproduction. Too much cortisol, for example, may cause weight gain, impaired healing, and fragile skin. Dr. Robles’ team is always vigilant about side effects.

How is Bioidentical Hormone Replacement Therapy delivered?

Hormones can be optimized in pill, patch, pellet, or gel form.

Pellet therapy

Dr. Robles will inject a hormone pellet under the skin of your abdomen, where it dissolves and absorbs into your bloodstream. BHRT pellets can be as small as size of a rice grain or as big as a Tic Tac – small enough to allow your usual activities. However, you should avoid vigorous physical activity and swimming for 4-5 days after the pellets are inserted. You can shower, but do not scrub the incision for about five days, or until it is properly healed.

Pellet therapy is minimally invasive and safer than other methods because it’s:

  • gradual: instead of shocking the body with one very high dose, subcutaneous pellets deliver hormones gradually and consistently
  • long-lasting: a single pellet often lasts for months, without the need to take pills or remember schedules
  • easily implemented: pellets are almost always inserted accurately, with great success

You may begin to see these improvements as soon as 24-48 hours, or they might take up to a week:

  • improved sleep
  • increased energy
  • improved memory
  • a positive attitude
  • increased strength
  • decreased fatty tissue
  • improved skin tone and hair texture

Women’s pellets typically last 3-5 month, while men’s pellets usually last about 5-6 months. Stress, physical activity, and certain medications can make them dissolve faster. After treatment begins, your hormone levels will be measured every few months to determine its effectiveness. In some cases, pellet therapy lasts up to five years.

Other treatments that can help restore women’s estrogen to normal levels include:

  • pill: generally taken once a day without food, pills are the most common hormone treatment
  • patch: worn on the skin of your abdomen to regulate estrogen
  • topical: spray, gel, or cream that’s absorbed into your bloodstream through your skin
  • vaginal: cream, ring, or tablet to manage your menopause symptoms

Some testosterone optimization treatments for men include:

  • skin patch: applied once a day to introduce testosterone into your bloodstream
  • gel: delivers testosterone into your bloodstream daily via skin or inside your nose
  • mouth patch: a tablet that sticks to your gums and continuously releases testosterone
  • injection: testosterone administered directly into the muscles
  • pellet implant: an implant beneath your skin that slowly releases testosterone

What results can I expect?

Restoring testosterone to optimal levels may induce:

  • renewed sexual interest and vigor
  • increased muscle mass
  • increased cognition (mental ability)
  • enhanced confidence and motivation
  • greater concentration
  • increased personal and professional performance
  • stronger mood stability
  • increased or bone density

Restoring estrogen to optimal levels may:

  • reduce hot flashes
  • reduce vaginal dryness
  • reduce risk of osteoporosis
  • improve mood stability
  • renew sexual interest and vigor
  • reduce adrenal fatigue

How can estrogen optimization treat osteoporosis?

More elderly Americans die every year of orthopedic fractures than die of cancer. In women, there is a direct correlation between menopause and the development of osteoporosis due to sudden and often severe drops in estrogen levels.

In a randomized, double-blind trial, 500 osteopenic women were given low doses of 17β-estradiol every day. After 2 years, 77.3% receiving this bioidentical hormone had no measurable bone loss in the lumbar spine – the control group did.

Primary subtypes of osteoporosis include:

  • type 1 (postmenopausal): occurs due to a loss of estrogen in women between 50-70. Women are 6 times more likely to have this then men
  • type 2 (senile): caused by a long-term calcium deficiency. Women are twice as more likely than men to have this type

Men are also at risk of developing osteoporosis due to a drop in testosterone called andropause. Research shows that about 70% of men with osteoporosis also experience other symptoms of testosterone deficiency syndrome (TDS), suggesting that age-related testosterone deficiency is one of the major causes of senile osteoporosis.

Secondary osteoporosis causes include disease that affects the growth of new bone, such as:

  • diabetes
  • leukemia
  • liver disease
  • multiple myeloma
  • Cushing’s syndrome
  • metastatic bone disease
  • intestinal malabsorption
  • hypercortisolism from long-term oral corticosteroid use
  • medications like antacids containing aluminum, heparin, and methotrexate
  • imbalance from the increased activity of the parathyroid glands (hyperparathyroidism)

What are the possible side effects BHRT?

Like any medical procedure, hormone therapy presents potential risks and side effects that will vary depending on your age, genetics, environmental factors, biochemistry, and general health.

Male hormone optimization therapy side effects may include:

  • hair loss
  • testes shrinkage
  • breast enlargement
  • limited sperm production
  • acne or other skin reactions
  • sleep apnea (breathing stops and start during sleep)
  • deep vein blood clot formation (deep vein thrombosis)
  • blood clot blocking lung blood flow (pulmonary embolism)
  • noncancerous prostate growth (benign prostatic hyperplasia)

Female hormone optimization therapy side effects may include:

  • nausea
  • stroke
  • fatigue
  • headaches
  • mood swings
  • breast cancer
  • heart disease
  • water weight gain
  • mild breast tenderness
  • sensitive hormone receptors
  • vaginal bleeding (non-menstrual)
  • bone density and muscle mass increase
  • uterine cancer (unless progesterone is also taken)
  • deep vein blood clot formation (deep vein thrombosis)
  • blood clot blocking lung blood flow (pulmonary embolism)

If you experience any of these side effects, call Dr. Robles immediately.

Request Your Appointment Today!

Unbalanced or decreasing hormone levels are a natural part of the aging process, but these changes don’t have to dampen your quality of life.

Hormone optimization therapy can help restore your vigor, appearance, and sense of well-being. As with all medical procedures, results will vary depending on your age, genetics, medical history, environmental factors, and general health.

To discover how Dr. Robles can enhance your daily life and health and learn which hormone optimization treatment best suits your needs, call Advanced Pain Relief Clinic today at (956) 854-4483 or contact us here.


1. Peixoto, Clayton, et al. “The Effects of Dehydroepiandrosterone (DHEA) in the Treatment of Depression and Depressive Symptoms in Other Psychiatric and Medical Illnesses: A Systematic Review.” Current Drug Targets 15.9 (2014): pp. 901-914(14). Web. 18 May 2018.