Medication Policy
Doctor Whitelaw provides patients with information on the alternative treatment options for hormone imbalance by way of medication, including:
• Hormone Replacement Therapy (HRT)
• Body Identical HRT
• Bioidentical HRT (BHRT)
• Testosterone
It is important to note that she will only prescribe plant based hormones such as licensed body identical hormones and unlicensed bio-identical hormones.
Traditional non-plant based HRT is not prescribed. The reason for this is that plant hormones have the same molecular structure as naturally occurring hormones (progesterone, oestrogen, testosterone) produced in the human body. Evidence supports that a human bodies receptors more readily recognise and effectively utilise plant based hormones unlike traditional synthetic non-plant based hormones.
The doctor may also recommend vitamins, health and nutritional supplements in some instances.
Body Identical HRT
In recent years, there has been some advancement in the manufacture of progesterone and oestrogen hormone replacement medication that is derived from plants. These are generic in their formulation (i.e. they are not compounded to an individual’s needs in contrast to bio-identical hormones) and are commonly referred to as Body Identical hormones. These hormones are licensed and approved by the National Institute for Health and Care Excellence (NICE).
Body identical hormones are usually delivered in either an oral capsule (progestogen) or a patch or gel (oestrogen).
Dr Whitelaw is able to prescribe Body Identical HRT. In this instance, a prescription would be raised and the patient would then take the prescription to a pharmacy of their choice. Please note that its availability in the UK may vary.
Bio-identical Hormone Replacement Therapy (BHRT)
Dr Whitelaw has significant experience in hormone re-balancing with bio-identical hormones.
Bio-identical hormones have the same molecular structure as naturally occurring hormones produced in the human body (progesterone, testosterone and oestrogen) and their effects and benefits replicate them closely. They are derived from diosgenin which is sourced from the yam plant.
Bio-identical hormones can be very beneficial to patients who are experiencing hormone imbalances and are looking for treatment, or alternatively may have tried other hormonal medication, including traditional HRT, and had undesirable effects.
BHRT is founded on the principle that each patient is different and therefore requires a unique approach with their hormone treatment (i.e. personalised medicine). To this end, Dr Whitelaw will prescribe bio-identical hormone supplementation that is bespoke to the patient’s needs (i.e. at a dose or preparation that is unique to the patient and not routinely available from the NHS). The medication is compounded by a specialist designated compounding pharmacy that is rigorously regulated by the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA is the UK’s regulator of medicines and medical devices and is responsible for ensuring their safety, quality and effectiveness.
Bio-identical hormone medication is not licensed due to the bespoke nature of the compounding. However, the use of bio-identical hormones has been well established in the USA for more than 30 years and are widely used in Australia and many other parts of Europe (e.g. France, Switzerland, Austria, Germany, Italy).
Bio-identical hormones can be delivered in a variety of formats: transdermal creams, lozenge, oral capsule, vaginal gels. The mode of delivery will be determined by the doctor, taking account the most effective and safe form of delivery and any specific patient requirements.
To determine a patient’s BHRT requirements, it will be necessary for new patients to have blood tests so that baseline levels can be established. After this you will require a blood test on an annual basis. Dr Whitelaw may require blood tests more frequently in the early stages if adjustment to medication is required. For further information on blood tests please click here.
It should be noted that balance is regained over a period of time – for many it is days, for some it is weeks and for others it can be a few months.
Testosterone
Testosterone is an important hormone for both men and women. It can improve libido, muscle tone, mood, energy and concentration as well as the maintenance of bone. There is not currently a licensed preparation of testosterone available in the UK.
At Equilibrium we prescribe bio-identical testosterone that is delivered either as a vaginal gel or transdermal cream.