Frequently Asked Questions

At what age should I worry about hormone therapy?

Most women experience menopause between the ages of 45 and 55. Many women will have “peri-menopausal” symptoms as early as age 30 and might benefit from bio-identical hormone therapy (BHRT). There really is no “upper” age limit for BHRT.

Once treatment is started what is the average time before relief is noted?

While this can vary, most women will experience significant relief within 30 days of institution of treatment. Many of our patients experience immediate relief.

How are the hormones administered?

The frequency and dosage of administration is dependant on the individual needs of the patient. Most of the hormones are administered via the trans-dermal route. The compounding pharmacist blends the hormone into an absorbable cream and a pre-measured amount is self-applied to the inner thigh on a (usually) daily basis. Some of the hormones (DHEAS) are administered by sub-lingual drop absorption.

I have had breast cancer … Can I take BHRT?

Each patient will have to make this decision for herself. We advise that you talk with your oncologist and get his/her opinion. Be sure to ask if you were pre menopausal would your Dr. require you to have your ovaries removed. Since we are replacing with hormones that are exact replicas of your own naturally occurring ovarian hormones, this question might help you to make this important decision.

Will BHRT act as birth control for me?

No. Since we are replacing your own ovarian hormones in the quantity that are naturally produced, there should be no birth control effect. Likewise, it will not make you fertile if you have already gone through the menopause.

I am currently taking an antidepressant. Will BHRT have any effect on this?

Unfortunately, many physicians have gotten into the habit of treating hormone imbalance symptoms with antidepressants. While we would not recommend that you stop the antidepressants right away, most patients are able to decrease and ultimately stop them once balance is achieved. We will help you to work with your prescribing physician on this.

I am already on postmenopausal hormones that have been prescribed by my own physician. Is it recommended that I switch to BHRT at this point?

The answer to this question depends, of course, on what type of hormones you are taking. We feel that it is always recommended that BHRT is the best and safest method of hormone replacement, and it is never too late to switch.

As a woman, I am uncomfortable with male physicians, and wish to only be examined by another woman.

The examination is usually limited to vital signs and an extensive verbal interview. All of our centers, present and future will be staffed with a female nurse practitioner as well as myself. We are always very sensitive to the individual needs and desires of our patients.

Will I be required to terminate my relationship with my current Gynecologist to see you and start on BHRT?

Absolutely not. We encourage you to continue to work with your current health care provider for your yearly pap smears, mammograms and other necessary periodic exams. At your request, we will relay all lab and treatment data to your local physician.

Vaginal Rejuvenation Surgery

Who is a candidate for this type of surgery?

Any cosmetic surgery must be looked at as non-life saving and perhaps “not necessary.” I would advise those interested in such a surgery to evaluate the risk/benefit analysis and decide if it is truly for you. The benefit is very obvious, that is to shrink the caliber of the vagina to enhance sexual feelings for both the woman and the man. The risks or “cons” are mostly centered on the post operative pain involved and the small chance of a surgical complication. These risks and discomforts are basically the same that are seen with other cosmetic surgeries such as breast augmentation and tummy tucks. In other words, anyone who feels they have genital changes as a result of childbirth or other reasons, resulting in a loosened vagina or decreased sensation during sex should consider this surgery. Your surgeon should discuss the risks and possible complications and help you decide if you are a good surgical candidate.

Should I consider this surgery if I am still contemplating further child birth experiences?

The short answer is No. This is because a future vaginal birth can and probably will break down the rejuvenated vagina. If, however, you are contemplating a repeat C-section, there is no contraindication to the surgery.

How will my doctor know how small to make my vagina?

This decision will be made after an in depth discussion with you, and possibly your partner, as to the size of his penis and the extent of the defect noted in your vagina. Some patients bring in photographs of their partner’s erect penis with measurements for consideration.

If I have had a hysterectomy can the surgery still be done?

Yes, the presence or absence of a cervix and uterus does not affect the outcome of the vaginal rejuvenation procedure.

I am scheduled for a hysterectomy for another indication (fibroids, etc.), can an elective vaginal rejuvenation be done at the time of the hysterectomy?

Absolutely. This is the perfect time to accomplish the vaginal rejuvenation. I will often discuss this and other cosmetic surgeries with patients when considering a hysterectomy for other indications.

I looked at your fee schedule and wonder if there are any “hidden charges” that will come up.

The fee schedule includes the use of the surgery center, peri and post operative nursing care, anesthesia, and any equipment that might be needed to complete the procedure as well as the surgical fee. There should be no “hidden charges.”