What’s the best way to take bio-identical hormones?

There are several ways you can take bio-identical hormones, orally, topically, subdermally, etc. Various considerations should be taken when you decide which is best for you, like how well the hormones work, how safe they are, and how good they make you feel. In my experience, topical administration is the best. Why? Hormones are not naturally routed through the digestive tract, but through the bloodstream, and when taken by mouth, this severely distorts their natural metabolism.

For more consideration, here is a quick list of the methods available for BHRT:

  • Creams or gels. An optimal way of using bio-identical hormones. You can rub a cream or a gel into your skin (transdermal), or better yet, your vaginal mucosa or inner surfaces of your labia (transmucosal or transvaginal). Note: vaginal administration minimizes drowsiness, the primary side effect of excessive doses of oral progesterone.
  • Suppositories. For rapid transmucosal absorption, a hormone suppository can be inserted into the vagina or the rectum.
  • Oral capsules. Not the best way to take bio-identical hormones, as a capsule must go through your gastrointestinal system where they do not naturally belong. This method burdens the liver, which can lead to poor metabolism of the hormones and therefore possible side effects and complications.
  • Troches (lozenges) and Sublingual drops. Dissolve the troche or drop under your tongue and try not to swallow. In this way, majority of the hormone gets absorbed directly into your blood stream through the mucous membranes that line your mouth. This is another transmucosal method. Due to normal saliva formation however, it can be difficult not to swallow the hormone which would then end up in the digestive tract anyway.
  • Pellet implants. Pellets with hormone can be implanted under the skin. Though it avoids the GI tract, the timing of hormone release by the pellets is not natural and increases the risk of cancer

BHRT treatment begins with a series of tests to determine the functioning of the endocrine system, the hormone levels and hormonal balance in the body. Once the diagnosis is determined, an individualized treatment plan, combining hormone replacement, supplements, and/or lifestyle changes will be discussed.

Brigit Kang