By Belmar Pharma Solutions

Your bustling, successful practice is full of women who really care about their appearance, and they trust you to help them look and feel beautiful. It’s natural that discussions in your treatment rooms run the gamut from wrinkles to sagging skin to hair thinning. 

But midlife wellness goes even deeper—clear into the hormones circulating in your patients’ bloodstreams. Sex hormones like estrogen, progesterone, and testosterone control myriad aspects of their overall health, and when these hormones start to decline, skin health suffers and other signs of aging start to accelerate. 

You have a unique opportunity to educate your existing perimenopausal and menopausal patients about their hormonal health. While the aesthetic procedures you provide make them look good on the outside, there’s another piece of the anti-aging puzzle that works from the inside: compounded bioidentical hormone replacement therapy (BHRT).

What are bioidentical hormones?

As you know, hormones are biochemical messengers that are made in glands in the body. Hormones travel through the blood and bind to receptors in their target organs and tissues, causing changes in metabolic functions. 

Bioidentical hormones are different from synthetic hormone products manufactured by pharmaceutical companies. Bioidentical hormones are derived from plants like yams or soy. Their molecular structure perfectly matches the hormones your body makes. 

Compounded BHRT can be customized to meet your patients’ needs, including the types of hormones, dosages, and the excipients in the formulation. Some of the available forms include oral tablets, topical creams, pellets, and vaginal creams. 

How to know which patients may benefit from BHRT

Since sex hormones typically begin to drop as early as the 30s and continues to decline through the next few decades, the majority of your clients are probably candidates for BHRT. As the years pass, women may experience many perimenopause and menopause symptoms, but attribute them to “aging” without realizing these symptoms are linked to loss of estrogen, progesterone, and testosterone.

Perimenopausal symptoms include outward signs like fine lines, crepey skin, sagging jowls, and lip thinning. But there are many less visible symptoms that significantly affect a woman’s quality of life, such as hot flashes, insomnia, vaginal dryness, low libido, migraines, joint pain, mood changes, and brain fog—just to name a few.

Starting a conversation about BHRT

To start a deeper conversation about the relationship between symptoms and hormone decline, check with your patients about how they’re feeling overall, then listen closely to their responses. You can ask questions to clarify their symptoms and make sure they understand that midlife hormone depletion is a root cause of many symptoms. That’s your opening to bring up the benefits of BHRT.

For instance, if a patient talks about feeling tired all the time and having dark circles under her eyes, you can ask about her sleep quality. Explain that low energy and daytime fatigue due to poor sleep may be related to hormonal shifts. While aesthetic treatments may not have a direct solution for undereye circles, replenishing hormones may actually lead to better sleep and less fatigue. And being more rested may help fade the dark circles and return a healthier-looking skin tone. 

Through a quick discussion, you’ve made the connection for your patient that hormone imbalance can cause sleep disturbances.  Since poor sleep quality affects not only her appearance but how she feels during her day-to-day activities, she may be open to further discussion about BHRT as a solution.

Addressing patients’ misconceptions and fears about BHRT

If a patient brings up concerns about hormone replacement therapy, knowing the origin of her misconceptions can help you dispel common myths. 

One source of misinformation is the controversial Women’s Health Initiative (WHI) study that was published in 2002. The media reported an increased risk of developing breast cancer for women taking hormone therapy, which scared women and doctors so much that many women were taken off their hormones and many doctors stopped prescribing them.

But there were problems with the study which skewed the results. 

First, the women in the study were using synthetic hormone drugs called Premarin and Prempro, not bioidentical hormones. (DeRosa, p11)

Second, the study design was flawed because the treatment group was older women instead of women in their 40s and 50s who typically use HRT. (The median age of women in the study was 63 which is older than perimenopausal age.) That means it didn’t make sense to apply the results—even if they had been valid—to perimenopausal women, who are the population most likely to benefit from BHRT. (Bluming, p64, DeRosa, p11) 

A later reevaluation of the WHI data debunked the study results, concluding that women on estrogen and progesterone had no significant increase in breast cancer risk. (Clark)

So when you’re talking with your patients, sharing the truth about the WHI study may help alleviate any fears they may have about hormone therapy.

How to learn more about BHRT

Women who come to your spa for aesthetic treatments are already interested in addressing skin health and aging so they can look and feel their best. Many of these midlife women may also benefit from hormone support for both their skin and overall health, and they aren’t sure where to turn. You’re already a trusted practitioner, so with some training, YOU can become a reliable source for hormone information too.

To learn more about compounded bioidentical hormone therapy and how to offer these personalized hormones for your patients, arrange for your providers to watch this one-hour clinician webinar: Women's HRT Compounding 101 - Belmar Pharma Solutions.

If you plan to offer BHRT for your patients, further education and certification are available from the Hormonal Health Institute, Worldlink Medical Academy or The American Academy of Anti-Aging Medicine (A4M).

Founded in 1985 in Golden, Colorado, Belmar Pharma Solutions is a leading compounding pharmacy organization focusing on women’s and men’s hormone health and longevity. With a special focus on women’s hormonal health and wellness, Belmar Pharma Solutions has a dedicated women’s clinical health team to help providers and patients navigate hormone replacement therapies and personalized medications. Belmar sets a high standard for safety and compliance at its six 503A Compounding Centers of Excellence across the country, located in Colorado, Arizona, Florida, Kansas, Utah, and Wisconsin, as well as two 503B FDA-registered outsourcing facilities in Colorado, serving healthcare providers and patients in all 50 states.

References:
DeRosa A. A Woman’s Hormonal Health Guide: How to Prevent Your Doctor From Slowly Killing You. 2nd edition. DeRosa Media, LLC. 2018.
Bluming A, Tavris C. Estrogen Matters: Why Taking Hormones in Menopause Can Improve and Lengthen Women’s Lives—Without Raising the Risk of Breast Cancer. Hachette Book Group. 2018.
Clark JH. A critique of Women's Health Initiative Studies (2002-2006). Nucl Recept Signal. 2006;4:e023. doi: 10.1621/nrs.04023