BIOIDENTICAL HORMONE REPLACEMENT THERAPY

Bio-Identical Hormone Replacement Therapy implies the use of hormones that are identical in their molecular structure to the hormones produced naturally within the human body.

BHRT is also used more generally to describe the practice of using only Bio-Identical hormones in the treatment of all hormone deficiencies such as: PMS, Hypoactive Sexual Desire Disorder, Peri-Menopause and Menopause in women and Andropause in men.

Hormones regulate the activity of cells and tissues throughout the body. Optimizing and balancing hormones are essential to good health and a feeling of well-being. In both men and women, hormones decrease with age causing a wide range of symptoms such as fatigue, weight gain, loss of sex drive, depression and disrupted sleep patterns .The hormones estrogen, testosterone, progesterone, thyroid, DHEA and cortisol all play a very serious role in daily life and health and an imbalance can impact life dramatically.

Many people resign themselves to living with the serious symptoms caused by hormone imbalance, accepting them as an unchangeable and an untreatable part of the aging process. However, maintaining optimum levels of hormones promotes an improved quality of life and prevents many of the degenerative illnesses commonly associated with aging.

Dr. Beninati has been prescribing Bio-Identical Hormones for almost 20 years. He also stays up to date with the most current and fast evolving literature and periodically attends conferences concerning these issues. He is a member of the “Bio-Identical Hormone Society” and the “Andropause Society”.

You can make an appointment with Dr Beninati to discuss your concerns about the safety and benefits of Bioidentical Hormone Replacement Therapy; he will provide you with all the current information and answer all pertinent questions that you may have, so you can make an informed and sound decision whether BHRT is appropriate for you.

INTEGRATIVE MEDICINE FOR MEN

Androgen Deficiency / Low T

If you suffer from gradual loss of virility and vitality, you may have Androgen Deficiency. Androgen Deficiency is defined as an absolute or relative deficiency of testosterone or its by-products. This condition can be successfully managed. According to the need of the individual at that time in his life, the management will be individualized and followed up with regular consultations.
Testosterone is important to the male body because it:

Gives men their virility and vitality
Decreases total cholesterol and LDL
Improves muscle strength
Improves oxygen uptake throughout the body
Helps mental concentration
Helps to maintain a healthy immune system
Promotes coronary vasodilatation
Increases cardiac output volume

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Clinical Nutrition Consultation and Evaluation for:

Healthy Aging and Longevity
Optimal Nutrition and Lifestyle changes
Weight Loss
Fatigue/Depression
Mood Disorders
Prevention of Osteoporosis
Reduction of Cholesterol
Improvement of Digestion/Chronic Constipation
Metabolic Syndrome/Pre-Diabetes
Prevention of Cardiovascular Disease

INTEGRATIVE MEDICINE FOR WOMEN

Gynecology

We unite traditional gynecology, clinical nutrition and complementary and alternative medicine to offer the following services:
Office Gynecology
PMS Evaluation and Management
Recurrent Yeast Infections
Management of:

Atrophic Vaginitis

PCO’s (Polycystic Ovary Syndrome)

Dysfunctional Uterine Bleeding

Dysmenorrhea

Uterine Fibroids

Fibrocystic Disease of the Breast

Endometriosis

Osteoporosis

Vulvodynia

Individualized Menopause Management
Bio-Identical Hormone Replacement with the direct cooperation and advice of compound pharmacists

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Clinical Nutrition Consultation and Evaluation for:

Healthy Aging and Longevity
Optimal Nutrition and Lifestyle changes
Weight Loss
Fatigue/Depression
Mood Disorders
Prevention of Osteoporosis
Reduction of Cholesterol
Improvement of Digestion/Chronic Constipation
Metabolic Syndrome/Pre-Diabetes
Prevention of Cardiovascular Disease

EvexiPel

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EvexiPel

Pellets are made up of either estradiol or testosterone. The hormones are pressed or fused into very small solid cylinders. These pellets are larger than a grain of rice and smaller than a ‘Tic Tac'. In the United States, the majority of pellets are made by compounding pharmacists and delivered in sterile glass vials. Testosterone pellet production is highly FDA regulated.

This What are Pellets?

Data supports that hormone replacement therapy with pellet implants is the most effective and the most bio-identical method to deliver hormones in both men and women.

Implants, placed under the skin, consistently release small, physiologic doses of hormones providing optimal therapy.

Why pellets?

Pellets deliver consistent levels of hormones for 3-5 months in women and 4-6 months in men. They avoid the fluctuations, or ups and downs, of hormone levels seen with every other method of delivery. Estrogen delivered by subcutaneous pellets, maintains the normal ratio of estradiol to estrone. This is important for optimal health and disease prevention. Pellets do not increase the risk of blood clots and other untoward side effects like conventional or synthetic hormone replacement therapy.

In studies, when compared to conventional hormone replacement therapy, pellets have been shown to be superior for relief of menopausal and andropausal symptoms, maintenance of bone density, restoration of sleep patterns, and improvement in sex drive, libido, sexual response and performance.

Testosterone delivered by a pellet implant, has been used to treat migraine and menstrual headaches. It also helps with vaginal dryness, incontinence, urinary urgency and frequency. In both men and women, testosterone has been shown to increase energy, relieve depression, increase sense of well-being, relieve anxiety and improve memory and concentration.

Testosterone, delivered by pellet implant, increases lean body mass (muscle strength, bone density) and decreases fat mass. Men and women need adequate levels of testosterone for optimal mental and physical health and for the prevention of chronic illnesses like Alzheimer's and Parkinson's disease, which are associated with low testosterone levels.

Even patients who have failed other types of hormone therapy have a very high success rate with pellets. There is no other ‘method of hormone delivery' that is as convenient for the patient as the implants. Pellets have been used in both men and women since the late 1930's. There is more data to support the use of pellets than any other method of delivery of hormones.

How and where are pellets inserted?

The insertion of pellets is a simple, relatively painless procedure done under local anesthesia. The pellets are usually inserted in the flank (“love handle”)or upper buttocks through a small incision, which is then taped, closed. Evexypell will provide Dr Beninati the correct dosage of each patient by a software system that calculates the dosage based on patient blood levels, weight, age and the intensity of the physical activity.

Why haven't I heard about Pellets?

You may wonder why you haven't heard of pellets. Pellets are not patented and have not been marketed in the United States. They are frequently used in Europe and Australia where pharmaceutical companies produce pellets. Most of the research on pellets is out of Europe and Australia. Pellets were frequently used in the United States from about 1940 through the late 70's when oral patented estrogens were marketed to the public. In fact, some of the most exciting data on hormone implants in breast cancer patients is out of the United States. Even in United States, there are clinics that specialize in the use of pellets for hormone therapy.

What if my primary care physician or my gynecologist says that there is ‘no data' to support the use of pellet implants?

He or she is wrong. There is a big difference between ‘no data' and not having read the data. It is much easier for busy practitioners to dismiss the patient, than it is to question their beliefs and do the research. There is a plethora of data to support the ‘long term' safety of hormones delivered by pellet implants. It's about a patient making an informed choice. After pellets are inserted, patients may notice that they have more energy, sleep better and feel happier. Muscle mass and bone density will increase while fatty tissue decreases. may notice increased strength, co-ordination and physical performance. They may see an improvement in skin tone and hair texture. Concentration and memory may improve as will overall physical and sexual health.

Are there any side effects or complications from the insertion of the pellets?

Complications from the insertion of pellets include; minor bleeding or bruising, discoloration of the skin, infection, and the possible extrusion of the pellet. Other than slight bruising, or discoloration of the skin, these complications are very rare. Testosterone may cause a slight increase in facial hair in some women. Testosterone stimulates the bone marrow and increases the production of red blood cells. A low testosterone level in older men is a cause of anemia. Testosterone, delivered by implants or other methods, can cause an elevation in the red blood cells. If the hemoglobin and hematocrit (blood count) get too high, a unit of blood may be donated (this applies for men only).

After the insertion of the implants, vigorous physical activity is avoided for 48 hours in women and up to 5 to 7 days in men. Early physical activity is a cause of ‘extrusion', which is a pellet working its way out. Antibiotics may be prescribed if a patient is diabetic or has had a joint replaced.

How long until a patient feels better after pellets are inserted?

Some patients begin to ‘feel better' within 24-48 hours while others may take a week or two to notice a difference. Diet and lifestyle, along with hormone balance are critical for optimal health. Stress is a major contributor to hormone imbalance and illness.

How long do pellets last?

The pellets usually last between 3 and 5 months in women and 4-6 months in men. The pellets do not need to be removed. They completely dissolve on their own.

How are hormones monitored during therapy?

Hormone levels will be drawn and evaluated before therapy is started. This will include a FSH, estradiol, testosterone and free testosterone for women. Thyroid hormone levels may also be evaluated. Men need a PSA, sensitive estradiol, testosterone, liver profile and blood count prior to starting therapy. Levels will be reevaluated during hormone therapy, usually prior to insertion of the next set of pellets, 4-5 months. After the first year of therapy, hormones levels may be followed less frequently. Men must notify their primary care physician and obtain a digital rectal exam each year. Women are advised to continue their monthly self-breast exam and obtain a mammogram and/or pap smear as advised by their gynecologist or primary care physician.

For women ONLY

Is there a role for testosterone implants (pellets) in a pre-menopausal female?

Testosterone pellets may be used in pre-menopausal females (women who have not stopped menstruating). Testosterone has been shown to; relieve migraine or menstrual headaches, help with symptoms of PMS (premenstrual syndrome), relieve anxiety and depression, and improve sex drive and libido. If a pre-menopausal female has a testosterone pellet inserted; she must use birth control. There is a theoretical risk of ‘masculinizing’ a female fetus (giving male traits to a female fetus).

In conclusion, estrogen and testosterone therapy by implantation of pellets is a safe and effective method of hormone therapy for both men and women. Long, continuous administration of hormones by pellets is convenient and economical for the patient. Pellet implantation has consistently proven more effective than oral, intramuscular, and topical hormone therapy with regard to bone density, sexual function, mood and cognitive function, urinary and vaginal complaints, breast health, lipid profiles, hormone ratios and metabolites.

Do pellets have the same danger of breast cancer as other forms of hormone replacement therapy?

Pellets do not carry with them the same risk of breast cancer as high doses of oral estrogens that do not maintain the correct estrogen ratio or hormone metabolites. Nor, do they increase the risk of breast cancer like the synthetic, chemical progestins used in the Women's Health Initiative Trial. Data supports that balanced, bio-identical hormones are breast protective.

Testosterone, delivered by pellet implantation, has been shown to decrease breast proliferation and lower the risk of breast cancer, even in patients on conventional hormone replacement therapy. Clinical studies show that bio-identical testosterone balances estrogen and is breast protective. This is not true of oral, synthetic methyltestosterone found in Estratest®, which gets converted to a potent synthetic estrogen, which can stimulate breast tissue. In the past, testosterone implants have been used to treat patients with advanced breast cancer. In 1940, it was theorized that treating patients with testosterone implants earlier, at the time of diagnosis, would have an even greater benefit, preventing recurrence. Androgens have also been shown to enhance the effect of Tamoxifen® therapy in breast cancer patients. References supporting these statements can be found in the data section of the website in the ‘Breast Cancer Folder'. A power point presentation ‘Nov 07', summarizing the full text references, may be viewed.

Are there side effects to estrogen delivered by pellet implantation?

When a patient first starts on hormone therapy there may be mild, temporary breast tenderness, which resolves on its own. Hormone receptors may be very sensitive and take time to adjust. There may be a temporary water weight gain, which will also resolve on its own.

Will hormone therapy with estradiol and testosterone pellets help with hair loss?

Hormone deficiency is a common cause of hair loss and treatment with estradiol and testosterone implants can help to re-grow hair. Hair becomes thicker and less dry with pellet therapy.

Do patients need progesterone when they use the pellets?

Most times when estradiol is prescribed, progesterone is also prescribed even if the patient has had a hysterectomy. The main indication for the use of synthetic progestins, like Provera®, is to prevent the proliferation (stimulation) of the uterine lining caused by estrogen. However, there are progesterone (not progestin) receptors in the bone, brain, heart, bladder, breast and uterus where progesterone has been shown to have beneficial effects. Progesterone can be used as a a vaginal cream, an oral capsule or a sublingual rapid dissolve tablet.

If a patient is pre-menopausal, she uses the progesterone the last two weeks of the menstrual cycle (day 1, the first day of bleeding). Hormone therapy with pellets is not just used for menopause. Women at any age may experience hormone imbalance. Levels decline or fluctuate contributing to debilitating symptoms. Pellets are useful in severe PMS, postpartum depression, menstrual or migraine headaches, and sleeping disorders. Pellets may also be used to treat hormone deficiencies (testosterone) caused by the birth control pill.

For more information visit: www.evexipel.com

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For further information please give as a call (610) 269-9010.

OPTIMAL NUTRITION

Optimal Nutrition for a particular individual is the appropriate diet that applies to his or her condition and is based on their genetic and biochemical individuality. That could be the Vegan diet, Paleo diet, Mediterranean diet, Intermittent Fasting diet or Ketogenic diet.

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Vegan Diet / Paleo Diet

For some people with severe cardiovascular disease a strict Vegan Diet or a modified Paleo Diet are indicated.

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Ketogenic Diet / Paleo Diet

For other people suffering from prediabetes or metabolic syndrome, diabetes or PCOs a Ketogenic diet or Paleo diet are indicated.

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Intermittent Fasting Diet /Ketogenic Diet

For an individual with a serious weight gain problem the Ketogenic Diet or the Intermittent Fasting Diet are very efficient for significant weight loss.

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Paleo Diet

For individuals who are suffering from an autoimmune disorder such as: multiple sclerosis, Hashimotos thyroiditis, rheumatoid arthritis or inflammatory bowel disease, to mention some, a strict Paleo Diet is one of the major pillars to correct the “leaky gut”, quench inflammation and support a healthy immune system function.

These general guidelines are not intended to treat any condition without all necessary medical information that applies to your case. Please do not hesitate in making an appointment to see which diet plan is appropriate for you.

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For Clinical Nutrition Consultation and Evaluation please give as a call (610) 269-9010.

SUPPLEMENTS

Recommended supplements links

APPOINTMENTS & POLICIES

Downloadable Forms

The following forms are downloadable as PDF files. Click on the link, print out of the form, fill it out and bring them with you.
The following forms are required for your initial visit. Please bring the completed to your first visit.