We are proud to announce that we can help you with bio-identical hormones using telemedicine.
What are bio-identical hormones?
Bio-identical hormones are closer to what the human body makes. Many people take Premarin which stands for PRegnant MAre UrINe and is made from the urine of pregnant horses. Others are on modified estrogens and progesterone such as esterified estrogens or medroxyprogesgterone which are modified so they can be patented. Bio-identical hormones, on the other hand, are closer to what the human body makes so tend to work better.
Bioidentical hormones also contain milder hormones such as Estriol that are not currently available at regular pharmacies. Estriol does not bind to the estrogen receptors as strongly and make cells divide as much. This milder estrogen might protect against breast cancer but there is no FDA approved product that contains estriol. Compounding pharmacies are able to compound some of this milder estrogen with the stronger estrogen called estradiol and this might reduce the risks of hormone therapy.
Currently the only FDA approved product that contains the natural progesterone is an oral pill. However, getting progesterone topically is better as the hormone is broken down by the stomach acid and liver. We are able to get progesterone compounded in a cream which tends to work better at countering the weight gain effects of estrogen than the oral estrogens. Natural progesterone also helps with sleep and mood.
Testosterone is also important for women and some people are on a modified testosterone called methyl-testosterone. The natural versions are what the human body is used to and work better but many physicians are not aware of how to prescribe these.
Dr. Bawa and his team of providers go to many conferences on bio-identical hormones and have been prescribing these hormones for over 15 years. If you cannot afford the compounded versions, we we can also help you find some versions from a regular pharmacy that are close to what the human body makes if that is what suits your budget.
Are there some bio-identical hormones I can get from the regular pharmacy?
Instead of Premarin that is a horse estrogen, all pharmacies have estradiol which is a human estrogen. Vivelle (estradiol patch) is a topical form of estradiol that is better than the oral estradiol because oral hormones are broken into little pieces by the stomach acid and liver and do not stay bioidentical. If the bio-identical hormones from a compounding pharmacy are too expensive and the fee to do compounded bio-identical hormones is not in your budget, we can order some hormones from a regular pharmacy that are better than Premarin. If testosterone is needed for women and you cannot afford the compounded version we can help you with some work arounds. Let us know your preferences and we can help you!
What are the costs for bio-identical hormones?
We take insurance to do an evaluation, order and review blood work and/or saliva tests and discuss all your options. You might have a copay or deductible and we should be able to tell you in advance how much this is and collect it prior to your visit.
If you choose to do bio-identical compounded hormones, that is considered a concierge service that requires additional training that is not a part of traditional medicine, and we charge $150 for an entire 12 months. This fee is in addition to what the insurance pays for your visit.
If you do not have any insurance, we have discounted prices for the visit. These range from $115 to $175 depending on whether you see a nurse practitioner or physician and if it is a new visit or a follow up visit.
What are the costs at a compounding pharmacy?
We can order your bioidentical hormones at any compounding pharmacy of your choice. There are some compounding pharmacies that only charge $40/month for a three-ingredient cream and charge only $8 for shipping and we can help you find the one best fits your budget and is conveniently located to you.
How do I do telemedicine visit?
Once you make an appointment we will send you instructions on how to download an app on your smart phone and do a secure telemedicine visit as required by insurance.
What states can I do this in?
Currently we only provide telemedicine bio-identical hormones in Florida but we hope to add more states soon.
Can you do saliva testing for hormones? How much does this cost? Can you check cortisol?
We can do a saliva test and we use ZRT labs for our saliva test. We like the profile III which checks estradiol, progesterone, Testosterone, DHEA and cortisol (Cortisol is checked four times in one day in profile III). Profile III costs $275 and we can mail you a saliva test kit. If profile III is too expensive and if you do not need to check cortisol four times in one day, you can choose profile I which is $175 and it checks estradiol, progesterone, testosterone and cortisol only once in the morning. Cortsiol is the stress hormone that is higher in the morning to help us wake up and goes down later in the day to help us relax and sleep. Some people produce too much cortisol and gain weight and others do not produce enough in the morning, causing day time fatigue and others produce too much at night affecting sleep. Therefore, it helps to test cortisol multiple times in one day