What are the side effects of hormone therapy, and can they be avoided?

Bioidentical hormone treatments have gained significant popularity — and for good reason.

If you’re one of the millions of people feeling the effects of getting older, you may be wondering if hormone replacement therapy (HRT) is right for you and what potential side effects to expect. You might have heard bioidentical hormones (BHT) can help treat many common symptoms of aging — fatigue, low sex drive, sleep issues, and low motivation, to name just a few.

But is hormone therapy safe? And what medical providers in the Winter Park/Orlando area are the best and most experienced with hormone therapy treatment?

Whether you’re a woman looking for relief from symptoms of menopause (hot flashes, night sweats, a leaky bladder, fatigue, dramatic mood swings, and thinning hair, to name just a few) or a man wanting to bring back sex drive, focus, and strength, bioidentical hormones can help you feel like yourself again.

You might be also wonder about the potential side effects of hormones and how to minimize them. Don’t worry — at RegenCen, we believe in transparency. We’re sharing everything you need to know about bioidentical hormone replacement, common side effects, and why your choice of medical provider matters when it comes to feeling like yourself again.

What are bioidentical hormones and why are they superior to synthetic hormone replacement therapy?

Here at RegenCen in Winter Park, Florida, we treat patients with bioidentical hormones (BHT), which offer a more natural alternative to traditional hormone therapy.

But why bioidentical hormones instead of synthetic hormones? Well, one of the key advantages of bioidentical hormones is their ability to behave exactly like the body’s own hormones, leading to potentially fewer side effects and a more balanced hormonal profile.

For our female patients who experience menopause and perimenopause symptoms, BHT estrogen therapy can offer relief without the risks associated with traditional synthetic estrogen and progestin hormone treatments. That’s because estrogen impacts almost everything in the body, from energy levels to tissue strength and response. Did you know estrogen also affects bone density, vaginal function, and brain function? In addition to bioidentical estrogen, we also treat testosterone and progesterone imbalances in women.

Similarly, men with low testosterone (T) levels may benefit from bioidentical testosterone therapy, which helps improve energy levels, libido, and overall well-being. Research shows testosterone therapy can improve cognitive function and muscle mass, and reduces the risk of diabetes.

Unlike synthetic hormones, BHT hormones are derived from plant sources and are structurally identical to the hormones produced in the human body. This allows us to customize our approach to hormone replacement by testing our patients current levels, then supplementing to achieve ideal bioidentical hormone levels.

Even though bioidentical hormones offer the advantage of matching the human body’s own hormones (leading to potentially fewer side effects), hormone replacement is not a one-and-done treatment. Unfortunately, we see a lot of patients who tried either traditional synthetic hormone therapy (HRT) or bioidentical hormone pellets with other providers, and gave up.


Hormone therapy patients give up because they either had side effects from their dose being too high, or they felt no improvement because they didn’t have the right balance of estrogen, progesterone, and testosterone.

It doesn’t have to feel like this. It’s possible to maximize the many benefits of bioidentical hormones and minimize or eliminate potential side effects. Before we break down the importance of monitoring and tweaking, let’s talk about those side effects.

What are common side effects of hormone replacement therapy?

Though bioidentical hormones are a safer, natural option compared to regular hormone therapy, they can still cause side effects. These are some of the most common — and treatable — hormone treatment side effects we see:

  • Vaginal bleeding — this is usually a result of higher-than-ideal estrogen levels.
  • Weight gain is a common worry because these hormones can affect metabolism and where fat is stored.
  • Breast tenderness — another symptom of estrogen levels being too high.

If these are the potential side effects, you might be reluctant to try BHT. You don’t want to feel worse from a medical treatment that’s supposed to improve the quality of your life. We get it!

That’s why our approach at RegenCen is comprehensive — including close monitoring of blood labs, symptoms, and includes multiple treatment modalities.

We’ve worked with thousands of patients, minimizing or eliminating side effects while boosting the benefits of hormone therapy. It’s a big part of what makes RegenCen so different from other hormone centers, where the provides aren’t experienced in treating with hormones, or have no background or track record in practicing medicine. These centers tend to overdose beyond physiologic levels.

We tell our patients our motto is, “We want you back to where you were (hormonally), not take you where you’ve never been.”

At other medical providers or so-called “hormone centers,” patient treatment isn’t always customized. The same dosage levels and types of hormones are prescribed to all patients, regardless of weight, age, symptoms and blood work. This one-size-fits-all approach leaves patients frustrated by side effects that are preventable.

Any hormone replacement approach should include a few visits to monitor and tweak dosages. A customized approach helps minimize and mitigate side effects. Here are a few common examples:

  • Just because a certain progesterone dose worked for your friend doesn’t mean it will have the same impact on you.
  • Conventional practitioners use an age-based definition of “normal” to guide testosterone treatment in men, even though research clearly shows better outcomes in energy and health by maintaining higher young normal T levels.
  • Women who’ve survived cancer and need to avoid estrogen may believe there’s no hormone balancing treatment for
    them, but progesterone and testosterone both offer these women hormone alternatives that bring meaningful relief of
    symptoms. (Think more energy, higher libido, better focus, and improved sleep!)

Why do so many patients quit hormone replacement therapy? (and how traditional medicine is getting hormone replacement therapy wrong)

Our patient Dee was thrown into menopause — hard.

Almost overnight, she stopped sleeping well, was crabby, and her migraines worsened. She started missing work. In desperation, Dee went on a patch — and it made the migraines even worse. So she quit taking the patch, and thought this was her lot in life. That she was slowing down and changing because of age…and nothing could change that.

“I thought hormones were supposed to make me feel better,” she told us. “I’d rather go back to how I felt before than how that patch made me feel.”

Thankfully, she was friends with another patient of ours who told Dee about her experience at RegenCen. We constantly monitor patients lab work and symptoms, and tweak hormonal levels and the specific “mix” of hormones we treat with.

Many primary care physicians won’t suggest or offer hormone replacement therapy, and those that do may prescribe the same standard dosage for all patients or prescribe what Dee got — a patch.

The insurance industry is also partly to blame: doctors prescribe and treat under a narrow set of guidelines to meet insurance requirements. Prescribing and treating outside these guidelines may lead to rejected claims. Insurance generally won’t pay for customized hormone replacement approaches, ongoing monitoring, and tweaking of dosages.

Additionally, many traditional medical providers aren’t educated on the differences between the synthetic hormones of years ago, and modern bioidentical hormones/BHT. They may get stuck on safety concerns associated with old-style synthetic hormones (Premarin and other non-bioidentical estrogen pills).

But bioidentical hormones do not pose the same risks as synthetic hormones. Despite the improved safety of bioidentical hormones, the insurance industry may also not cover bioidentical hormone pellets and may only offer coverage on synthetic hormone prescriptions.

Courtney Lo, founder and CEO, discusses estrogen replacement options

Traditional medicine hasn’t caught up with modern advancements in hormone replacement therapy that offer patients both safe and effective treatments for common aging symptoms. The standardized approach of hormone therapy from years prior doesn’t make for the best patient outcomes.

So what does work?

Monitoring, tweaking, and customization.

How long does it take your body to adjust to bioidentical hormones — and why is tweaking hormone therapy so important?

When it comes to hormone therapy, one thing is clear – there is no one-size-fits-all approach. Each individual’s hormonal needs are unique and can change over time. This necessitates a customized approach that takes into account factors such as age, genetics, lifestyle, and overall health.

One of the many advantages of bioidentical hormones (versus synthetic hormone replacement therapy) is they offer a more tailored and natural approach to managing hormonal imbalances.

Bioidentical hormones closely mimic hormones naturally produced by the human body, and they don’t contain the ingredients found in synthetic hormones that lead to both side effects and safety concerns.

But any form of hormone replacement therapy requires regular monitoring and adjustments to meet each person’s needs. It may take several weeks for the body to adjust to the introduction of bioidentical hormones.

If your medical provider isn’t consistently monitoring your hormone levels (via blood labs) and symptoms, there’s a strong chance your levels won’t be appropriate at some point – too high, too low, or just out of balance. That leads to side effects or fewer positive effects.

In Winter Park and our other RegenCen locations throughout Michigan and Florida, our customized, individual approach to hormone therapy minimizes side effects and decreases the time it takes your body to to see a positive response to hormones.

Regular monitoring of bioidentical hormones through blood tests and under the supervision of a medical provider experienced in hormone therapy is crucial for maintaining hormone balance and optimizing health outcomes.

These hormones can have varying effects on individuals due to factors like metabolism and lifestyle. By tracking hormone levels over time, our providers can adjust dosages as needed to ensure optimal results without adverse side effects.

Moreover, regular blood tests allow for the early detection of any deviations from the desired hormone levels, enabling proactive intervention before imbalances lead to more serious health issues.

Experienced medical providers play a key role in understanding test results and deciding on the best treatment options. Monitoring bioidentical hormones ensures that people get personalized care that fits their body, maximizing the benefits of hormone therapy while reducing risks.

Adjusting bioidentical hormone treatment involves changing the dosage and trying different options to find the right balance for good health.

At RegenCen we use a combination of estrogen, progesterone, and testosterone for women (and not every woman may need all 3, and definitely not the same levels of each) and testosterone for men.

Every body is built differently, so it’s important to work with a bioidentical hormone therapy specialist to monitor levels and make informed decisions.

How lifestyle, diet and exercise impact hormones and the effects of BHT/hormone replacement therapy

Diet and exercise are important for balancing hormone levels when using bioidentical hormones. Eating a diet with lots of nutrients, especially proteins, healthy fats, and antioxidants, can help support a healthy hormonal balance.

Regular exercise can also help by lowering stress hormones like cortisol and increasing happy hormones like endorphins. Doing strength training can raise testosterone levels naturally, and activities like yoga can help manage estrogen imbalances.

It’s important to not exercise too much or eat too little, as this can harm hormone balance. Too much exercise can raise cortisol levels and disrupt menstrual cycles in women, while not eating enough can stress the body and cause hormone imbalances. Exercise and eating well helps supports hormone function during bioidentical hormone treatment. That’s where having a medical provider experienced in hormone therapy comes into play.

For example, at RegenCen we look at your body and lifestyle as a whole. We combine analysis of your blood labs and symptoms with dietary and exercise analysis. Then we devise a hormone therapy plan that works WITH your life, instead of forcing you to make even more dramatic changes to see improvement.

We’ll always encourage eating a healthy diet and exercising, but unlike so many primary care physicians who dismiss the symptoms of aging and think diet and exercise alone will alleviate symptoms, we know there’s much more to the story, starting with your hormone levels.

Is hormone therapy worth it? Why we’re so enthusiastic about bioidentical hormones and what our patients say

You’ve learned about what makes bioidentical hormones different from synthetic HRT, the potential side effects of bioidentical hormone therapy, and why monitoring and tweaking are crucial in improving how you feel on hormone therapy.

But what makes bioidentical hormone therapy worth it?

Several years ago, RegenCen founder Courtney Lo began to feel the effects of perimenopause. Her energy was suddenly low, she struggled to sleep through the night, and her brain wasn’t focusing like it used to.

“I thought I was going crazy,” Lo says. It didn’t immediately occur to her that her hormones were the problem until her husband, and RegenCen medical director Dr. Gustav Lo, suggested she get a hormone panel.

When the results showed that Lo’s hormone levels weren’t in balance and were much lower than optimal for sleep and focus, she researched various treatments and discovered bioidentical hormones in the form of pellets, as well as bioidentical progesterone.

Within weeks of starting pellets, Lo was sleeping through the night, and her brain was functioning again like it did in her 30s.

“Bioidentical hormones were a game changer for me,” Lo says. “Like so many other women, I thought I had to accept my symptoms as part of aging and menopause. After the pellets made a huge difference in my quality of life, I knew I wanted to get this treatment into the hands of other men and women suffering from age-related decline.”

Bioidentical hormones, in the form of pellets placed in a patient’s upper hip area, became a foundational treatment at RegenCen in Winter Park and other Florida and Michigan centers.

Why should you do pellets for hormones instead of compounded cream?

Pellets have several advantages over the other stuff.

First of all, oral estradiol tablets increase blood clotting risk (because they pass through the liver, which reacts by increasing clotting factors), and that increased risk has not been seen with pellets.

Secondly, of all the various forms of hormone therapy (including hormone pills, hormone patches, hormone creams, and hormone injections), pellets give the most stable and predictable hormone levels.

We use pellets because they last longer and require fewer maintenance visits, especially after the first round or two of treatments and adjustments. With pellets, most women need to come in only 3 times a year for a treatment. And men can get away with 2 times a year.

Beyond the time-saving factor of pellets, our patient results continue to reinforce that bioidentical hormones can dramatically improve the quality of a person’s life.

After starting pellets with us, our patient Dee started sleeping better, stopped having migraines, and noticed — almost immediately — an improvement in the games and puzzles she played (crosswords, Wordle, and spelling games).

Another patient says hormones keep her — and everyone around her — happier. “Give me the pellets and no one gets hurt,” she told us. She’s calmer, more positive, and no longer has the mood swings that gave her a short fuse.

Men are often surprised at how effective testosterone pellets are. Because age-related symptoms develop gradually in men, they often don’t come in for treatment until their wives or partners coax them to make an appointment.

“Men like to play it tough and think they feel just fine,” says Dr. Gustav Lo. “But when I ask them if they felt like this 20 years ago, they’ll admit they feel less energy, stamina, and libido. They also don’t feel as motivated – just kind of blah.”

Testosterone therapy gives men back drive, stamina and even strength gains. Men who struggled to beat personal bests at the gym or see gains in weight lifting notice improvements after starting T therapy.

Dr. Gustav Lo, RegenCen Medical Director, on the problem with the “normal” testosterone range, and what really helps men

The list goes on and on. When maintaining physiologic levels or bioidentical hormones, safety concerns are very low and potential benefits are high , AND there are health benefits, like protective effects against Alzheimer’s, Parkinson’s and osteoporosis.

Treatment: Patients love BHRT to treat:

  • Hot flashes
  • Strength/Stamina/Motivation
  • Cognitive/Memory
  • Sleep disorder
  • Weight gain/Body changes
  • Pain
  • Looking better/feeling better

Prevention: Doctors love BHRT to prevent:

  • Heart attack
  • Stroke
  • Alzheimer’s/cognitive decline
  • Osteoporosis
  • GSM
  • “Frailty”

Wrapping it up: why a customized, individual approach to hormone therapy leads to the best outcomes

Hormone therapy can help almost anyone over 40 feel and function like they used to when they were younger. But not all hormone therapy — or hormone treatment providers — are created equal.

Bioidentical hormones offer significant safety and efficacy advantages over synthetic HRT, but even bioidentical hormones work best when the treatment plan is customized and personalized for the patient.

When treatment is tailored to each person’s unique hormonal needs, patients are more likely to have fewer or no side effects, better outcomes and a higher quality of life.

Customized hormone therapy helps manage symptoms, reduces side effects, and improves overall well-being. It’s essential for a knowledgeable healthcare provider who’s experienced in customized hormone therapy to supervise and monitor the effectiveness of the personalized hormone therapy plan.

This ongoing supervision ensures that any necessary adjustments can be made promptly to address changing hormone levels or health conditions. By focusing on individualized care with regular assessments and adjustments as needed, patients can trust in the effectiveness and safety of their bioidentical hormone therapy.

Start to feel like yourself again with BHRT

Curious if bioidentical hormone therapy is right for you? Talk with an experienced hormone therapy provider in Winter Park (or any of our other Florida and Michigan RegenCen locations).

Click here to schedule a consultation and blood labs. We’ll assess your symptoms and lab results, review your options, and tailor a customized hormone treatment plan for you.