Hormone Replacement Therapy: What Is It and Who Is It For?

We’ve all heard of hormones — and, most likely with a negative connotation. But, without hormones, we’d be in a lot of trouble. They’re responsible for processing many of our body’s most essential functions, like metabolism, blood pressure, sexual function, and mood.

When our hormones aren’t optimized, we refer to it as a ‘hormonal imbalance.’ Several factors can cause this imbalance and, unfortunately, a lot of them are out of our control. For instance, there are certain situational events (e.g. puberty, pregnancy, and menopause), health-related issues (e.g. tumors, thyroid disorders, diabetes, adrenal dysfunction, etc), and genetics that can make our hormones go haywire.

On the other hand, there are some lifestyle changes we can make to improve hormone levels. Exercising regularly, eating healthfully, managing stress, and limiting exposure to environmental toxins (e.g. smoking, alcohol, etc) have been proven to help keep hormone levels in check.

In some instances, it becomes nearly impossible to correct hormone imbalances naturally and medical intervention is required. For patients who find themselves in this position, doctors will turn to hormone replacement therapy (HRT) to improve their patient’s quality of life. Here’s everything you need to know:

What Exactly is Hormone Replacement Therapy?

As mentioned above, hormones are responsible for regulating everything from our mood to our physical well-being. When unbalanced, they have a number of unpleasant side effects, including sluggishness, weight gain, and sleep disruption. HRT is a treatment with the goal of restoring hormonal balance in men and women to improve the overall sense of well-being.

HRT is available in many formats (e.g. pills, patches, gels, creams, sprays, and intrauterine devices (IUDs) and is often prescribed by an ob-gyn or primary care physician. That being said, some board-certified plastic surgeons also offer HRT in conjunction with cosmetic procedures.

Typically, practitioners will only offer HRT for up to five years, but Jamie Gabel, PA-C, a certified physician assistant at New York’s Advitamin at the Shafer Clinic, says that when prescribing hormones, you have to consider each patient's individual history to best determine when to start, finish, or continue HRT.

In addition to traditional HRT, a lot of prescribers like bioidentical hormone therapy (BHRT), which many consider to be closest to natural human hormones. Dr. William Kennedy, MD, board-certified Head & Neck Surgeon and Facial Plastic Surgeon, and Founder of AEDIT MedSpa™ says the hormones used in HRT are derived from the urine of pregnant horses and other organic hormones. Bioidentical Hormones used in BHRT on the other hand are derived from plants and are chemically identical to naturally occurring hormones in the body. Being chemically identical to our own hormones gives BHRT a significant advantage over traditional HRT in that you have fewer side effects and dosing can be more precisely titrated to doses that meet the patient’s exact needs.

The Benefits of HRT

Hormone imbalances can cause an array of health conditions and can affect the skin, reproductive organs, metabolism, and mental health. To counteract these effects, many doctors will prescribe HRT to drastically improve well-being.

Board-certified cosmetic dermatologist in West Hollywood, Jason Emer, MD, says that when women experience a hormonal imbalance, they could suffer from headaches, hair loss, excessive hair growth on the face, acne, irregular periods, vaginal dryness, and discomfort during sex. Men, on the other hand, might have difficulty maintaining muscle mass, difficulty concentrating, erectile dysfunction (ED), swollen breast tissue (gynecomastia), and decreased facial and body hair growth. To determine whether or not someone would be a good candidate for HRT, most doctors will perform and assess bloodwork.

“You can have someone who is younger with endocrine issues that needs HRT and someone who is going through decreased values with age, stress, catastrophic life events, etc. There is no specific person that is or isn't a candidate,” says Dr. Emer.

Previously, it was believed that people above the age of 60 or those with a history of blood clots or heart disease were ineligible candidates for HRT. Dr. Emer says that if someone has low levels, improving their hormone levels may help their heart disease or cholesterol. That being said, Dr. Emer adds that if someone is older with a lot of comorbidities, it may be better to hold off on treating the hormonal imbalance until the person is in better health.

Why Plastic Surgeons Are Excited About HRT

It’s no secret that plastic surgeons are obsessed with outward beauty — it’s what makes us feel individualized and empowered, after all! But, as clichéd as it sounds, outer beauty starts from within. We need to look and feel good, both physically and mentally. That’s why our network of experts is particularly excited about incorporating HRT into their practices.

Dr. Emer, for instance, focuses on a ‘holistic’ approach to antiaging where he not only addresses patients’ outside cosmetic concerns but also their internal aging process. “We discuss evaluating hormonal changes as they age and after events, like pregnancy or weight loss, to determine if hormonal supplementation or peptides are needed to aid in concerns they have with age (e.g. stress, sleep issues, hair loss, joint pains, sexual dysfunction or loss of drive, and skin changes),” Dr. Emer tells The AEDITION. During each of his cosmetic consults, Dr. Emer discusses internal wellness and, if they have any concerns, his team evaluates it with blood tests and supplementation.

Dr. Kennedy is excited about the advances HRT and BHRT have made over the past few years and the promise of more advances on the way. “As we age, changes to the way we look and feel are a direct result of changes in our internal production of chemicals and hormones. At AEDIT Medspa™ we replenish these hormones so both the cause and effect of aging are addressed. Success at AEDIT Medspa™ is a person feeling great about themselves not just on the outside but on the inside too.”

HRT can be used independently or in conjunction with other treatments (e.g. results. anti-aging, sexual rejuvenation, or fat reduction) to enhance results. At Advitamin at the Shafer Clinic, they sometimes offer BHRT with treatments like IV infusion therapy, peptide therapies, regenerative procedures, and nutritional supplements, depending on the needs of the patient.

The Takeaway

With a proven track record, Hormone Replacement Therapy (HRT) is rapidly gaining popularity among plastic surgeons and other healthcare providers. The integration of HRT into their offerings underscores its pivotal role in not only optimizing our hormonal balance for physical well-being but also in enhancing our outward appearance.