Bioidentical hormones are hormones that are chemically identical to hormones produced by the human body. The term can describe both FDA-approved products and compounded preparations. A physician-led bioidentical hormone evaluation should distinguish the specific hormone deficiency or menopause-related symptom being treated, whether an FDA-approved option exists, and whether there is a genuine clinical reason to consider a compounded preparation.
Are bioidentical hormones safer than other hormone therapy? The term “bioidentical” does not by itself mean safer or more effective. FDA-approved products containing estradiol or progesterone can be chemically identical to hormones made by the body.
Are compounded bioidentical hormones FDA approved? No. Compounded preparations are not FDA-approved finished drug products and do not undergo the same premarket review for safety, effectiveness and quality.
When might compounded hormones be considered? Compounding can have a role when a patient has a specific medical need that cannot be met by an available FDA-approved product, but it should not be assumed to be preferable simply because it is customized.
Do I need hormone testing before menopause HRT? Routine hormone-level testing is generally not needed to diagnose a typical menopause transition or to start treatment for typical menopausal symptoms; testing is more useful when another endocrine disorder or an atypical presentation is being evaluated.
“Bioidentical” does not by itself mean that a treatment is safer, more effective, more natural, or appropriate for every patient.
FDA-approved hormone products include forms of estradiol and micronized progesterone that are chemically identical to endogenous hormones. Compounded bioidentical hormones are not FDA-approved finished drug products and may be considered only when an individualized clinical need cannot be met by an appropriate commercially available product.
At Hormone Replacement Therapy LA, David Nazarian, M.D., Board-Certified in Internal Medicine, evaluates symptoms, medical history, medications, reproductive and fertility goals, relevant laboratory findings, and individual risk factors before recommending treatment.
Hormone Replacement Therapy Consult $450
Progesterone plays important roles in reproduction and endometrial health. In women with a uterus who use systemic estrogen for menopausal symptoms, an appropriate progestogen is generally used to reduce the risk of endometrial hyperplasia and cancer. The specific product, dose, route, and schedule should be individualized.
Symptoms such as sleep disruption, hot flashes, night sweats, vaginal symptoms, mood changes, and changes in menstrual patterns can occur during perimenopause and menopause, but they can also have other causes. Treatment decisions should follow a complete medical evaluation rather than hormone levels alone.
FDA-approved micronized progesterone is available. Compounded progesterone is not automatically safer or more effective than an FDA-approved product. Treatment choice should reflect the patient’s diagnosis, uterine status, symptoms, preferences, and risk profile.
Estradiol is the primary estrogen produced during the reproductive years. FDA-approved estradiol is available in several forms, including oral and transdermal products. For appropriately selected patients, systemic estrogen can be effective for bothersome vasomotor symptoms, while local vaginal estrogen may be considered for genitourinary symptoms.
The most appropriate estrogen route depends on the treatment goal, whether the uterus is present, age, time since menopause, cardiovascular and thrombotic risk, breast and gynecologic history, medication interactions, and patient preference. Treatment should be reassessed over time.
Yes. Oral tablets, transdermal patches or gels, and local vaginal preparations have different absorption patterns, indications, and risk considerations. Transdermal and local routes may be preferred in some clinical situations. There is no single formulation that is best for every patient.
Testosterone therapy should not be prescribed solely because testosterone levels decline with age or for general anti-aging, bodybuilding, or weight-loss purposes. Men with symptoms of possible testosterone deficiency should have appropriately timed confirmatory testing and evaluation for contributing causes, fertility goals, sleep apnea, medications, metabolic health, and other risks before treatment is considered.
Hormone Replacement Therapy Consult $450
Testosterone Replacement Program
Includes
Hormone therapy can be beneficial for appropriately selected patients with a defined indication, such as bothersome menopausal symptoms or confirmed testosterone deficiency. It is not a universal treatment for fatigue, weight gain, mood changes, reduced libido, or normal aging. These symptoms may have multiple medical causes.
FDA-approved hormone therapies have been evaluated for safety, effectiveness, quality, and manufacturing consistency for their approved uses. Compounded hormone preparations are not FDA-approved finished drug products. Compounding may have a role for an individual patient with a documented need that cannot be met by an appropriate FDA-approved formulation, but compounded products should not be presented as inherently superior.
There is no universal maximum duration that applies to every patient. Duration should be individualized according to the reason for treatment, symptom burden, age, time since menopause when relevant, treatment response, changing health risks, and patient preferences. Benefits and risks should be reassessed periodically.
Hormone therapy may be inappropriate or require additional specialist input in certain situations, including unexplained vaginal bleeding, some hormone-sensitive cancers, prior blood clots, stroke or heart attack, significant liver disease, pregnancy, fertility concerns, or other complex medical conditions. The specific risks depend on the hormone, dose, route, and patient.
Potential risks vary by treatment and patient. Monitoring may include symptom response, blood pressure, laboratory testing, blood counts, breast or gynecologic screening, prostate-related evaluation, fertility considerations, adverse effects, and other preventive care. Treatment should be adjusted or discontinued when risks change or expected benefits are not achieved.
Board-Certified in Internal Medicine
Dr. David Nazarian provides physician-led hormone evaluation and individualized treatment for women and men. His approach considers symptoms in the broader context of cardiovascular and metabolic health, sleep, thyroid function, medications, nutrition, reproductive goals, and other medical causes before hormone therapy is recommended.
Learn more about hormone replacement therapy, hormone testing and evaluation, testosterone therapy, and women’s hormone and menopause care. Treatment recommendations depend on the individual clinical evaluation and are not based on symptoms or laboratory values alone.
Written and medically reviewed by David Nazarian, M.D., a board-certified internal medicine physician. Content is intended for patient education and does not replace an individualized medical evaluation.
Our Beverly Hills office serves patients throughout greater Los Angeles seeking physician-led hormone evaluation and individualized care.
Commonly served areas include: Beverly Hills, West Hollywood, Century City, Brentwood, Santa Monica, West Los Angeles, Bel Air, Culver City, Hollywood, and Pacific Palisades.
Serving Los Angeles & Beverly Hills
Our physician-led hormone practice serves patients from Beverly Hills, West Hollywood, Century City, Westwood, Brentwood, Santa Monica, Hollywood, Bel Air, Culver City, Studio City, Sherman Oaks, and surrounding Los Angeles communities.
Information on this page is educational and does not replace individualized medical advice. Prescription hormone therapy requires an appropriate medical evaluation.
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David Nazarian, M.D., is Board-Certified in Internal Medicine and provides physician-led hormone evaluation and individualized care for women and men. His approach emphasizes comprehensive assessment, patient education, individualized treatment, safety, and ongoing follow-up. Dr. Nazarian specializes in bio-identical hormone replacement therapy in men & women. He has extensive training and knowledge in treating andropause and testosterone replacement therapy in men and menopause and estrogen replacement therapy in women. Supported by his experienced medical team, Dr. Nazarian treats men and women with hormone deficiencies and imbalances and enjoys the one-on-one relationship between patient and doctor.
HRT LA provides physician-led hormone evaluation and individualized care in Beverly Hills and Los Angeles with David Nazarian, M.D.
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