What Are My Options for Hormone Therapy?

After reading The Hormone Controversy: A Brief History, you may be wondering the best option to fit your customized needs if you want to pursue Bio-Identical Hormone Therapy (BHT) with Amy Brenner, MD & Associates. We would like to educate you on the potential benefits and possible side effects of each of the sex hormones (Estrogen, Testosterone and Progesterone) as well as additional lifestyle strategies to get you on the road to feeling your best.
Optimizing hormonal balance can produce life-changing results.  With hormone optimization, our patients have experienced:

  • Increased mental and physical energy
  • Stronger metabolism to build bones, build muscle and lose fat
  • Improved sleep, relaxation and mood
  • Improved sexual function with enhancing libido, orgasms and vaginal lubrication for women and erectile issues in men
  • Reduction or elimination of hot flashes and night sweats

Optimizing hormones with Bio-Identical Hormones can also reduce the risks of: cardiovascular disease, osteoporosis, Type 2 diabetes, high cholesterol, Alzheimer’s and dementia.
Now that you know why BHT can help you experience your best possible health, let’s explore the application you may choose to do that. We prescribe Bio-Identical Hormones in the form of topical creams, subcutaneous injections, oral capsules and pellet therapy. There are pros and cons to each method, and this chart makes it easy to see at a glance:




High efficiency (it works!)

High compliance (insertion only 3-4 times per year)

Monitor levels via blood work

No transfer of medication to family or pets

Delivery method for testosterone (men and
women) and estrogen (postmenopausal women)


Mini procedure

Bruising/soreness <5% of patients

Difficult to remove

Extrusion rate 2% of female patients; 10% for male patients

Infection <1% of patients


Can adjust prescription at any time

Does not require a procedure

Delivery method for testosterone (men and
women) and estrogen (postmenopausal women)

Possible transfer to family and pets

Issues with compliance (must use daily and
 rub in to vulva or scrotum for 2 minutes)

Monitor levels via saliva test (more expensive)


High efficiency

Monitor levels via blood work

Requires moderate level of compliance (1-3 week self-injections)

No transfer of medications to family or pets

Can adjust prescription at any time

Self-administered subcutaneous injections

Skin irritation <1% patients

Skin nodules at injection site <1% of patients

Delivery method for Testosterone ONLY (men and women)

Oral Capsules

High efficiency

High compliance (daily nighttime dose)

Monitor levels via blood work

No transfer of medication to family or pets

Can adjust prescription at any time

Compounded formula is hypoallergenic

Delivery method for Progesterone ONLY in our practice

We shy away from oral estrogen due to the controversial data on its risk of increasing the development of clots (deep vein thrombosis, pulmonary embolism). When hormones go through the liver (orally), oral Estrogen has the ability to stimulate blood clotting. Bypassing the liver (creams, injections, pellets) with testosterone and estrogen means there is not an increase in blood clotting.
It may surprise you to know that Dr. Brenner was “anti-pellet therapy” until she received expert education on the importance of dosing and management, which includes the specific type of testing that should be used to monitor hormone levels. There is no “one size fits all” approach to optimizing hormones! If you see other practitioners or pharmacists speaking negatively about certain methods, there is a very strong likelihood they have not been properly educated about them, and that’s why they don’t offer them. The compounding pharmacies that produce compounded hormones have to maintain specific licenses, have a designated sterile processing room, and are subject to both scheduled and random FDA inspections.

We realize that you may have additional questions about which therapy is best for you. You are welcome to schedule a Hormone Consultation with any of our doctors (women and men) and nurse practitioners (women only) to help you understand your options. Simply email contact@dramybrenner.com or call our office at 513.770.0787.