Your Guide to Hormones and Bio-Identical Hormone Therapy for Women in Cincinnati

woman and man pausing for a break after running

Hormones play a huge role in our body’s daily functions, so when they’re imbalanced, you may feel a bit off. In the past, many women have turned to traditional hormone replacement therapy (HRT) to alleviate some of their low-hormone symptoms, but with the rising popularity of bio-identical hormone therapy (BHT), people are changing gears. 
Many women come to Amy Brenner, MD & Associates wondering how bio-identical hormone therapy can help them. Our doctors believe it’s incredibly important that all our patients are well informed before deciding on a hormonal therapy treatment. If you’re thinking about getting a treatment for yourself, keep reading to learn all you should know about hormone therapy for women in Cincinnati. 

Why are hormones so important?

Think of hormones like a project manager for the body. They’re the messengers that tell your body what to do, when to do it, and how long it should do it. Without hormones your body would be a directionless mess. 
Part of the endocrine system, glands secrete hormones that are then secreted into the blood. You have a variety of glands that have different functions. These include the:

Pituitary gland: Also known as the “master gland,” the pituitary gland secretes hormones that control a variety of bodily processes, including controlling other glands. 

Pancreas: The pancreas produces insulin to regulate blood sugar levels. Problems with insulin can lead to diabetes or insulin resistance. This can affect your weight, cravings and mood. 

Thyroid: Your thyroid is crucial for maintaining your metabolic rate. An overactive thyroid (Grave’s Disease) or underactive thyroid (Hashimoto’s Disease) can affect your weight, heart rate, energy levels, and more. 

Adrenal glands: The adrenal glands are in charge of your “fight or flight” response. They primarily secrete adrenaline, corticosteroid hormones, and DHEA.

Pineal glands: Pineal glands secrete melatonin, which regulate your sleep cycles and helps you get a good night’s rest. 

Ovaries: Your ovaries secrete reproductive hormones (estrogen, progesterone, and androgens a.k.a testosterone) These three hormones affect about 500 things in the body. We’ll go into this in more detail later. 

Hormones flow through the body, but only certain cells are designed to receive them. Basically, the endocrine system is a complex network of messages with hormones being at the center of it all. Any time your hormone levels are off, it could lead to disease, weight changes, weak bones, infertility, and more. 

Types of hormones in women

Since bio-identical hormones for women focus on replacing reproductive hormones, let’s go into detail about those hormones. 
The ovaries produce three main types of hormones: 

  1. Estrogen
  2. Progesterone
  3. Androgens (a.k.a. testosterone)

Throughout your menstrual cycle, these hormones fluctuate and shift. 


We’re sure you’ve heard of estrogen as the “female sex hormones,” but what exactly does estrogen do? 
Not only does estrogen impact menstruation, it also aids in different bodily functions, including cardiac, brain, vascular, and urinary health. Estrogen also helps with bone development. 
Estrogen is an umbrella term for hormones that are chemically similar: estrone, estradiol, and estriol
During puberty, estrogen helps with the development of breasts, pubic hair, wider hips and other physical changes maturing girls go through. It also helps regulate the menstrual cycle by controlling the thickening of the uterine lining. That means estrogen levels are highest before your period starts, but quickly decline if the egg hasn’t been fertilized. 
One of the main focuses of bio-identical hormone therapy for women is to balance low estrogen levels during menopause. During your middle-aged years, your body stops producing as much estrogen as it did before. This can lead to many symptoms. The most common symptoms of low estrogen include: 

  • Bone depletion & osteoporosis
  • Irregular or absent periods
  • Hot flashes/night sweats
  • Vaginal dryness


Progesterone plays a crucial role in pregnancy. If an egg is fertilized, progesterone works with estrogen to stop ovulation. Progesterone is in charge of changing the structure of the endometrium (the mucus layer that lines the uterus) to make it easier for a fertilized egg to implant. It also helps with the development of mammary glands, an essential component for breast milk production.
Benefits of progesterone include: 

  • Prevents estrogen dominance
  • Promotes breast health 
  • Protects against uterine cancer, breast cancer, and fibrocystic disease
  • Helps women relax and sleep better
  • Increases mood, especially before a period


Androgens are a group of hormones, the most well known being testosterone (yes, women need testosterone too!). 
Both the ovaries and adrenal glands produce androgens, but by the time you reach 40, your androgen levels about half of what they were when you were 20. 
Many women overlook what an androgen deficiency could do. You may think, “if androgens are known as male sex hormones, as a woman I shouldn’t worry about my levels going down.”
Not quite. 
Yes, it’s true that androgens such as testosterone is crucial for male reproductive development, but women need the perfect balance of androgens to avoid negative side effects such as: 

  • Tiredness
  • Decrease in libido
  • Loss of muscle mass & strength 
  • Lowered mood

In women, testosterone helps produce new blood cells, maintain sex drive, and increase levels of other reproductive hormones. So think twice before you ignore a testosterone deficiency. 

What causes hormonal changes in women?

The cause of hormonal changes in women isn’t a one-size-fits-all answer, and some women are more sensitive to hormonal changes than others. Although it varies from woman to woman, a lot of changes can be narrowed down to: 

  • Puberty
  • Menstrual cycle
  • Pregnancy, childbirth, and breastfeeding
  • Perimenopause (the 5 to 10 year period before menopause) and menopause
  • Medical conditions and medications


Most people know that reproductive hormones surge during puberty. An increase in estrogen helps the female body to develop and promote the onset of a regular menstrual cycle. 

Menstrual Cycle

Different hormones are prominent during different points in your menstrual cycle. During your period (the shedding of the uterine lining) estrogen and progesterone levels are low, which can affect your mood. Before ovulation, estrogen levels peak then drop off. In between that time when the body is preparing for a fertilized egg, progesterone peaks, but if pregnancy doesn’t occur, that too drops off. 
Keep in mind that hormonal changes during your menstrual cycle are not only normal but also a sign that your body is working properly. 

Pregnancy, childbirth, and breastfeeding

Pregnancy is the most dramatic hormonal shift your body goes through. While other changes are more gradual, pregnancy spikes hormonal levels all at once (hello, morning sickness). Your body even creates a new organ called the placenta that produces even more progesterone. 

Perimenopause and menopause

The onset of perimenopause and menopause is the leading factor that drives our patients toward bio-identical hormone therapy for women. During perimenopause and menopause, a decrease in hormone production can lead to symptoms such as hot flashes, fatigue, decreased libido, weight gain, sleep issues and more. 

Medical conditions and medications

Outside of natural changes, there are medical conditions and medications that impact your hormone levels and response to therapy. Medications that inhibit ovulation (such as birth control medications) and pregnancy change the natural hormonal fluctuations during the menstrual cycle.  Antidepressants, narcotics, and anxiety medications can affect hormone levels and/or lead to undesirable symptoms. 

Signs you have a hormone imbalance

Knowing you have a hormone imbalance is the first step in deciding whether or not you should consider bio-identical hormone therapy for women.  

Heavy, irregular, or painful periods

It’s normal for your period flow to change throughout the years, but extreme changes could be a sign of a hormone imbalance. For most women, periods come every 21 to 35 days. But if your period doesn’t come around the same time each month or even skips a month, the balance of progesterone and estrogen could be out of whack. 

Hot flashes and night sweats

Hot flashes and night sweats are a prime side effect of perimenopause and menopause. This can be due to low estrogen, progesterone, and even testosterone levels, and can really disrupt your sleep and daily comfort. 

Vaginal dryness

Estrogen helps the vagina to produce a natural lubrication to ensure comfort during sexual intercourse. If you’re noticing that vaginal dryness has become a normal occurrence, definitely look into getting your estrogen levels checked. 

Stomach and digestive issues

Fun fact: your stomach is lined with cells that respond to estrogen and progesterone. So if your levels are off, you may notice stomach pain, bloating, diarrhea, or constipation. 

Mood swings and depression

All the reproductive hormones (estrogen, progesterone and testosterone) affect brain chemicals that keep us happy. These chemicals include serotonin, dopamine, and norepinephrine. Fluctuations in those chemicals can lead to mood swings, and a major dip could also lead to depression.

Weight gain

There are a couple ways a hormonal imbalance can affect your weight. An indirect cause is mood swings due to dips in estrogen levels. Some women eat more and pick up unhealthy eating habits when they’re feeling down or irritable. Decreased estrogen can also impact leptin levels (a hormone that regulates food intake). Estrogen also makes insulin work better.  
Women can also have too much estrogen known as estrogen dominance. One of the main symptoms is weight gain, especially around the midsection. 
Inadequate testosterone can also indirectly affect weight. Testosterone increases muscle mass and more muscle burns more calories. 

What is bio-identical hormone therapy for women?

Bio-identical hormone therapy is a natural approach to traditional hormone replacement therapy (HRT) to help alleviate symptoms that come from hormonal imbalances. Unlike HRT, bio-identical hormones are molecularly identical to the hormones your body produces, and your body can’t tell the difference between the two. 
Bio-identical hormones are used to replenish estrogen (especially estradiols that decrease after menopause), progesterone, and testosterone. Doctors can determine a proper dosage based on your symptoms along with a blood, urine, or saliva test. 
Depending on your specific needs and what you feel most comfortable with, you can receive bio-identical hormone therapy via creams, hormone pellet therapy, or injections. 

Who can get bio-identical hormone therapy?

Most women can benefit from bio-identical hormone therapy since it’s a more natural way to increase your hormone levels. If you’re noticing signs of hormone decline, BHT could be a great solution for you. 
There is significant published data showing how some hormones reduce the risks of:

  • Cardiovascular disease
  • Osteoporosis
  • Diabetes
  • Alzheimer’s disease
  • Macular degeneration
  • Cataracts
  • Decreased immune function
  • High cholesterol

If you’re in the Cincinnati area, our doctors and nurse practitioners at Amy Brenner, MD & Associates can help you determine if bio-identical hormone therapy is right for you. 

Bio-identical hormone therapy at Amy Brenner, MD & Associates

At Amy Brenner, MD & Associates, we offer three types of bio-identical hormone therapy options for women in Cincinnati. 

  1. Pellet Therapy (Subcutaneous implants): After using a local anesthetic, we place Testosterone +/- Estradiol pellets through a 3mm incision in the hip or buttocks. The procedure only takes about three minutes. 
  2. Testosterone Injection Therapy: Many women don’t realize that testosterone also has a huge impact on female sexual health. These injections are self-administered (usually in the belly or love handle area) 1 to 2 times a week. 
  3. Bio-identical Hormone Cream: Estrogen/Progesterone/Testosterone cream is self-administered everyday and eliminate the need for needles and downtime. 

Our therapy options are catered toward women of all ages. Women as young as 25 use bio-identical hormone therapy to help with PMS or PCOS. After getting BHT, many patients benefit from: 

  • Increased libido
  • Reduced blood sugar
  • Vaginal lubrication
  • Peaceful sleep
  • Reduced stress
  • Enhanced sense of overall well-being
  • And more!

Rebalance with bio-identical hormone therapy for women

It’s never too late to focus on your hormonal balances. Our team of doctors and nurse practitioners at Amy Brenner, MD & Associates will customize a plan that can relieve symptoms of low hormone levels to help you enjoy your daily life.
Contact us or schedule a consultation to get started on replenishing your hormone levels. 
You can also learn more by subscribing to our Hormone Education for Women email series!
Contact Us Schedule a Consultation