Dr. Joseph M. Perlman Advanced Plastic Surgery Centre

At Advanced Plastic Surgery Centre, we’re always looking for better ways to help our patients. We now offer consultation and management of hormone dysfunction using BHRT. Hormones regulate many bodily functions including growth, reproduction, and metabolism.

Peak levels for most of the hormones occur in our 20s and early 30s. Hormone levels decrease over the next 20 years both in men and women. Estrogen and progesterone levels decrease markedly at the time of menopause and testosterone levels decrease in men at about the same time. These lead to a number of symptoms including lack of energy and sex drive in both men and women and women in particular, hot flashes, thyroid dysfunction, mood swings, and weight gain, among other problems.

The key to understanding and managing hormone dysfunction requires individualizing the right hormone replacement, based on a patient’s symptoms and lab tests. During the initial consultation, not only do we have the patient’s fill out a questionnaire in which they check off their symptoms but we also want to know things such as their sleeping habits, tobacco and alcohol use, height and weight, type of exercise they regularly do, the medications they are taking and most importantly, their eating habits. A proper diet is key to maintaining good hormone balance. Avoiding a lot of sugar and eating proper portions of proteins, carbohydrates, and fats is essential. Many patients don’t realize that starvation diets actually work against the metabolism, by breaking muscle down in addition to losing fat.

During the initial consultation, we determine what lab work is necessary. All testing is done through an accredited facility and the results are sent back within five days. We then meet again with the patient to discuss the results and plan the proper BHRT. The hormones are compounded at a certified local pharmacy. The most common BHRT for women includes estrogens, progesterone, testosterone, and occasionally thyroid supplement and cortisol supplements.

We also have the patient monitor their symptoms, once they start therapy, to make sure that they are improving. We always start with the lowest dose that we think will be effective. Patients who are already on synthetic hormone replacement at the time of their initial consultation, are usually tapered off those hormones and gradually replaced with BHRT.