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Diane Brzezinski, D.O. FACOI

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Dr. B's Blog

hormone therapy

Finding Menopause Symptom Relief with Bioidentical Hormone Replacement Therapy

Hormone replacement therapy (HRT) was recognized as a highly effective treatment for menopause symptoms decades ago, but the therapy has been clouded by misinformation ever since the release of a 2001 Woman’s Health Initiative (WHI) study. That study linked HRT to the dreaded C-word—cancer and an increased risk of stroke, blood clots, and other health issues, causing HRT prescriptions to plummet. Once women were scared off of their hormones OF ANY KIND, there was an 8 fold increase of heart disease in women after the first year of discontinuation quickly becoming one of the top killers of women. While researchers have since identified flaws in the initial report, and follow-up studies have established that HRT benefits outweigh potential risks, HRT acceptance remains subdued, and most women (and men) remain confused about the therapy’s benefits and safety.

As a woman who underwent premature menopause in her early 40s, Naples-based internal medicine specialist Dr. Diane Brzezinski, D.O., has first-hand experience using HRT to successfully treat her symptoms and is a passionate proponent of the therapy. Based on personal experience and years of effectively treating patients with the therapy, Dr. B believes that all-natural bioidentical hormone replacement therapy (BHRT) is the optimal form of HRT. Read on to learn how BHRT can help ease your menopause-related symptoms.


Women’s estrogen levels naturally diminish with age and tend to drop dramatically during the approach and onset of menopause. Estrogen declines are closely associated with all three stages of menopause. No matter how much effort a woman makes to live healthily, this natural hormonal disruption can affect her health. Irregular menstrual cycles, hot flashes, insomnia, mood swings, urinary issues, and decreased libido are mainstays of the menopausal cycle. Other discomforting symptoms that affect many women include:

  • Headaches
  • Night sweats
  • Indigestion
  • Decreased bone density
  • Loss of concentration
  • Vaginal discomfort and dryness
  • Breast tenderness
  • Weight gain
  • Thinning skin
  • Brittle hair
  • Hair loss

Medical issues and events like hysterectomy, metabolic syndrome, adrenal fatigue, and thyroid disorder can also cause significant estrogen declines and associated symptoms. No matter what causes the estrogen decline, replenishing lost hormones has proven effective at easing symptoms.


All hormone therapies are designed to restore hormone levels lost due to medical issues or natural causes like menopause. These therapies have proven effective at reducing symptoms associated with decreased hormone levels, with bioidentical hormones marking the latest advance in the field. While the previously mentioned WHI study curtailed the therapeutic use of all HRT, numerous medical organizations and the FDA now support its controlled use to address menopause symptoms.

Derived from plant sources, bioidentical hormones contain the exact same chemical and molecular structure as the hormones produced by the human body. Researchers believe this provides better absorption and utilization rates than synthetic hormones used with many HRTs.

While HRT has traditionally been administered through injections, gels, pills, or transdermal patches, Dr. B relies on pellet hormones inserted under the skin of the buttocks. This promotes the steady absorption of hormones to maintain a consistent level as needed. Traditional HRT delivery methods do not maintain constant hormone levels, which can lead to fluctuations in patient energy levels and mood.


BHRT-induced estrogen replacement cannot do anything to stop the inevitable end of fertility, but it can help relieve many associated symptoms. Every woman has a distinctly different health and hormone profile, so BHRT’s benefits vary. With the approach of menopause—perimenopause—BHRT can help most women reduce mood swings, restore libido, and better control incontinence. It also helps prevent brittle hair, thinning skin, and bone density declines. During menopause, most women find that BHRT also helps alleviate depression, insomnia, hot flashes, night sweats, vaginal dryness, and headaches. These benefits tend to continue when BHRT is used post-menopause.

Because Dr. B takes a holistic, “whole patient” approach to medical care, she may recommend combining other treatment options with BHRT to secure optimum results.


BHRT’s symptom-easing benefits widely vary due to dosage and each woman’s health and hormone level profile. While some women experience relief from menopause-related symptoms within a few weeks, others may not notice symptoms easing for a month or two. In general, it takes about three months for the full effects of any hormone therapy to become apparent.

Each pellet therapy session lasts three to six months, depending on hormone dosage and the patient’s hormonal profile. Depending on results and hormonal profile, dosage amounts may be reconfigured for subsequent sessions.


All medical therapies carry at least some risk, and Dr. B strives to mitigate any BHRT-associated risks by following medical guidance offered by the FDA and various medical organizations. Based on health profile and any specific medical condition risks, Dr. B refrains from recommending BHRT to some women.


Dr. B’s passion about the benefits of BHRT can be reviewed on this YouTube video, which also provides a wealth of additional information about the therapy. If you have more questions about BHRT, Dr. B will gladly talk to you in a personal consultation. You can schedule an appointment by contacting her Naples-based Internal Medicine practice today at (239) 261-9990.