Bio-identical Hormone Replacement Therapy by Joe Edwards MD

12/27/2025

Testosterone therapy is the missing ingredient in hormonal therapy for men and women. Testosterone increases energy, improves mood, boosts libido, reduces body fat, strengthens bone, deeper sleep, decreases brain fog, and enhances recovery from exercise. For men, there are 3 choices: creams, injections, and pellets. For women: creams, pills, injections, and pellets. I have had tremendous success with pellets and have been using them myself for over six years. I calculate the dosage based on multiple factors: weight, blood work, symptoms, and age. Absorption rates of the pellets is the one thing that is not predictable, which is the reason you need post pellet blood work done about 5 weeks after insertion. For those not ready for pellets, I use creams that can be adjusted up and down based on your results. Find someone that will listen to you and base your therapy on what works best for you.

– As a man of Science, I’m supposed to hide my enthusiasm about this somewhat controversial subject, and instead direct you only to the peer-reviewed studies.  But man, I feel like I’ve …

11/17/2025

As a second generation OBGYN with 30+ years experience, I am doing my best to educate women, as well as men, about the importance of hormone replacement therapy (HRT). If you have symptoms, like any other problem, you should be aware of your treatment options. The missing ingredient in most HRT regimens is testosterone, which helps with libido, energy, brain fog, and sleep. The treatment should be individualized based on many factors: age, symptoms, blood work, and weight. Estrogen helps with hot flashes, night sweats, and dryness. Progesterone helps minimize bleeding and sleep (which helps one’s mood). Send me any questions and I’ll try to answer them for you.

Menopausal HRT has been touted as a longevity drug for women and a danger to their health. Is the government’s call to remove the black-box warning a good idea?

11/08/2025

As an OBGYN, I deal with hormonal imbalance concerns every day. The amount of misinformation and companies trying to make money on women seems endless. Saliva tests are not accurate. Women who are not on any type of contraceptive have a natural fluctuation of their hormones: estrogen dominates the first half and progesterone the second half. It matters what day in your cycle that your blood work is drawn.

Birth control is prescribed to treat a range of hormonal issues. But women in their 20s and 30s are increasingly pursuing alternative solutions, taking a D.I.Y. approach to health.

10/31/2025

Hormone replacement therapy (HRT) is an effective treatment for the symptoms of menopause, but many women are afraid because of their concerns regarding the presumed increased risk of breast cancer. The flawed WHI study many years ago has continued to confuse patients and health care providers. I do not believe that HRT increases the risk of breast cancer and has many benefits. Estrogen helps with hot flashes, night sweats, and dryness. Progesterone helps with sleep and decreases one’s chance of uterine cancer; if you still have your uterus. Testosterone is the missing ingredient and helps with libido, fatigue, sleep, and brain fog. It is up to the individual to decide what is best for her.

Here’s what you should really know about new research on decreased risk of cancer and stroke for those taking estrogen during perimenopause.

10/31/2025

Veteran journalist Christiane Amanpour, who shared her ovarian cancer diagnosis in 2021, revealed she's battling the disease again in a new interview.

07/28/2025

The Women’s health initiative set back hormonal health many years ago by frightening women about hormone replacement therapy (HRT). These thoughts are still with health care providers today. The study was a total disaster and failed to take into account many factors. The hormones were Premarin (pregnant horse urine) and MPA: both were not bio-identical. There were a large number of smokers and the average age was 13 years after menopause began. There were 3 parts to the study: the Premarin alone patients saw a DECREASE in breast cancer, which was never mentioned. Most experts (including me) agree that starting HRT around menopause lowers your risk of heart attacks and strokes. The missing ingredient is testosterone, which helps with libido, energy, brain fog, and sleep. It is up to the patient to decide what is best given your issues.

Dr. Marty Makary, the agency’s commissioner, said too many women avoid hormone therapy because the risks have been overstated.

07/11/2025

My sweet patient celebrated her 70th birthday this week and had been looking for someone to help her with her menopausal symptoms. I obtained the appropriate labs. As expected, she had zero hormones and had tried other remedies without success. I offered her hormonal pellets and she has now received...

06/28/2025

Most women get tired of having their monthly visitor and are ecstatic when they finally stop having their menstrual cycle (through surgery or menopause). Men would not tolerate monthly bleeding and pain. The fluctuation in hormones occurs because estrogen dominants the first half of the normal menstrual cycle with progesterone dominating the second half: an important reason for timing of blood work. The varying levels of hormones is misunderstood by patients, as well as physicians. The more ovulatory events one has, the greater the risk of ovarian cancer. (a potential problem for extending ovarian function). When your hormones are checked, a FSH and an estrogen level are drawn. If you are on oral contraceptives, those levels will give you a false reading for menopause. Everyone talks about how terrible estrogen therapy is, but it is the estrogen that decreases the risk of heart attacks in women who are premenopausal. After menopause, the rate of heart attacks matches men.

New efforts to boost women’s health and extend fertility depend on developing tools to slow the aging of ovaries.

06/28/2025

The wives of Robert Kraft and Leonard Lauder died of ovarian cancer. When my wife turned 50, I had her ovaries removed because I did not want her to be the 1 in 70 women who develops ovarian cancer. The studies mentioned in this article have too many confounding variables (different factors) to have any meaningful conclusion. The lack of hormone replacement therapy (HRT) knowledge makes these issues confusing for women. HRT can relieve hot flashes, night sweats, dryness, libido, brain fog, insomnia, fatigue, osteoporosis, muscle weakness etc. the missing ingredient is testosterone. My rule of thumb for ovarian removal: 50 remove. One’s history, physical exam, blood work, symptoms, and expectations should allow for individualized care. If you are not happy or satisfied with your care, as well as my patients, you should seek a second opinion. I sleep better at night knowing that my wife of 37+ years no longer has her ovaries

Removing ovaries with a hysterectomy might increase risk of heart disease, stroke and dementia

06/28/2025

Declining testosterone begins in your 30s. The symptoms of low testosterone are fatigue, insomnia, brain fog, loss of libido, loss of muscle mass, and unexplained weight gain. Each individual has to find out what is best for them. Also, medications can affect the way you feel. I would get basic blood work and check your free and total testosterone. Everyone responds to different levels of testosterone. Treatment can be in the form of creams, injections, or hormonal pellets. Good luck.

If your libido’s dried up and your energy levels are dipping, it could be a hormone problem. Here's how to find out if it is.

06/24/2025

FSH measurements should be done on the third day of a woman’s menstrual cycle because the levels vary depending on the day of the cycle that it is drawn. If desiring pregnancy, you want your level to be less than 10 (the lower, the better). If you have irregular cycles, you may not be ovulating, then you will have a random FSH drawn. The key to ovulation is every 26-30 day cycles that are consistent in length as well as an egg white mucus discharge mid-cycle. The problem for women taking oral contraceptives (OCP) is that it suppresses your FSH level: you are then told that you are not menopausal despite having the symptoms. It is easier to go on OCP’s in your late forties for cycle control, but they are doing nothing for menopausal symptoms. If on OCP’s, have your AMH (prior post) checked to measure your ovarian reserve, which will help you determine if you are menopausal. There is no reason to wait one year without a menstrual cycle to have the diagnosis of menopause. The treatment is up to you.

This test measures the level of follicle-stimulating hormone (FSH) in your blood. FSH affects sexual development in children and fertility in adults. Learn more.

06/22/2025

Manopause, like menopause, is a treatable condition. I have been treating men with Low T with hormonal pellets. I have seen significant improvements in energy, less brain fog, better sleep, and an increase in their libido (some men are banned from pellets in my office because they are already too frisky). I adjust the dosing based on their symptoms. The one thing that I cannot predict is the absorption, which is the reason that post-pellet bloodwork (done about 5 weeks post insertion) is so important. The levels and their response to the pellets then determine if a boost is needed. Male pellets last about 16-20 weeks and women pellets last about 12-16 weeks. Eventually, you can figure out your own rhythm to the pellets: knowing your dosing and intervals to minimize the peaks and valleys. The key is the least amount that does the most good. Good luck!!

A new study finds men with low T who used a gel to increase the hormone did not have a higher rate of heart attacks than men on a placebo. But the anti-aging benefits are iffy.