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Hormone replacement therapy

Remember how you felt when you were 18 years old?  Unbound energy, skinny, strong as an ox, and a sex drive that was off the charts. Chances are pretty good that if you’re over the age of 40, those days are a distant memory. But it doesn’t have to be that way. One of the changes happening as we age is a decrease in the production of our sex hormones. Mainly, testosterone for men, and Estrogen, Progesterone and Testosterone in women. Did I say testosterone in women? Absolutely, yes! As these levels fall, our bodies may start to feel older. Often referred to as hormonal imbalance. Hormonal levels are supposed to decrease as we age, that’s normal and really not out of balance, it’s as natural and normal as the aging process itself. And if you are content with aging and all the side effects that go along with it, then read no further. If, however, you want to recapture your youth, get your swagger back, cheat the aging process and turn back the hands of time, then read on!  


Times sure have changed. Twenty years ago, the majority of individuals taking testosterone (T) were body builders, weightlifters and elite athletes. Now a days it has become much more mainstream.  Andropause, the male equivalent of menopause is a recognized condition for which T may be prescribed.  Chances are pretty good that someone you know is taking it for one reason or another. For men, testosterone reaches its peak at about 18 years of age and gradually declines after that. Normal Testosterone ranges are between 250-1100 ng/dl. If your 40 years or older and have had your T levels checked it’s probably in the low normal range, most likely hovering around 300ng/dl. That’s enough for your doctor to say you are low normal,  and you insurance isn't going to pay for any T replacement.  But you would probably feel a lot better in the upper normal range. At Invigorate Med spa, when we start patients on T, we monitor the individuals response, and if necessary, gradually titrate until the patient notices the desired effects. Those may include morning erections, improved libido and increasing energy and strength in the gym. T levels are then checked and if you feel good at 500ug/dl great! If another patient feels that way and its 1000ug/dl that’s also ok.  Everyone is different, we don’t treat numbers alone, we treat the whole person. Testosterone  offers one of the biggest, "bang for your buck,"therapies out there. Relative low cost with tremendous effect,


Benefits of Testosterone Replacement:

  • Increase muscle mass and strength

  • Decrease body fat

  • Increase energy

  • Increased sex drive/libido

  • Improved erectile function (in men)

  • Improved concentration

  • Improved mood and sense of well-being

  • Quicker recovery time after workouts

  • Increased bone strength


So that’s some of the good. What about the bad?  Interestingly, that number is shrinking almost daily. 


Here’s a list of some facts and myths about T:


  • Increases risk for Prostate cancer - Absolutely false. As a matter of fact, there on ongoing trials using high doses of T to treat prostate cancer

  • Increase your bloodwork PSA level  and cause prostate enlargement Known as BPH - Perhaps minimally, not been shown to be significant

  • Increase risk of heart disease - Conflicting reports, several new studies state it's cardioprotective

  • Erythrocytosis - Yes. Erythrocytosis is the opposite of anemia. If you remain on it, donate blood every three months, you’ll be doing something nice for humanity, and you’ll feel good about yourself

  • Acne - Possibly

  • Fluid retention - Possibly

  • Decreased testicular size and sperm count - If on treatment for a long period of time, yes. If you want to have children, there are ways to regenerate your sperm count

  • Increase risk of a blood clot - Retrospective studies say there is an increase risk. So yes, for now.

  • Increased aggression - Mixed reviews


A word about over the counter supplements.  If you feel good taking testosterone boosters wonderful.  It’s probably a placebo effect andnd that’s perfectly fine. Don’t be confused though, over the counter (OTC), medications are not FDA approved and/or regulated.  You could be consuming grass clippings for all you know. Many of them are a rip-off, and for about the same price as a "Testosterone Booster," you can have the real thing. A lot of our patients used to buy T over the internet or got it from a gym buddy. Again, you have no idea what you are getting. At the very best, it doesn’t work and you just lose your money. At its worst, it is some contaminated garbage that can cause infection make you sick or even worse.



Stanozolol is a synthetic steroid that is derived from testosterone and possesses both anabolic and androgenic properties. Stanozolol acts as an androgen receptor agonist, similar to testosterone. It has been used to treat aplastic anemia, hereditary angioedema, vascular disorders and growth failures. It has also been shown to reduce sex hormone binding globulin (SHBG) by over 50%. A high SHBG level indicates less free testosterone is available to your tissues than would be expected by a total testosterone value.


Oxandrolone is a synthetic steroid, similar to the naturally occurring steroid testosterone. Oxandrolone is indicated as adjunctive therapy to promote weight gain after weight loss following extensive surgery, chronic infections, or severe trauma. It can also be used to offset the protein catabolism associated with prolonged administration of corticosteroids and for the relief of bone pain frequently accompanying osteoporosis.

Benefits of Oxandrolone:

It is the safest anabolic among all existing steroids in tablet form

Muscle gain without  water and fat deposits

Builds strength and endurance

Accelerates the fat burning effect

Little or no aromatization

No breast enlargement or suppression of testosterone production




DHEA is the most abundant hormone found in humans and is a precursor to many other steroids. DHEA declines steadily as we age, and low levels of DHEA have been associated with Alzheimer’s disease, cancer, and atherosclerotic disease. DHEA offers you an exciting option to help increase natural testosterone production.


Benefits of DHEA:

  • Helps boost testosterone

  • Aids in immune support

  • Promotes weight loss

  • Enhances libido

  • Improves sports performance and muscle mass

  • Slows the aging process and combats bone density loss in women

Nandrolone Decanoate

Benefits of Nandrolone:

  • Low risk of androgenic sides 

  • Lasting muscle quality

  • Often used with Testosterone



Just as men's sex hormones decline at middle age, so do women's. Estrogen, the major sex hormone for women, starts to decrease rapidly, in their mid to late 40's. 95% of women between the ages of 45 and 55 will be menopausal. Some women go through this change without missing a beat, but the vast majority, roughly 80%, suffer. The most common complaint during menopause are "hot flashes" (vasomotor symptoms). With time, vulvovaginal atrophy and vaginal dryness can follow.


Common symptoms in menopause are:

  • Hot flashes and night sweats (vasomotor symptoms)

  • Vaginal dryness, painful intercourse

  • Bone thinning or osteoporosis

  • Decreased libido

  • Decreased energy

  • Thinning hair

  • Sleep problems

  • Moodiness

  • Concentration and memory difficulties

  • Smaller breasts and an accumulation of fat in the abdomen

25 years ago, it was "correct" medicine to prescribe hormone replacement therapy (HRT) to postmenopausal women no matter the age. In 2002, The Women's Health Initiative publication showed that women receiving HRT had an increased risk of heart disease, stroke and breast cancer. Physicians were concerned, and rightfully so, and most stopped prescribing these estrogens. However, studies later showed that these trials were biased, and included older women in their samples. More recent trials show that these treatments, when prescribed for properly screened women between their 40's and mid 60's,, are at low risk with few complications.


We use bio-identical hormones to replenish deficiencies and restore and improve quality of life. This can be done in pill, topical or pellet form.  We mostly use topical creams which bypass the liver and minimize the risk of blood clots. Hormone replacement isn’t for all women. Women who have a history of breast cancer, ovarian cancer, heart disease, stroke or blood clots should not undergo hormonal replacement therapy.


Progesterone is a steroid sex hormone prominently produced by the ovaries. It is of the steroid hormone class progestogens and is both the most abundant and important progestogen in the human body. Progesterone plays a prominent role in pregnancy, embryonic development, and the menstrual cycle.


Benefits of Progesterone:

  • Amplify effects of estrogen

  • Enhance libido

  • Improve thyroid function

  • Neuroprotection

  • Increases metabolic rate to help utilize fat

  • Improves thyroid function

  • Reduces anxiety and upregulation on GABA

  • Reduces blood pressure and risk of breast cance

  • Helps to reduce cholesterol



Estradiol (E2) is a naturally occurring and bioidentical estrogen, or an agonist of the estrogen receptor, the biological target of estrogens like endogenous estradiol. Due to it’s estrogenic activity, estradiol has

antigonadoptric effects and can inhibit fertility and suppress sex hormone production in both women and men. It’s an estrogen and is used mainly in menopausal hormone therapy and to treat low sex hormone levels in women. It can be used in hormonal birth control for women and in the treatment of hormone-sensitive cancers like prostate cancer in men and breast cancer in women, among other uses.


Estrogen combinations available in creams (Estradiol, estriol, bi-est), tablets, or injections


Benefits of Progesterone:

  • Amplify effects of estrogen

  • Enhance libido

  • Improve thyroid function

  • Neuroprotection

  • Increases metabolic rate to help utilize fat

  • Improves thyroid function

  • Reduces anxiety and upregulation on GABA

  • Reduces blood pressure and risk of breast cancer

  • Helps to reduce cholesterol



For females: Testosterone is also vitally important for females. There are several causes of low testosterone in women, often related to menopause & perimenopause. That said, women may also experience low testosterone secondary to estrogen dominance, childbirth, cancer

treatment, adrenal fatigue, use of birth control pills, depression, endometriosis, and statin drugs. For females, testosterone replacement therapy has been shown to increase libido, emotional well-being, muscle mass, pain tolerance, and neurotransmitter production. Additionally, it aids in memory retention, keeps skin from sagging,

reduces body fat, & maintains bone density.

We look forward to talking with you and answering any questions you may have.  Call us for an appointment or schedule a telemedicine visit and start feeling better today. Invigorate Med Spa 412-248-7777.

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