A Team Approach to Care

Bioidentical Hormone Replacement Therapy (BHRT)

Bioidentical hormone replacement therapy (BHRT) is used to treat men and women who experience a reduction in hormone levels or unbalanced hormone levels. It has also been shown to treat adrenal and thyroid disorders, fibromyalgia, osteoporosis, sleep problems, depression, anxiety, and other medical conditions.

Comprehensive Urology in Los Angeles employs a team of friendly, knowledgeable hormone therapy experts who are available to teach patients about BHRT. Our team can explain how BHRT works and determine whether this type of hormone therapy can help a patient achieve his or her desired treatment results.

BHRT treatments are made in a compounding lab from plant-based sterols. In particular, bioidentical estrogen and testosterone pellets are formed into tiny cylinders the size of a grain of rice or a Tic Tac. These hormones are chemically identical to those produced by the human body, and they include testosterone, estrogen, and progesterone. 

The hormones also come in a variety of forms, such as:
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  • Creams
  • Gels
  • Injections
  • Patches
  • Pellets
  • Pills
Comprehensive Urology offers testosterone pellets only for both men and women. Our testosterone pellet treatments have been shown to deliver safe, effective results. We are also happy to teach patients about all aspects of pellet therapy and determine if an individual is a good candidate for this treatment.
WHAT YOU NEED TO KNOW

Pellet Therapy Procedure
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Both men and women may take a natural aromatase inhibitor. Comprehensive Urology prefers Myomin because it contains astragalus, an anti-aging herb. TA-65 has also been shown to increase telomeres. Or, DIM or I3C may be utilized.

Myomin helps block the aromatase enzyme. If a person blocks or reduces the production of aromatase, he or she can limit the production of estrogen in the body.

TA-65 is an all-natural, plant-based compound. It has been shown to help people maintain or rebuild telomeres, structures that protect chromosomes in the body. Telomeres diminish as people get older, and a telomere’s length indicates an individual’s overall health status. In fact, short telomeres have been linked to cellular aging and dysfunction.

DIM and I3C are compounds isolated from cruciferous vegetables such as broccoli, cabbage, and watercress. They have been shown to enhance the estrogen metabolism in both men and women. By doing so, DIM and I3C help protect people against hormone-dependent cancers, including breast, cervix, and prostate cancers.

Men may use saw palmetto, or Prostachi, to decrease conversion to DHT. Research shows saw palmetto helps the body maintain more of its testosterone and create less dihydrotestosterone, a testosterone byproduct that may stop the growth of the prostate gland. Because this therapy is more natural than many comparable options, Comprehensive Urology prefers not to use synthetic medications. The bioidentical testosterone used in pellet therapy comes from yams.

Benefits of BHRT

  • Reduced urogenital symptoms
  • Reduced insomnia
  • Reduced depression
  • Improved overall well-being
  • Improved cognition
  • Increased muscle and bone mass
  • Increased collagen
  • Increased elastin
  • Decreased hemoglobin A1C in diabetics

Additional Benefits

BHRT has also been shown to help patients address many issues related to hormone loss, including:

  • Hot flashes
  • Mood changes
  • Night Sweats
  • Weight gain
  • Sleep issues
  • Lack of interest in sex
  • Pain during sex

BHRT for Men

Finding the right bladder cancer surgeon is critical when undergoing treatment. When bladder biopsy reveals aggressive (high grade) or invasive (into bladder muscle) bladder cancer, more aggressive treatment is required. The bladder may need to be removed in order to give the best chance for cure (termed cystectomy).

In men, traditionally the bladder, prostate and surrounding lymph nodes are removed. Most urologic surgeons only perform this type of cystectomy, and the end result is often urinary incontinence and almost always impotence.

At Comprehensive Urology cancer control as well as overall quality of life of our patients is of utmost importance. Our surgeons can help determine before the surgery if you are a candidate for prostate sparing cystectomy. In certain cases, when the prostate and the nearby bladder is not involved with cancer, the prostate capsule can be spared in order to allow a continence and nerve sparing cystectomy. 

BHRT treatments often help men overcome symptoms commonly associated with male menopause. These symptoms include:

  • Lack of endurance or strength
  • Reduced sex drive
  • Depression

Meanwhile, BHRT treatments have been shown to help men in several ways, such as:
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  • Reduced risk of heart attacks, strokes, diabetes, and other medical conditions
  • Increased blood flow to the brain
  • Improved memory and intelligence
  • Improved sexual function
  • Reduced risk of prostate cancer, dementia, and Alzheimer’s disease

Improving Male Sexual Performance with
Low-Intensity Shockwave Therapy
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Low-intensity shockwave therapy is a non-invasive male enhancement procedure that leverages low-frequency sound waves to boost blood flow to the penis. It helps patients strengthen their erections, as well as increase sensitivity during sexual intercourse and bolster sexual performance.A typical LISWT procedure involves the following steps:

  • Meet with a LISWT Advisor. The Comprehensive Urology team includes LISWT advisors who are happy to teach patients about all aspects of the procedure. Our team can help a patient determine if he is a viable candidate for LISWT, along with respond to this individual’s treatment concerns and questions.
  • Arrive for a LISWT Treatment. A patient should arrive at least 30 minutes prior to a LISWT procedure. At this point, our team will apply a numbing cream before the LISWT sound wave treatment.
  • Complete the LISWT Procedure. A LISWT procedure requires between 20 and 30 minutes to complete, and a patient can return to his everyday activities following treatment.

Research indicates 75% of men achieve positive results after a LISWT procedure. Also, the procedure has been shown to deliver long-lasting male enhancement results.
Benefits of Low-Intensity Shockwave Therapy

There are many reasons why men frequently choose Low-intensity shockwave therapy for long-term male enhancement, and these reasons include:

  • Improved erections
  • Enhanced sexual performance
  • Increased sensation during sexual intercourse
  • Effective treatment for erectile dysfunction and Peyronie’s disease (causes curvature of the penis and pain during erections and sexual intercourse)
  • No drugs or surgery required
  • Performed in an office setting
  • Proven to deliver long-term results

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How does Low-Intensity Shockwave Therapy compare to other Male Enhancement Procedures?

In addition to low-intensity shockwave therapy, some of the most common male enhancement treatments include:

  • Shockwave Therapy: Uses acoustic waves to trigger the formation of blood vessels to treat erectile dysfunction. Although shockwave therapy has shown promising results in early clinical trials, it remains an experimental male enhancement treatment. As such, additional research is needed to verify if shockwave therapy can deliver long-term results to treat ED.
  • Platelet-Rich Plasma (PRP) Injections: Requires platelets from the blood to stimulate the growth of tissues in the penis. Unlike LISWT, patient success rates associated with PRP injections are below 75%.
  • Phosphodiesterase-5 Inhibitors (PDE5i): Provide a first-line medical therapy to address ED. PDE5i are found in Viagra, Cialis, and other ED medications, and success rates with these medications vary based on the patient. Furthermore, determining the right PDE5i may require extensive time and resources based on the patient and the severity of his ED symptoms.
  • TriMix: Offers an injectable medication to treat ED. TriMix consists of three drugs (Papaverine, Alprostadil/Prostaglandin, and Phentolamine) and is available as a prescription medication. Various side effects have been associated with TriMix, and these include bleeding at the injection site and painful erections.

LISWT is a male enhancement treatment unlike any other. It has minimal side effects and offers a safe option for men who are dealing with pre-existing medical conditions. Best of all, the CU team uses a comprehensive protocol during LISWT treatments to optimize safety and deliver the best possible results.

Are you a Candidate for Low-Intensity Shockwave Therapy?

Men who are dealing with ED, Peyronie’s disease, or other male enhancement issues may qualify for low-intensity shockwave therapy. For those who want to find out if they qualify for LISWT, it is important to meet with a urologist. That way, a patient can receive a comprehensive evaluation and gain the necessary insights to achieve his desired male enhancement treatment results.

At Comprehensive Urology, we strive to provide each patient with full details about LISWT. Our team teaches patients about LISWT and helps them determine if they qualify for the procedure. If a patient qualifies for LISWT, our team will provide extensive support before, during, and after treatment. Or, if a patient does not qualify for LISWT, our team will offer male enhancement treatment alternatives.

BHRT for Women

Women have testosterone, but they have less testosterone than men. As women get older, their testosterone levels decrease. This often causes women to feel less interested in sexual intercourse, develop anxiety and depression, experience fatigue and brain fog, and lose muscle mass. Like men, women may lose elasticity and collagen in their skin, too.

Testosterone pellet therapy has been shown to help women improve their energy, libido, muscle mass, and bone mass. It also has been shown to increase vaginal lubrication in women and may be used to treat many conditions in women.

These conditions include:
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  • Menopause
  • Depression
  • Anxiety
  • Low sex drive
  • Osteoporosis
  • Heart disease
  • PMS
Testosterone pellet therapy is identical for men and women, except that men get a dose that is 10 times higher than that of women. The procedure involves the insertion of pellets under the skin of the buttocks. Implantation of pellets in men generally takes longer than that for women because pellets are implanted one by one and not two or three at a time.

Why Testosterone vs Estrogen?

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Estrogen therapy has been shown to cause uterine bleeding and increase a woman’s risk of breast cancer. It has also been linked to hot flashes and other menopausal symptoms.

Comparatively, with testosterone pellet therapy, men and women can restore their testosterone to youthful levels. Comprehensive Urology has found that continuous testosterone therapy offers a proven treatment to alleviate hot flashes and other menopausal symptoms. Plus, pellet therapy does not cause uterine bleeding in postmenopausal women, breast tenderness, and other unwanted side effects commonly associated with estrogen therapy.

In one study, women who experienced menopausal symptoms were given testosterone, testosterone with estradiol (an estrogen steroid hormone), and estradiol and a placebo. The study showed testosterone in the brain, bones, vascular system, breasts, and adipose tissue was converted into estrogen. Thus, study participants who used testosterone alone were better equipped than all others to alleviate their menopausal symptoms.

Testosterone is also preferred over estrogen because excess amounts of estrogen have been shown to cause a variety of symptoms, including:

  • Anxiety
  • Breast tenderness
  • Belly Fat
  • Weight gain
  • PMS
  • Mood swings
  • Lack of emotional stability

Long-term exposure to estradiol and Premarin (conjugated estrogens tablets) has been linked to breast cancer. Furthermore, estrogen-like chemicals such as BPA in plastics and phytoestrogens in soy may be problematic. Some women and men also convert too much testosterone to estradiol. When this happens, women and may struggle to maximize the benefits of testosterone. However, an aromatase inhibitor may be prescribed to prevent this problem from occurring.

HORMONE REPLACEMENT

BHRT WOMEN – FAQ

Reasons to use Pellets instead of Creams or Injectables

Implants have been used since the 1930s, and various studies support the use of testosterone implants in both men and women.

Pellets have been shown to provide consistent, healthy levels of hormones within three to four months of treatment in women and four to five months of treatment in men. They also help patients reduce the risk of blood clots, and ultimately, play key roles in health and disease prevention.

Recent studies show pellets help patients address menopausal symptoms, insomnia, sexual dysfunction, and other health problems better than traditional hormone replacement therapy via creams and injectables. Additionally, testosterone delivered via pellet helps patients treat migraines and menstrual headaches, as well as relieve vaginal dryness, incontinence, and other urinary issues.

Testosterone pellets help patients boost their energy levels, alleviate depression, and improve memory and concentration, too. They frequently enable patients to simultaneously increase their muscle strength and bone density and lower their fat mass, as well as reduce their risk of chronic illnesses like Alzheimer’s and Parkinson’s disease.

Moreover, testosterone pellets are implanted under the skin, which limits the risk of cross-contamination of spouses, children, and pets. They often prove to be more convenient and deliver long-lasting results in comparison to creams or gels as well.

Traditional Hormone Replacement Therapy(HRT) VS. Bioidentical Hormone Replacement Therapy(BHRT)

HRT helps women relieve menopause and perimenopause symptoms. It has been shown to help women reduce the incidence of hot flashes and lower their risk of osteoporosis. HRT may also be used in male hormonal therapy and treatment for individuals who undergo a sex change.

Some studies have suggested HRT helps women improve muscle function, reduce the risk of heart failure and heart attack, and prevent skin aging. Comparatively, other research indicates HRT may actually cause breast cancer in women.

Certain types of HRT contain both progesterone and estrogen. Other types of HRT contain only estrogen, and some contain testosterone.

BHRT is intended for women who had a hysterectomy, are experiencing menopause, or do not want to use synthetic hormones. Or, BHRT may be administered to men who are dealing with hypogonadism (a condition that limits the functional activity of the gonads), low testosterone, low muscle mass, or fatigue.

Before a patient receives HRT or BHRT, it is important to consult with a hormone therapy expert. That way, a patient can evaluate both hormone replacement therapy options and make an informed treatment decision.

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