Even FDA-approved hormones have received bad press, and many people avoid prescribing things that are controversial.
A little history: Hormones fell out of favor after the Women’s Health Initiative (WHI) study was published in 2002. The media sensationalized the results, and suddenly everyone was afraid of hormones — even bioidentical ones. To me, they were never gone. I kept using them when appropriate because I knew the difference between synthetic and bioidentical, and I understood the flaws in how the WHI data was applied.
While other doctors stopped prescribing and women suffered, I picked up other skills. Herbs. Aromatherapy. Holistic nutrition. Naturopathic medicine. Functional lab testing. I became a better, more complete physician because I couldn’t just rely on one tool.
Now, hormones are coming back into favor. The research has caught up. But I never left. And I meet you where you are — whether that means hormones, herbs, lifestyle changes, or all of the above.
Bioidentical hormones are not included in our core medical training, so we must seek education on our own. Traditional doctors do not usually have the time or the resources to seek expertise in bioidentical hormones. I underwent extensive training in bioidentical hormone therapy and have specialized knowledge of anti-aging, functional, and regenerative medicine. I also earn continuing medical education in the area of Age Management and Functional Medicine.
Q. What is your preferred method of administering bioidentical hormone therapy?
A. This is where the art of hormone optimization comes in. It’s the job of the clinician and the pharmacist to find a method of hormone administration that works for that particular patient. I use a variety of approaches:
- Patches — Easy to use, steady absorption, good for maintenance dosing.
- Compounded creams — Customizable strength, applied to skin, good for those who prefer topical.
- Injections – Predictable absorption, precise dosing, good for those who need higher levels or have absorption issues.
- Troches – Dissolve in the cheek or under the tongue, bypass the liver partially, convenient and portable.
- Sublingual drops – Similar to troches but in liquid form, fast absorption, easy to adjust dosing.
- Pellets – Implanted under the skin every 3-6 months, steady release, no daily dosing, very convenient for the right patient.
I also utilize The Wiley Protocol — a specific method of bioidentical hormone replacement that mimics the natural cyclical pattern of a young menstrual cycle using twice-daily topical creams. It is designed for women in perimenopause, menopause, or surgically induced menopause who want to restore youthful hormone patterns rather than just “replacing” to a static level.
I utilize all of these approaches — including the Wiley Protocol where appropriate — to obtain reproductive blood serum levels for optimum hormone restoration. There is no one-size-fits-all. We find what works for you.
I utilize all of these approaches to obtain reproductive blood serum levels for optimum hormone restoration. There is no one-size-fits-all. We find what works for you.
Q. How often are follow-up appointments?
A. Follow-up appointments are generally within 3-6 months, and at a minimum of every 6-12 months, depending on the complexity of each patient’s situation. Testosterone is a controlled substance in the state of Texas, and patients MUST be seen in the office every 6 months to continue receiving prescriptions. Initial appointments are 1 hour; follow-ups are 30-45 minutes, with rare exceptions determined by Dr. Comeaux. Follow-up phone appointments (for those with a long commute) are charged the same rate as in-person appointments.
Resources
If you need help detailing your symptoms, consult one of the questionnaires below for guidance.
For Women
Metagenics Women’s Health Questionnaire
Sexual Function section
Tamyra Comeaux, MD 