Functional Medicine

Get to the root cause of medical problems

Bio-Identical Hormones

Many women consider hormone replacement therapy as an option in treating the symptoms of menopause, which can include hot flashes, vaginal dryness, and mood swings. Hormone replacement therapy can also lower the risk of brittle bones and heart disease.

However, there are concerns about the long-term use of traditional hormone therapy. These include increased risk of breast cancer, blood clots, stroke and even heart disease. As a result, alternative methods, such as bioidentical hormone therapy, have been developed.

Dr. Jamie Walraven and the medical professionals at Ageless Wellness Center in Peachtree City have become experts at using bioidentical hormone therapy to treat a variety of symptoms.


Bioidentical hormones are manufactured in a lab yet molecularly identical to those produced in your body, as opposed to synthetic hormones which are not exactly identical, Walraven explains. The advantages of bioidentical hormone therapy are the same as if the patient had maintained hormones at optimal status their entire life, as opposed to going through the problems one experiences through menopause or andropause.

“When talking about hormone replacement, the goal is to restore hormones ideally to optimal levels like they were when you were in your 20s and 30s, when hormones were balanced.”


As women approach menopause, they start making less progesterone. After menopause, they make less estrogen and this also coincides with making less testosterone. The loss of the natural formation of these hormones cannot be understated, Walraven says.

“Estrogen has over 400 functions in the body. Just about every cell in the body has a receptor for estrogen,” she says. “It is the hormone that makes women women. It is what makes women round and soft, and also supports our cardiovascular system and bones. Progesterone balances out estrogen. It is an anti-diuretic and also plays a role in mood stabilization, so it’s like the natural Prozac for women. When women start making less progesterone, they may experience worsening PMS symptoms, heavier periods, ovarian cysts, fibrocystic breasts, mood instability, weight gain, anxiety as well as start having problems sleeping.”

When a woman goes through menopause she starts experiencing symptoms of estrogen deficiency. “Everything dries out — your skin, your vagina. You may also experience some hot flashes initially and some brain fog,” Walraven explains.

Most women also see reduction in testosterone, which is responsible for libido, lean body mass, energy, sleep and a general sense of well being. Estrogen, progesterone and testosterone all three play a part in maintaining strong bones.


How hormones are administered is important. When taken orally, both estrogen and testosterone are metabolized through the liver, which requires higher doses and increases the risk of stroke or blood clots. That’s not the case with transdermal applications such as patches and creams, or pellet therapy in which small implants about the size of a grain of rice are painlessly inserted under the skin, releasing hormones directly into the bloodstream over a period of months.

To determine the best course of treatment, a patient is typically given a saliva test first to measure hormone levels and adrenal function, Walraven says.”You take it home and spit in a little tube four times during the day about a week before your menstrual cycle and send that off.” Once the results come back, the patient returns for a follow-up visit to review them with her provider and create a treatment plan together.

Walraven recalls one client named Sally, who is 42 years old and has been having heavier periods that are now irregular. “She’s been experiencing headaches before her menstrual cycle. What used to be a few days of moodiness and irritability before her cycle started is now about a week,” Walraven says. “She’s also experiencing anxiety and can’t sleep.”

Depending on how bad a patient’s adrenals are, and whether her progesterone is low, Walraven says she would typically start someone like Sally on progesterone treatments.

“Typically that person would also, especially if they are complaining of fatigue, low energy and weight gain, have some adrenal issues, which we would address through lifestyle modification like decreasing stress,” Walraven says. “We’d also support the adrenals through adaptogenic herbal formulas. And we may add something called DHEA which is another precursor hormone for cortisols as well as pregnenolone. It may take a period of time before the adrenals are better, but people usually start feeling better within the first couple of weeks or so.”

If there’s no reason to look at Sally further from a functional medicine standpoint, she’d typically return to Ageless Wellness for a reassessment in about three months. “We may spend a couple of months tweaking everything until she feels optimal, and then it’s important to do another saliva test once a year just to make sure where you are is OK.”