FAQ

Frequently asked questions

My doctor said my hormone levels are normal, but I still look and feel terrible. Why?

Normal is not optimal. They were right when they said your hormone levels are normal because they were based on your current age. To allow recovery of your youth, your hormone levels need to be enhanced to therapy after the replacement optimal levels with Bio-Identical Hormone Replacement Therapy (BHRT).

Is BHRT safe?

Bio-Identical Hormone Replacement Therapy (BHRT) is exclusively prepared by ASL Pharma Compounding Pharmacy, a PCCA (Professional Compounding Chemical Association)–certified facility. Only the finest imported, plant-based raw materials are used, and all formulations are prepared in a controlled environment using proprietary technology that adheres to the highest standards of safety, quality, and efficacy.

Is Bio-Identical Hormone Replacement Therapy expensive?

While Bio-Identical Hormone Replacement Therapy (BHRT) may be comparatively more expensive than standard supplements, it is cost-effective in the long term due to its effectiveness and faster results. The pricing reflects the professional medical consultation, personalised treatment planning, and customised formulations involved. By supporting immune health and offering better protection against life-threatening diseases, BHRT delivers significant value that cannot be measured by cost alone.

How does Bio-Identical Hormone Replacement Therapy work?

Bio-Identical Hormone Replacement Therapy (BHRT) is available only by medical prescription. Treatment begins with a simple blood test to assess your hormone levels. Based on these results, your doctor will prescribe a personalised BHRT regimen, with specific dosages tailored to your individual needs. The formulation is then prepared by a licensed compounding pharmacy in accordance with the prescribed treatment plan.

Can I stop my BHRT supplements when my hormone levels are in optimal level?

Generally, discontinuation is not recommended, as hormone levels may decline once supplementation is stopped due to the body’s natural reduction in hormone production with age. For this reason, BHRT is typically recommended as a long-term, often lifelong, therapeutic intervention, subject to regular medical review and monitoring.

Is BHRT covered by insurance?

Insurance coverage varies depending on the provider and individual policy. Patients are advised to check directly with their insurance company regarding coverage for consultations, laboratory testing, and prescribed medications.

Is BHRT suitable for men?

Yes. Men experiencing symptoms of andropause—such as low energy, reduced muscle mass, increased body fat, low libido, or mood changes—may benefit from Bio-Identical Hormone Replacement Therapy (BHRT) when clinically indicated and medically supervised.

How are hormone levels assessed before treatment?

Hormone levels are assessed exclusively through blood tests. For menstruating women, testing is performed at specific times in the menstrual cycle, (Days 14–16 or Days 20–22) to ensure accurate interpretation. Test results are reviewed in conjunction with reported symptoms, medical history, and lifestyle factors to guide appropriate treatment planning.

What are hormones and why do I need them?

Hormones are an essential part of the metabolic process of living. Hormones are important for the cells, organs, and metabolism. Our hormones decline through aging, menopause, disease or trauma. When this happens, we begin an accelerated aging process. Loss of hormones is one of the major reasons for our deterioration as we get older, both physically and mentally. Hormones are beneficial at any age, but the best long term protective benefits are achieved if hormones are replaced when you begin to lose them, usually in our 40’s.

What are the typical hormones that are prescribed?

Synthetic estrogen (ie: Premarin) and progestins (ie: Provera) are produced in a laboratory. They are chemically altered so that they can be patented by the pharmaceutical companies. They are not identical to human hormones. They are designed to try to elicit the same responses in your body as your natural hormones. Because synthetic hormones are not identical to human hormones, they might adversely stimulate the cells and lead to side effects or cancer. Premarin is an estrogen obtained from pregnant horses and is not human identical. Provera is a progestin. Both have been implicated in causing problems in some women, including breast cancer.

How are bio-identical estrogen and progesterone produced?

Hormones that are identical to human hormones are found in yams and soy. We call these “natural” because they are natural to the body. The hormones are extracted from these vegetables and then processed by a specialty compounding pharmacy into a prescription dose and form. The body accepts and metabolizes these hormones as if it made them.

What are the problems with synthetic hormones?

When first developed, synthetic hormones were well received because they provided some of the benefits of hormone replacement: controlling the symptoms of menopause and fighting osteoporosis and heart disease. However, the long-term results have shown that synthetic hormones sometimes elicit a negative metabolic response. Some women can’t tolerate synthetic hormones – often suffering with side effects such as bloating, bleeding or mood swings. In some patients, synthetic estrogens and progestins contributed to the development of breast and uterine cancer.
Synthetic hormones are not a perfect match in the body. Synthetic hormones produce abnormal metabolites that can cause side effects and increase the risk of cancer. A natural hormone is a perfect fit in the body – it is a biologically identical hormone replacement.

Why doesn’t my gynecologist prescribe bio-identical hormones?

Natural supplements such as vitamins and hormones are protected by federal regulation and may not be patented. Major pharmaceutical manufacturers are interested only in patentable drugs that are exclusive and profitable. A lot of what physicians learn is from the drug companies who are promoting their products. Therefore, your doctors are primarily taught only about synthetic products. Bio-identical hormones do not come under specific brand names. Your physician must be self-educated and experienced in prescribing and monitoring natural hormones. They probably just don’t know a lot about them or must prescribe within the constraints of your health insurance.

What is the truth about the recent publicity about the risks of taking hormones?

The Womens’ Health Initiative (WHI) is a study that focused on synthetic estrogen (Premarin) and progestin (Provera). NOTE: Progestin is not progesterone. There were different “arms” of the study using different drug combinations. The arm of the study using Premarin and Provera (PremPro) was discontinued before completion because an increased risk of breast cancer was detected in the early stages of the study. This risk is attributed to the Provera portion of the regimen. This is not the first time progestins have been implicated in increasing risks for women. The arm of the study using Premarin did not show an increased risk of breast cancer, but was discontinued because of an increased incidence of strokes in older women. A recent study showed that natural estrogen did not have the same effects. Unfortunately, the media has misrepresented the facts of this study by targeting all hormone therapy.

THIS IS WRONG! Again, the culprits are synthetic progestin, Provera, and horse estrogen (equilinin) not natural estrogen or natural progesterone. There are numerous studies showing the long term benefits of hormone therapy. You just need to make sure you are receiving the right hormones (bio-identical) in the right balance. It is also important to begin hormone replacement as soon as you begin to lose the hormones to avoid any length of time without their protective benefits.

What are Bio-Identical Hormones and are there different types?

Synthetic Hormones are chemically modified versions of naturally occurring human hormones. Due to structural differences, they may not be fully compatible with the body and have been associated with a higher incidence of adverse side effects in some individuals.

Bio-identical hormones, on the other hand, are derived from plant sources and are structurally identical to the hormones naturally produced by the human body.

When appropriately prescribed and medically supervised, Bio-Identical Hormones have been widely used in Western countries for over 50 years and, according to current evidence, have not demonstrated the same risk profile as certain synthetic hormone therapies.

How do I get started with BHRT

1. Schedule a blood test
Visit our website to book your blood test conveniently through Google Calendar. drsharanclinic.my

2. Consultation with Dr. Sharan

Once your results are available, you will meet with Dr. Sharan to review your symptoms, medical history, and available treatment options.

3. Personalised BHRT prescription

Based on your blood test results, Dr. Sharan will create a personalised BHRT plan. The prescription is sent to ASL Pharma Compounding Pharmacy for verification and preparation.

4. Follow-up appointment
After completing the initial 3-month BHRT course, a follow-up consultation with Dr. Sharan is scheduled to review your progress and adjust your treatment plan as needed.

Can I lose weight with BHRT supplements?

Yes, we provide personalised lifestyle guidance alongside your BHRT treatment to support optimal health outcomes.

What are the long term benefit of BHRT?

When properly prescribed and monitored, Bio-Identical Hormone Replacement Therapy (BHRT) supports healthy ageing and disease prevention—not just symptom relief.

Key long-term benefits include:

~ Heart health:
Supports healthy blood vessels and lipid balance

~ Bone strength:
Helps prevent bone loss and osteoporosis

~ Brain function:
Improves memory, focus, and mood stability

~ Metabolic health:
Supports weight control and insulin sensitivity

~ Muscle strength:
Preserves lean muscle and physical function

~ Sexual & urogenital health:
Improves libido and tissue health

~Sleep & emotional wellbeing:
Better sleep, reduced anxiety and irritability

Bottom line: BHRT helps patients age with strength, clarity, and vitality when individualised and regularly monitored.

Can BHRT help me with Menopause/andropause symptoms?

Yes, BHRT can help alleviate your symptoms and improve your overall quality of life.

How often will I need follow-up appointments?

Follow-up appointments are usually scheduled every 8–12 weeks initially. Once hormone levels are stable, appointments can be spaced every 3–6 months. After long-term stability is achieved, yearly follow-ups are recommended to ensure safety, effectiveness, and optimal dosing.

Who is suitable for BHRT?

BHRT may be suitable for women and men experiencing symptoms related to hormonal imbalance, including:

1. Premenopause, perimenopause, menopause, or postmenopause
2. PCOS (Polycystic Ovary Syndrome)
3. Andropause (male hormone decline)
4. Fatigue, poor sleep, or brain fog
5. Weight gain or difficulty losing weight
6. Mood changes, anxiety, or low motivation
7. Low libido or sexual dysfunction
8. Hot flashes or night sweats
9. Hair thinning or changes in skin

Suitability is determined following a comprehensive medical consultation and hormone assessment.

What are the signs of low Progesterone and what are the health benefits?

Progesterone is responsible for balancing estrogen and the female reproductive cycle. Deficiency results in symptoms of PMS, bloating, headaches, cramping, mood swings, breast tenderness, and irritability. A deficiency in progesterone can be a factor in frequent miscarriages.

Research shows that natural progesterone stimulates bone building osteoblasts, thus providing protection against osteoporosis. Progesterone reduces the mitotic change in breast and uterine tissue, thereby protecting against cancer (Provera does the opposite). Progesterone protects against heart disease. Progesterone is necessary for adequate sexual response, lubrication and vaginal vasodilation. Progesterone is responsible for the physiologic equilibrium with estrogen. At menopause, women lose both estrogen and progesterone and both should be replaced. Progesterone replacement is important, even if you have had a hysterectomy because it does much more than just protect the uterus.

What if I have been taking synthetic hormones?

You need hormones, but you need the right kind, the natural bio-identical hormones, in the right balance. Don’t tolerate the risks of the synthetic hormones when a safe alternative is available. Find a physician who will prescribe natural hormones and then make the switch.

Should I take estrogen and progesterone or not?

The risks of not taking hormone replacement therapy include elevated cholesterol, heart disease, strokes, osteoporosis, tooth loss, depression, Alzheimer’s Disease, and menopausal symptoms. The side effects of the synthetic hormones such as bleeding, swelling, weight gain and breast cancer can be almost eliminated by using the natural estrogen and progesterone. Overall health and well-being are improved, long term survival is greatly improved and the quality of life greatly enhanced. The risks of not taking hormones are tremendous. Just don’t take the synthetic hormones.

What about over-the-counter creams and saliva tests?

Products purchased over-the-counter are not usually of a strength sufficient to produce a long term therapeutic difference. A sufficient dose requires a prescription. Over-the-counter products might give you some symptomatic relief, but it is necessary to maintain certain hormone levels to achieve the long term protective benefits.

Because hormones are delivered to the organs by the blood and not saliva, we rely on blood tests to determine accurate and optimal levels. Blood and saliva tests do not correlate. Saliva testing has consistently been shown to be inaccurate in medical studies.

How does one know whether they are receiving adequate amounts of replacement hormones?

Blood tests determine deficiencies. Blood tests also determine whether adequate replacement has been prescribed. All people will absorb, assimilate, and respond to hormones differently than others. If the proper level (and therefore tissue level) is not achieved, then the full benefit of hormone replacement is not realized. We want hormone levels to be optimal and protective.

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