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Why I Prescribe Bio-Identical Hormones

By: Dr. James D. Fontaine


Why Do I Prescribe Bio-Identical Hormones?

The simple answer is that they work. Bio-identical hormones improve multiple aspects of your health. I have been a physician for 28 years now and I have seen lots of changes in medicine. New drugs have been invented and new surgical procedures have been developed, but in all the years that I have practiced medicine, I have not seen anything that works as well as hormone optimization combined with good nutrition to help with weight control, prevention of muscle loss, injury recovery, prevention of cardiovascular disease, prevention of dementia, decreased risk of cancer and improved sense of well-being.

Why Hasn't Mainstream Medicine Adopted Bio-Identical Hormones?

You might wonder why bio-identical hormone therapy is not mainstream medicine if they are so effective. Unfortunately, the main reason is that there is no money in it for the pharmaceutical companies that have an enormous amount of influence over the practice of medicine in this country. Since bio-identical hormones are present in nature, they can’t be patented and thus there is no money to be made by the pharmaceutical companies. In addition, the practice of medicine has become less personal and more rushed over the years. In the typical medical practice in the United States, patients come to the physician with a complaint and the physician prescribes a medication to address the complaint rather than looking at the underlying cause of the problem. For example, if a patient has adult-onset diabetes, they are put on medications and may get a brief discussion on the need to diet and exercise. However, patients are not typically given a specific plan on how to incorporate proper nutrition and exercise into their diet. There is a lack of appropriate coaching. Furthermore, there is not a thorough discussion as to why the patient developed diabetes and that it is a preventable disease. At FontaineMD, we include several visits focusing on nutrition as part of our treatment plan. This allows the patient to have a much better understanding of why certain foods are good and why some are unhealthy. Once they are informed, patients know how they can help themselves achieve optimal health. The nutrition plan is not a calorie-counting diet, but rather simply eating healthy foods.

Why Doesn't Medical Insurance Cover Treatment?

To optimize one’s health with bio-identical hormones, you need to get to know the patient very well. This involves a detailed medical and lifestyle history and monitoring over time. Bio-identical hormone optimization treatment requires quite a bit of physician time, more than what is typically available in conventional medical practice. Thus, most bio-identical hormone practices use a concierge model outside of the medical insurance model. In a concierge practice, the physician has substantially more time with the patient and does not need to follow insurance guidelines that are focused on cost containment. In our practice, we want to optimize your hormone levels, nutrition, and exercise, not just get you to “normal” or “average”. We treat you based on symptoms combined with lab values, not just lab values.

Are Bio-Identical Hormones Safe?

There are multiple research articles published over the last 50 years that document that bio-identical hormones are safe and improve health. There is only one major medical study, the Women’s Health Initiative (WHI) back in 2002 that indicated that estrogen was not safe. The WHI used Premarin, which is made from horse urine and contains many harmful estrogens not found in humans. However, if that study is analyzed carefully, even that study demonstrated that estrogen is protective against heart disease after the first year and protective against breast cancer. There was only harm if the estrogen (Premarin) was combined with Provera which is a synthetic progestin. None of the negative outcomes in that study are present if a physician prescribes estradiol (a bio-identical form of estrogen) and progesterone (bio-identical progesterone). With regards to testosterone, there are multiple studies that have concluded that testosterone does not increase the risk of prostate cancer and that testosterone therapy is protective against heart disease.


Bio-identical hormones are safe and effective. The positive effects are magnified if the patient is willing to work on their nutrition and exercise. It has been said that our hormones don’t decline because we age, but rather we age because our hormones decline. We are the healthiest when we are younger and have optimal hormone levels. So, why not replace the declining hormones and optimize your health? With the amount of medical research documenting safety and efficacy, there are only good reasons to get a consultation and start your journey to optimal health.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.