What is hormone replacement therapy?

Invigorate Asheville offers personalized hormone replacement therapy (HRT) to improve your health and well-being. It’s normal to experience a decline in hormone levels as we age and some experience abnormal changes due to stress, genetics, environment and illness. Regulating hormone levels can have profound effects on physical, mental and overall wellbeing and quality of life.

Some circumstances for hormonal changes may be inevitable, but living with symptoms from it are not. Hormone replacement therapy not only improves symptoms and dysfunction, but  has been shown to decrease the likelihood of certain age-related  disease and all-cause mortality when implemented with correct timing. 

What are the signs that you need hormone replacement therapy?

Symptoms related to menopausal and post menopausal hormone loss in in women include hot flashes, night sweats, brain fog, and vaginal dryness, mood issues, sleep issues, and bone loss. Symptoms of low testosterone in men include decreased libido, erectile dysfunction, depression, anemia, loss of muscle or bone mass, loss of body hair, and fatigue. Both males and female report a decreased sense of well-being. 

If you are dealing with symptoms of a hormonal imbalance, there is help. Schedule a free 15 minute exploratory call to see if hormone replacement therapy is right for you. If you are a candidate for hormone replacement therapy, a consult will be scheduled, where Dr. Dula will complete a comprehensive exam, history, and necessary labs to guide your personalized treatment

Bioidentical Hormone Therapy - Menopausal and Post Menopausal Women

As we enter into menopause there is a reduction of female hormones (mostly estrogen and progesterone) that can create a number of uncomfortable symptoms in addition to increasing the risk of osteoporosis, cardiovascular disease, and other age-related illness. BHRT increases hormone levels to a more optimal state by using hormones identical to what your body produces. They are plant-derived and customizable to the particular patient. Hormone replacement therapy is an FDA-approved first line defense to help combat symptoms and risks of low hormone related illness. Hormone therapy after menopause showed a “decrease in all-cause mortality when HT was started under age 60 or less than 10 years after the final menstrual period”

  • Reduction in menopausal related symptoms: night sweats, hot flashes, irritability, mood and sleep disturbances, vaginal dryness and painful intercourse.
  • Ease overactive bladder: vaginal estrogen may reduce frequency issues and potentially reduce recurring UTI’s
  • Bone Health: BHRT can reduce the risk of osteoporosis and fractures related to bone density. It can be an alternative for women who can’t tolerate other bone density medications
  • Reduces your risk for cardiovascular disease: Studies consistently supported a 35% to 50% lower risk of coronary heart disease (CHD) with postmenopausal HT in primary prevention. Studies have shown HRT to have favorable effects on cholesterol, blood vessel functioning and oxidative status.
  • Reducing diabetes risk: BHRT can reduce insulin sensitivity which reduces the risk of type 2 diabetes.
  • Skin Health: estrogen has shown to increase thickness of skin and collagen content of skin.
  • BHRT can improve overall quality of life by reducing physical discomfort, stabilizing emotion and mood and provide healthy aging by reducing age-related illness potential.

Testosterone Therapy

Testosterone deficiency (TD) is a medical condition that negatively impacts overall  health, sexual function, and quality of life. Studies have observed that once men reach the third decade of life total serum testosterone levels begin to decline. This can be complicated by genetics, environment, lifestyle, and health. Normalizing testosterone levels in men who experience low testosterone have shown to have a broad range of benefits affecting physical and emotional wellbeing, which can lead to more satisfaction and longer, better quality of life.

  • Mood and mental health: may decrease anxiety, depression, fatigue and stabilize mood, energy and alertness caused by low testosterone levels
  • Musculoskeletal: Testosterone can increase muscle growth and keep bones from decreasing in density, which reduces risk of osteoporosis and fractures.
  • Sexual function: HRT may increase libido, sexual function and performance
  • Cardiovascular health: HRT has shown to improve myocardial ischemia, improve exercise capacity, decrease risk of congestive heart failure and coronary artery disease
  • Metabolic health: Normal levels of testosterone improves serum glucose levels and insulin resistance in men with diabetes and prediabetes. May help to reduce visceral fat and improve body composition 
References and Research:

Leslee J Shaw, C Noel Bairey Merz, Steven E Reis, et.al. Post-menopausal Hormone Therapy and Cardiovascular Disease – Lessons from the Women’s Health Initiative. US Cardiology Review, https://www.uscjournal.com/articles/post-menopausal-hormone-therapy-and-cardiovascular-disease-lessons-womens-health?language_content_entity=en#ArticleInfoTab\

Emily S. Lau, MD, MPH. (2025). Menopause, Heart Disease, and Benefits of Hormone. Mass General Brigham Newsroom, https://www.massgeneralbrigham.org/en/about/newsroom/articles/menopause-heart-disease-hormone-therapy

Allison Aubrey. (2024). Hormones for menopause are safe, study finds. Here’s what changed. NPR – All Things Considered, https://www.npr.org/sections/health shots/2024/05/01/1248525256/hormones-menopause-hormOne-therapy-hot-flashes

JoAnn E. Manson, MD, DrPH1, Carolyn J. Crandall, MD, MS2, Jacques E. Rossouw, MD,  et al, (2024). The Women’s Health Initiative Randomized Trials and Clinical Practice: A Review, JAMA, https://jamanetwork.com/journals/jama/article-abstract/2818206?resultClick=24

Mayo Staff, Testosterone Therapy: Potential Benefits and Risks as You Age, Mayo – Healthy Lifestyle: Sexual Health, https://www.mayoclinic.org/healthy-lifestyle/sexual-health/in-depth/testosterone-therapy/art-20045728

Paul J Rizk, Taylor P Kohn, Alexander W Pastuszak, et. al. (2018). Testosterone Therapy Improves Erectile Function and Libido in Hypogonadal Men. Original article: Curr Opin Urol. 2017 Nov;27(6):511–515: Resourced from NIH: PMCID: PMC5649360 NIHMSID: NIHMS910261 PMID: 28816715, https://pmc.ncbi.nlm.nih.gov/articles/PMC5649360/

Meara With. (2023). What to Know About Hormone Replacement Therapy for Males, Medical News Today, https://www.medicalnewstoday.com/articles/hrt-for-men

Travis Goodale 1, Archana Sadhu 1, Steven Petak, et. al. Testosterone and The Heart.  Originally Published in Methodist Debakey Cardiovasc J. 2017 Apr-Jun;13(2):68–72. Resourced from NIH PMCID: PMC5512682  PMID: 28740585, https://pmc.ncbi.nlm.nih.gov/articles/PMC5512682/

Ready to get treatment? Contact us to book an appointment today!

IV therapies can be booked and administered same day, while more intensive treatments require a pre-screening consult with Dr. Dula to determine the best course of treatment for your body’s specific needs.
Not sure what to do next? Give us a call at 828-237-1511, or email us at wellness@invigorateasheville.com and we’ll get you taken care of!