Ongoing Care Programs
FDA-Approved · Compounded · Personalized

Bioidentical
Hormone Therapy Estradiol, progesterone, and testosterone — prescribed to match your biology, not a generic protocol.

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3 Hormones
Estradiol · Progesterone · Testosterone
FDA & Compounded
Both Formulations Prescribed
Lab-Guided
Testing Before & During Therapy
Treatment
Bioidentical Hormone Therapy
Hormones
Estradiol · Progesterone · Testosterone
Formulations
FDA-Approved · Compounded
Indications
Menopause · Perimenopause · Deficiency
Coverage
Most Major Insurances
Ongoing Care Programs

Bioidentical Hormone Therapy — What It Is, Who It Helps, and How Dr. Andrei Prescribes It

Bioidentical hormones are hormones that are chemically identical in structure to the hormones produced naturally by your body. Estradiol, progesterone, and testosterone — the three hormones most commonly used in women’s hormone therapy — are all available in bioidentical form, and all three are prescribed by Dr. Andrei when clinically indicated.

The term “bioidentical” describes the molecular structure of the hormone — not how it was manufactured or whether it was compounded. FDA-approved bioidentical hormone products include estradiol patches, gels, sprays, and creams, as well as micronized progesterone (Prometrium). Compounded bioidentical hormones are custom-mixed formulations prepared by a compounding pharmacy to a specific dose or delivery form not available commercially. Dr. Andrei prescribes both, based on what is clinically appropriate for each patient.

This page explains the indications for bioidentical hormone therapy at Lapeer Women’s Health — who is a good candidate, what the evaluation involves, which hormones are used and in what forms, and how ongoing monitoring works. For information on the Hormone Therapy Management program specifically, see Hormone Therapy Management Visits.

Clinical Indications

Who Bioidentical Hormone Therapy Is Appropriate For

Bioidentical hormone therapy is not one-size-fits-all. These are the clinical scenarios in which Dr. Andrei considers it — based on symptoms, lab values, and the individual patient’s health history and goals.

Menopause — vasomotor symptoms

Hot flashes, night sweats, sleep disruption, and mood changes driven by declining estrogen and progesterone at menopause. Bioidentical estradiol is the most effective treatment for vasomotor symptoms and is first-line therapy in appropriate candidates.

Perimenopause — hormonal fluctuation

Irregular cycles, worsening PMS, sleep changes, mood instability, and breast tenderness in the years before menopause. Targeted hormone support during perimenopause stabilizes the transition and protects bone and cardiovascular health before levels decline further.

Surgical menopause

Women who have had both ovaries removed experience an abrupt drop in estrogen and testosterone. Hormone replacement following bilateral oophorectomy is particularly important — both for symptom control and for long-term protection of bone density, cardiovascular function, and cognitive health.

Genitourinary syndrome of menopause

Vaginal dryness, painful intercourse, urinary urgency, and recurrent UTIs caused by declining estrogen’s effect on the vaginal and urethral tissues. Local vaginal estrogen — a bioidentical formulation — is highly effective and carries minimal systemic absorption.

Low testosterone in women

Testosterone declines significantly after menopause and after oophorectomy. Low libido, fatigue, reduced energy, and difficulty with motivation and concentration are among the symptoms that respond to testosterone supplementation. Dr. Andrei uses compounded testosterone cream or pellets when clinical evaluation supports it.

Premature ovarian insufficiency

Women under 40 whose ovaries have stopped functioning normally require hormone replacement to protect bone density, cardiovascular health, and cognitive function — not just for symptom relief. Bioidentical hormone therapy in this population is standard of care, not optional.

Formulations

FDA-Approved and Compounded — Both Prescribed by Dr. Andrei

Dr. Andrei prescribes both FDA-approved bioidentical hormone products and compounded formulations. The choice depends on the specific hormone needed, the required dose, the appropriate delivery route, and the patient’s clinical picture.

  • Estradiol patches — transdermal delivery, steady absorption, lowest clotting risk; available in multiple strengths
  • Estradiol gel or spray — transdermal; dose flexibility; applied daily to skin
  • Micronized progesterone (Prometrium) — FDA-approved oral bioidentical progesterone; used for uterine protection and sleep support
  • Vaginal estradiol cream or ring — local bioidentical estrogen for genitourinary symptoms; minimal systemic absorption
  • Compounded progesterone cream — used when oral or standard formulations are not tolerated
  • Compounded testosterone cream — for women with documented low testosterone and appropriate clinical indications

“I prescribe bioidentical hormones because the evidence supports them — not because the term is trendy. The goal is always the right hormone, in the right form, at the right dose, monitored carefully over time. That applies whether the formulation is FDA-approved or compounded.”

— Dr. Ramona D. Andrei · MD, PhD, FACOG
  • FDA-approved bioidentical products have established safety data and standardized dosing — first-line when available
  • Compounded formulations are used when a standard product does not exist at the needed dose or delivery form
  • Compounded products are not subject to FDA manufacturing oversight — Dr. Andrei discusses this honestly with every patient
  • Pellet therapy is available as a compounded option — Dr. Andrei reviews the evidence and tradeoffs before recommending it
  • All hormone prescriptions are based on lab testing, symptom assessment, and individual health history — not a generic protocol
Before Your Visit

Questions About Bioidentical Hormone Therapy

Bioidentical hormones are not automatically safer than other hormone formulations. Safety depends on the type of hormone, the delivery route, the dose, the patient’s health history, and how carefully the therapy is monitored — not simply on whether the hormone is “bioidentical.” FDA-approved bioidentical estradiol patches and micronized progesterone have a strong safety profile supported by decades of data. Compounded formulations have less regulatory oversight and variable quality control. Dr. Andrei discusses the specific risk-benefit profile for each patient individually.
No. Women who have had a hysterectomy take estrogen alone — progesterone is not needed because there is no uterine lining to protect. Women with an intact uterus take both estrogen and progesterone, because estrogen alone increases the risk of endometrial hyperplasia. The specific regimen is determined by surgical history and individual clinical factors.
Yes. Dr. Andrei prescribes compounded testosterone for women when clinical evaluation — including lab testing and symptom assessment — supports it. The most common indications are low libido, reduced energy, and mood and concentration symptoms in the context of documented testosterone deficiency. Testosterone therapy in women is used at much lower doses than in men. Dr. Andrei monitors levels and symptoms at regular intervals and adjusts the dose accordingly.
Before initiating hormone therapy, Dr. Andrei orders a baseline hormone panel that typically includes estradiol, progesterone (if luteal phase assessment is relevant), total and free testosterone, FSH, and LH. Thyroid function is assessed when relevant. A lipid panel and metabolic labs may be included depending on cardiovascular risk factors. Results are reviewed in the context of symptoms — lab values alone do not drive prescribing decisions.
After initiating hormone therapy, Dr. Andrei typically sees patients for a follow-up visit at 6–12 weeks to assess symptom response, check labs, and adjust dosing if needed. Once the regimen is stable, annual visits with periodic lab monitoring are standard. Patients on testosterone therapy are monitored more frequently at initiation. Monitoring frequency is individualized based on the regimen and the patient’s response.
FDA-approved bioidentical hormone products — estradiol patches, gels, vaginal preparations, and micronized progesterone — are typically covered by insurance as standard prescription medications, subject to your plan’s formulary and copay structure. Compounded hormone formulations are usually not covered by insurance and are paid out-of-pocket. Dr. Andrei discusses the cost implications of different formulation options during the consultation.
FDA & Compounded
Both Formulations Available
Estradiol · Progesterone · Testosterone
All Three Hormones Addressed
MD, PhD, FACOG
Board-Certified Gynecologist
Both Offices
Lapeer & Rochester Hills
Schedule a Hormone Consultation

Bioidentical Hormone Therapy
Prescribed to Fit You.

The right hormone, in the right form, at the right dose — based on your labs, your symptoms, and your health history. Dr. Andrei prescribes both FDA-approved and compounded bioidentical formulations.

Lapeer Office
(810) 969-4670
Rochester Hills
(248) 923-3522

The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.