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Are You at Risk: 10 Mistakes “Hormone Experts” Make When Prescribing Hormone Replacement Therapy

Updated: Feb 6, 2020

Updated: May 7


Last week, I spoke with five new clients who were in hormone hell after seeing ‘hormone experts’ who robbed them not only of their hormone balance but also of thousands of their hard-earned dollars. They had been skeptical at first. But, the more they researched bioidentical hormone replacement therapy, the more they were convinced that it would be their solution to fat, flat, and fatigued. Seriously, who can argue with Angelina Jolie and Oprah Winfrey, right?

These poor women are only five out of countless of other desperate women searching for solutions for the physical and emotional chaos caused by hormone imbalances. The bottom line is that properly dosed and monitored bioidentical hormone replacement therapy can be life changing in a major way! In nearly 30 years of prescribing hormone replacement therapy for women, I have seen only great things happen. And… not a single one of my patients got cancer from the bioidentical hormone replacement therapy I prescribed.

But, here’s the problem…bioidentical hormone replacement therapy can also be dangerous if the practitioner prescribing them has no idea what they are doing. This is further complicated by the constant differences in opinion between the conventional and integrative medicine practitioners. The result? Very confused women!

Competent medical practitioners who really understand how to properly prescribe bioidentical hormone replacement therapy are hard to find. In fact, the countless women I’ve worked over the years needlessly suffered at the hands of so called ‘hormone experts’. So, what’s a woman with hormone imbalances to do?


I have trained healthcare practitioners all over the world on how to properly prescribe bioidentical hormone replacement therapy. My years of clinical experience, coupled with my thorough knowledge of the scientific research on hormone replacement therapy, has allowed me to safely and effectively help thousands of women.

Women with hormone imbalances must stay educated and be their own advocates, especially when it comes to hormone replacement therapy. I completely understand how confusing it can be when Dr. Google is the main medical consultant. I am a huge advocate of bioidentical hormone replacement therapy, but the maze of misinformation and quackery just gets keeps growing larger every day.

So, for women seeking safe bioidentical hormone replacement therapy, here are 10 common mistakes made by inexperienced practitioners who prescribe hormone replacement therapy. If your practitioner is making even one of these mistakes, look for a different practitioner!

Mistake #1. Not prescribing progesterone if women without a uterus

Progesterone is an incredibly important hormone with over 300 functions in the body. It also reduces the risk of breast and uterine cancer. In the conventional medical world, women who have had a complete hysterectomy are typically offered estrogen replacement alone. The rationale is that since the uterus is gone, progesterone is not needed to prevent uterine cancer. But, every other cell and tissue in a woman’s body still require progesterone for proper function.

Mistake #2. Prescribing estrogen as a capsule or in other oral forms

This is true even for conventional hormone replacement therapy. Oral estrogen replacement therapy is dangerous and has been tied to numerous health risks, including stroke, heart disease, high cholesterol, and increased blood clotting. Estrogen patches, creams, and gels are safer alternatives.


Mistake #3. Replacing testosterone without first uncovering the reasons why testosterone levels are low

Testosterone can turn into Estrogen. This means that low testosterone levels DO NOT always mean testosterone replacement is necessary it...Low testosterone levels may mean the body is converting it into estrogen. If this is the case, then testosterone replacement can cause MORE problems by increasing the levels of estrogen. Testosterone levels can also go down because of high cortisol…which means stress can also be the cause.

Mistake #4: Cycling hormones in menopausal women

The only reason why women have a menstrual cycle is to have babies. So, once a woman is in menopause, it makes absolutely NO SENSE to cycle hormones. Plus, giving a woman unopposed estrogen for two weeks every month can promote abnormal thickening of the lining of the uterus and make estrogen dominance worse in women who are already estrogen dominant.

Mistake #5. Ignoring the cortisol connection

Testosterone, DHEA, Estrogen, Progesterone, Thyroid, and Growth Hormone all lower cortisol. So, your doctor should never give you any of these hormones without doing thorough testing assessment of your stress response system (and this includes more than just a blood test for cortisol).

Mistake #6. Prescribing hormones in excessive doses

A woman’s peak hormone production is around the age of 25. Mother Nature has predetermined what those levels will be. The ultimate purpose of bioidentical hormone replacement therapy is to bring declining hormone levels closer their younger, healthier levels. The purpose is not to try and outsmart Mother Nature. Replacing hormones in doses that are too high will only create more hormone chaos and create awful side effects that can sometimes be irreversible.


Mistake #7: Believing bioidentical hormone replacement therapy is safer than conventional hormone replacement therapy

Even though bioidentical hormones are biologically identical to a woman’s own hormones does not mean they are safer! If the hormones are given in incorrect dosage forms (i.e. estrogen pills) and/or the doses of hormones are not balanced or too high, they can be just as dangerous as conventional hormone replacement therapy.

Mistake #8: Thinking that low estrogen alone is the cause of menopausal symptoms.

If a woman continues to have symptoms of hot flashes, night sweats, vaginal dryness, etc., even on bioidentical hormone replacement, it does NOT mean she needs higher doses of estrogen. It means that the hormone doses are not properly balanced and/or that other things are affecting the way her body is processing and metabolizing estrogen. It could also mean that the influence of other hormones, such as cortisol, are playing a role.

Mistake #9: Starting a new patient on hormone pellets

Yes…there is research supporting the use of pellets as a safer alternative to conventional hormone replacement and for conditions including migraine headaches in women. But, there is no way to know how a woman’s body is going to react to hormones when she first begins hormone replacement. Hormone pellets are placed under the skin and are slowly absorbed over 3 to 4 months. This means that if the doses of hormone pellets are off or there is an unexpected reaction, there are only two choices: 1) visit the local surgeon to have them removed; or 2) wait it out until the pellets are gone.

Mistake #10: Prescribing hormone creams then trying to monitor the levels in blood work

This is probably the number one reason I see that women on bioidentical hormone replacement therapy get overdosed and have horrible side effects. The mechanics are a little out of the scope of this blog. Suffice to say that when hormone creams are rubbed on the skin, the hormones are absorbed into arteries, veins, fat tissue, and lymphatics. Routine lab work samples blood from the veins. This blood has already been to all the cells and tissues of the body, and the good stuff and hormones have been absorbed. This means that there should not be any detectable hormone levels in the blood in the veins. Most doctors don’t understand this, so they just keep giving higher and higher of doses of hormones until they finally do show up in the venous blood. That is a serious mistake! Saliva and blood spot testing are the only reliable ways to check the levels of hormones which are being prescribed in cream form.

The world of bioidentical hormone replacement therapy has become a sequel the Wild West. Anything goes, and there is virtually no oversight on what, when, and how practitioners can prescribe hormones. There is no standard of care, no uniform protocols, and no central data base of bad outcomes in women who were given the wrong bioidentical hormone replacement.

Women must be careful, stay vigilant, and make changes if they are working with an inexperienced ‘hormone expert’.


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