As we age, both men and women naturally experience a decline in hormone production, which often begins in the 30s but becomes more apparent as we approach middle age. For men, the initial signs may include difficulties with sexual performance and a lack of motivation. Women, more attuned to their bodies due to their monthly menstrual cycles, may notice mood swings, weight gain, and a decrease in libido.
Because hormones influence numerous bodily functions, you may not immediately connect various symptoms to hormonal imbalances. For instance, you might seek treatment for specific issues like frequent headaches or insomnia without realizing they stem from underlying hormonal disruptions. Traditional healthcare approaches often focus on treating isolated symptoms rather than identifying the root causes, leading to frustration when connections between symptoms and hormonal health are overlooked.
While some providers may resort to synthetic hormone replacement therapy when other treatments fail, this approach can sometimes exacerbate existing issues. Synthetic hormones are linked to several serious health risks, including endometrial cancers, blood clots, heart attacks, abnormal liver function, and pancreatitis. Although these complications are not widespread, many patients report common side effects such as nausea and muscle cramping, which can deter them from continuing treatment.
At Kurtz Medical Aesthtics, we work with each patient to identify which therapy would suit them which can be various methods, including intramuscular injections, subcutaneous injections, topical creams, pellets, time-release patches, suppositories, and oral medications.
Hormones are vital to our daily health, influencing glycemic control, metabolism, reproductive function, energy production, and sleep. It’s important to recognize that hormone responses are unique to each individual. As men commonly require testosterone replacement as they age—studies indicate that over 38% of men over 45 may have low testosterone—women also experience a decline in testosterone, typically starting around 30, requiring much lower doses for replenishment.
If you’re feeling the effects of hormonal decline, our expert team is here to assist you in finding the right treatment plan tailored to your needs.
Many healthcare professionals do not receive sufficient training in managing menopause. Surveys show that while 60% of women seek clinical assistance for menopause-related symptoms, 75% of these women end up not receiving treatment.
Natural Menopause: Natural cessation of periods for 12 months, with elevated FSH ( >35) and low estradiol (0-20) - very few women fit this definition.
Surgical Menopause: Removal of BOTH ovaries.
Early menopause: age <45
Premature menopause: age <40 Perimenopause:
The time leading up to menopause, with volatile levels of estrogen, lowering of progesterone (often earliest, and testosterone.
Early Peri: more frequent periods
Late Peri: periods become more spaced out
Hot Flashes
One of the most recognized symptoms of menopause is hot flashes. A hot flash is characterized by a sudden sensation of heat, typically accompanied by flushing of the skin. These episodes can last from a few seconds to several minutes and can happen at any time, day or night. While some women may experience only a few hot flashes each week, others may have them multiple times throughout the day.
Night Sweats
Night sweats are another frequent symptom of menopause. They resemble hot flashes but occur during the night while you sleep. Consequently, night sweats can interrupt your rest and leave you feeling tired throughout the day.
Vaginal Dryness/Painful Intercourse
Vaginal dryness is a common symptom during menopause. The decrease in estrogen levels can cause the vaginal tissues to thin and reduce lubrication, which may lead to discomfort during intercourse and a heightened risk of vaginal infections. If you're dealing with vaginal dryness, there are effective treatments available.
Sleep Disturbances
Sleep disturbances are another frequent symptom of menopause. This may manifest as trouble falling asleep, waking up often during the night, or feeling unrefreshed in the morning. If you're experiencing sleep issues, consider establishing a consistent sleep schedule and refrain from working or using electronic devices in bed. It's also advisable to avoid caffeine and alcohol in the hours leading up to bedtime.
Mood Changes
As a result of the hormonal shifts that happen during menopause, you might also notice changes in your mood, including irritability, anxiety, or feelings of depression. If you're feeling especially low, it could be beneficial to speak with your doctor or a therapist. Additionally, you may want to consider joining a support group for women experiencing similar changes.
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Cost: $295 (these labs are performed once a year unless we need to monitor a specific issue)
Health optimization consultation includes: (Typically a 60 to 90 min appointment)
This is followed by a detailed plan of action, which includes:
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Perimenopause refers to the years preceding menopause, typically starting in your forties, when estrogen levels in the body begin to fluctuate. Symptoms of perimenopause can differ among women and may include irregular periods, prolonged or particularly heavy menstruation, sleep disturbances, acne, mood swings, irritability, anxiety, depression, weight gain, and occasional hot flashes and night sweats.
Menopause officially begins one year after the date of your last period. Prior to this, starting for most women around the age of 40, you are perimenopausal, and after one year of no periods you are forever and ever postmenopausal.
Menopausal symptoms, however, begin and end on a timetable all their own, starting well before the last period and continuing for months to even years after. It can be a fantastic, freeing time of life, but there are a host of symptoms that make it hard to enjoy. There are many symptoms of menopause, but some of the most common are hot flashes, night sweats, sleep disruption, vaginal dryness, mood swings, brain fog, and weight gain.
The goal of menopausal hormone replacement therapy is not to replace hormones at the levels present before menopause, but rather to use the amount necessary to effectively alleviate menopausal symptoms. The estrogen levels administered after menopause are significantly lower than what the ovaries produce during ovulation and are typically at least one half to one third of the estrogen found in a low-dose oral contraceptive.
In 2017, The Menopause Society published a position paper affirming that MHT is safe and effective for the vast majority of healthy menopausal women.
Understanding the Importance of Estrogen in Hormonal Health
Estrogen is an essential hormone produced by the ovaries, with its production significantly decreasing during menopause. After menopause, a woman’s estrogen levels decline, leading to alterations in vaginal pH. This change can shift the types of bacteria present in the vagina toward those more likely to cause urinary tract infections (UTIs). Estrogen plays a crucial role in safeguarding against various health issues, such as heart disease, stroke, osteoporosis, and Alzheimer’s disease. It also helps protect against conditions like vaginal atrophy, urinary incontinence, and a variety of menopausal symptoms, including hot flashes. Vaginal estradiol can be used in conjunction with patches, oral medications, transdermal options, or pellets, as it remains localized in the vaginal area to help prevent recurrent UTIs, vaginal dryness, irritation, painful intercourse, and issues like sneezing that causes peeing, while also balancing pH levels. An estrogen deficiency can lead to early menopause and produce symptoms such as forgetfulness, insomnia, sagging breast skin, urinary incontinence, increased facial wrinkles, chronic fatigue, depression or anxiety, mood swings, decreased libido, and painful intercourse. On the other hand, estrogen dominance can lead to symptoms like bloating, breast tenderness, irregular menstrual cycles, decreased libido, migraines, mood fluctuations, and abdominal weight gain.
The estradiol pill and patch are FDA-approved, plant-derived, bioidentical hormone therapies specifically designed to alleviate menopausal symptoms. The FDA has authorized estrogen for various applications, including the treatment of vasomotor symptoms, the prevention of osteoporosis, the management of Genitourinary Syndrome of Menopause, and for addressing premature menopause (defined as menopause occurring before age 45). Notably, estrogen is the only medication that has been scientifically proven to relieve menopausal hot flashes and night sweats while also helping to prevent osteoporosis.
The estradiol pill, also known as oral bioidentical estradiol, is generally safe for most women. It can be taken by healthy individuals who do not smoke, have well-controlled blood pressure, and do not have a history of heart disease, stroke, liver disease, or blood clots, nor genetic mutations that elevate the risk for clotting.
However, women with undiagnosed vaginal bleeding, active liver disease, a personal history of heart attack or stroke, or a history of estrogen-dependent cancers, such as breast or uterine cancer, may not be suitable candidates for estrogen therapy. It is important to note that a family history of these conditions does not automatically disqualify individuals from receiving menopausal hormone therapy.
Estradiol helps with:
– Increases metabolic rate
– Improves insulin sensitivity
– Regulates body temperature
– Helps prevent muscle damage
– Helps maintain muscle
– Improves sleep
– Reduces risk of cataracts
– Helps maintain the elasticity of arteries
– Dilates small arteries
– Increases blood flow
– Inhibits platelet stickiness
– Decreases the accumulation of plaque on arteries
– Enhances magnesium uptake and utilization
– Maintains the amount of collagen in the skin
– Decreases blood pressure
– Decreases LDL and prevents its oxidation
– Helps maintain memory
– Increases reasoning and new ideas
– Helps with fine motor skills
– Increases the water content of skin and is responsible for its thickness and softness
– Enhances the production of nerve-growth factor
– Increases HDL by 10 to 15%
– Reduces the overall risk of heart disease by 40 to 50%
– Enhances energy
– Improves mood
– Increases concentration
– Maintains bone density
– Helps prevent glaucoma
– Decreases lipoprotein(a)
– Acts as a natural calcium channel blocker to keep arteries open
– Increases sexual interest
– Reduces homocysteine
– Decreases wrinkles
– Protects against macular degeneration
– Decreases risk of colon cancer
– Helps prevent tooth loss
– Aids in the formation of neurotransmitters in the brain such as serotonin which decreases depression, irritability, anxiety, and pain sensitivity
Resources
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We offer a range of specialized treatments and procedures designed to help women look and feel their absolute best.
ThermiVa Vaginal Rejuvenation Therapy
Emsella Pelvic Floor Therapy
Vaginal Estradiol
AnteAgeMD growth factors
PRP/PRF Ohhhh Shot
Offering the Latest Vaginal Rejuvenation Technology
Natural aging and vaginal childbirth can result in vaginal laxity, or loss of vaginal tightness. Restore your confidence with ThermiVa®, a quick, non-invasive vaginal rejuvenation treatment to improve vaginal tightness, dryness and appearance.
ThermiVa is a non-surgical, in-office treatment for women who have experienced vaginal laxity, or looseness, that can happen due to vaginal delivery, the natural aging process, menopause, obesity, chronic constipation or other factors that may cause the vagina to stretch excessively.
ThermiVa uses radiofrequency energy to gently heat the vulvovaginal tissues, which in turn can stimulate and help rebuild collagen. Collagen is a protein that makes your tissues firm and elastic.
Am I a Candidate for ThermiVa?
You may be a candidate for ThermiVa if you're an adult and:
The pelvic floor muscles support the pelvic floor organs and control continence. However, natural body aging, childbirth and menopause can cause this group of muscles to decondition resulting in continence problems such as leaking urine when coughing or sneezing.
The BTL EMSELLA treatment uses High Intensity Focused ElectroMagnetic Energy (HIFEM) to stimulate and strengthen all the pelvic floor muscles, not just the subset that can be exercised with voluntary contractions (Kegel exercises). These stronger pelvic floor muscles restore continence and the confidence to enjoy normal daily activities without fear of losing bladder control.
During each 28-minute session you sit comfortably on the Emsella chair while it generates thousands of supramaximal pelvic floor muscle contractions. Each session is equivalent to doing 11000 pelvic floor exercises but without the hard work!
The procedure is non-invasive, and you remain fully clothed throughout. No drugs are required and the most you will feel is a slight tingling during the treatment. With no recovery time needed you can leave immediately after each session and resume normal daily activity.
The majority of people need a course of six sessions over a period of three weeks to see optimum results, with most people seeing and feeling results after just two or three treatment sessions.
If you are struggling with any of the following conditions linked with pelvic floor problems, then BTL EMSELLA might be the perfect treatment for you:
It is effective for both men and women in improving bladder control and intimate health.
How many treatment sessions will I need?
Your exact treatment plan will be tailored to your needs. For optimum results, most people need a course of six sessions, with 2 sessions per week over a period of three weeks.
In extreme cases, further sessions are required, but otherwise, a maintenance session every three to twelve months is enough.
How quickly will I see results?
Most people see and feel results after just two or three treatment sessions. Mild signs and sensations may be noticeable after your first session, but it will take several sessions before you begin to observe the full effect on your symptoms.
Urinary incontinence refers to the loss of control over urination. It can range from mild leaking due to sneezing, coughing or laughing, or develop into a complete inability to control urination. Both men and women can experience incontinence, and it may be temporary or ongoing.
ThermiVa is not recommended if you're using any cardiac devices, are pregnant, have any active infections or had recent vaginal surgery.
Understanding the Role of Progesterone in Hormonal Health
Progesterone, secreted by the ovaries, is essential for the production of other crucial hormones, including estrogen, testosterone, DHEA, and cortisol. This vital hormone is derived from cholesterol, which is then converted into pregnenolone, further facilitating the synthesis of other important hormones.
Beyond its role in hormone production, progesterone plays a protective role against uterine and breast cancers. It can also help mitigate serious health conditions such as osteoporosis, fibrocystic disease, and ovarian cysts. Additionally, progesterone is integral for optimal brain function, maintaining balanced blood sugar levels, and supporting the production of thyroid hormones. Research has shown that progesterone can significantly reduce premenopausal and postmenopausal symptoms, as well as alleviate premenstrual symptoms (PMS) like severe mood swings, migraines, bloating, and fatigue. It also plays a role in sustaining a healthy libido.
As women approach menopause, natural progesterone production declines, necessitating replenishment through Bioidentical Hormone Replacement Therapy (BHRT) to restore hormonal balance and enhance quality of life. Low progesterone levels can lead to symptoms such as heavy bleeding and cramping during menstruation. Conversely, excessively high progesterone levels may result in chronic fatigue and a pervasive sense of lethargy that rest cannot alleviate.
Progesterone works in delicate harmony with estrogen during the menstrual cycle, regulating the growth of the uterine lining. An imbalance—characterized by high estrogen and low progesterone—can lead to prolonged and heavy menstrual periods, particularly during perimenopause. When estrogen is present without progesterone (unopposed), it can cause unchecked thickening of the uterine lining, increasing the risk of endometrial cancer. This is why it is critical for women with a uterus to maintain both estrogen and progesterone levels after menopause.
Women who have undergone a hysterectomy, those with hormonal IUDs, transgender women, and individuals with a congenital absence of the uterus typically do not require progesterone supplementation.
Progesteorne has shown to be helpful with the following:
- Anti-inflammatory
- Balances estrogen
- Can lower cholesterol
- Enhances thyroid hormones
- Has a natural calming effect
- Helps improve libido
- Helps the body use and eliminate fats
- Improves sleep
- Increases metabolic rate
- Increases hair on your scalp
- Lowers high blood pressure
- Natural antidepressant
- Natural diuretic
- Neuroprotective
- Promotes the immune system
- Stimulates growth of new bone
The Women’s Health Initiative is a long-term national health study focused on women. In 2002, the WHI released a report stating that Hormone Replacement Therapy or HRT (now called Menopause Hormone Therapy or MHT) increased a woman’s risk of breast cancer, heart disease, and stroke. The WHI has since clarified its findings. Its initial study focused solely on older women but its results were mistakenly applied to women of all ages. As a result, doctors stopped prescribing hormone therapy, believing it to be dangerous. Having subsequently analyzed the findings in terms of age, the WHI now says younger women may benefit from hormone therapy, but that this course of treatment should be an individualized decision based on a woman’s health profile, including age, symptoms, and family history.
Document produced by Dr. Sarah Glynne, GP Menopuase Specialist from the UK
This booklet is written by Ellie Waters and Dr Louise Newson to provide information on the menopause after treatment for cancer.
Ellie experienced the menopause aged 15, after treatments for cancer. She had to learn about the menopause for herself and take action to get the right help. Louise is a GP and menopause expert, who created the free ‘balance’ menopause support app.
Do you often feel “unwell”? Are you experiencing symptoms like brain fog, low motivation, reduced libido, difficulty managing weight gain, or a pervasive sense of fatigue and weakness? We are dedicated to helping you regain your vitality through a comprehensive, evidence-based approach that focuses on your symptoms rather than just lab results.
At Kurtz Medical Aesthetics we provide testosterone replacement therapy for men aged 30 and above who are dealing with hypogonadism or testosterone deficiency. Our goal is to enhance your overall health and well-being, boost your energy levels, and improve your quality of life. We are committed to an evidence-based practice, supported by the most recent and relevant scientific research.
Your testosterone levels can be influenced by various factors, including age, lifestyle, environmental conditions, medical issues, and medications. But how can you tell if you have low testosterone? To accurately diagnose hypogonadism or testosterone deficiency, we consider a combination of symptoms and lab results. Relying on lab results alone isn't sufficient, as every individual is biologically unique. For instance, two men may have similar testosterone levels in their lab results, but one may exhibit symptoms of low testosterone while the other does not. Our focus is on treating symptoms and addressing individual needs rather than solely depending on lab results.
The symptoms that may indicate low testosterone encompass sexual, psychological, and physical aspects.
Sexual symptoms of testosterone deficiency:
Psychological symptoms of testosterone deficiency:
Psychological symptoms of testosterone deficiency:
Physical symptoms of testosterone deficiency:
Every patient we serve is biologically unique. There is no universal dosage or specific lab result that guarantees improvement in our patients’ well-being. We take an individualized approach, focusing on how each patient feels. As a result, the timeframe for experiencing the benefits of testosterone replacement therapy (TRT) varies from person to person. Our primary objective is to resolve symptoms, and our treatment programs are designed with this goal in mind. However, medical literature indicates that the effects of TRT can typically be felt within the following timeframes:
Once you begin testosterone therapy and experience its benefits, you'll find it hard to go without. It's essential to understand that testosterone replacement therapy (TRT) is a long-term commitment, as its positive effects unfold over the course of several years.
What Matters More: Total Testosterone or Free Testosterone?
In healthy men, only 1-3% of total testosterone is freely circulating in the bloodstream, while approximately 40-50% is bound to sex hormone binding globulin (SHBG) and 50-60% to albumin. It's the free testosterone that acts at the cellular level and delivers the beneficial effects associated with testosterone. Consequently, free testosterone is the most crucial indicator for diagnosing testosterone deficiency and monitoring treatment progress.
Each patient has a unique response to testosterone replacement therapy (TRT). Some individuals may notice improvements within weeks, while for others, it may take several months. The resolution of testosterone deficiency symptoms occurs along different timelines. It’s important to recognize that we are engaging in a marathon, not a sprint. This is a process, not a one-time event. You should anticipate experiencing the benefits of TRT over the course of months and years, rather than days or weeks. If a patient has been dealing with testosterone deficiency for an extended period, expecting a quick fix is not realistic. Additionally, lifestyle factors such as nutrition, exercise, sleep, and stress significantly influence how quickly the benefits of TRT can be recognized. The healthier one is the less side effects and the better one will feel.
At Kurtz Medical Aesthetics we utilize multiple methods of delivery. Patients are given the option of utilizing injectable testosterone, pellet therapy, oral Kyzatrex or a trans scrotal cream.
We understand that there isn't a one-size-fits-all method of delivery for testosterone therapy. While most men who opt for pellet therapy and find them effective, there will always be a percentage who prefer other options. The same applies to the trans-scrotal cream. If one delivery method isn't suitable or the patient is unhappy, they can easily switch to another option. The key, regardless of the delivery system used, is to maintain stable optimal hormone levels and avoid significant peaks and troughs.
At Kurtz Medical Aesthetics we discusses each delivery method, outlining the pros and cons of each, allowing patients to choose the approach that best fits their lifestyle. We are well-known for working with our patients and doing what is best for them. While injections have been a reliable option for testosterone therapy for decades, we offer an equally effective alternative that may be more suitable for some patients.
The fitness industry and health coach industry often resort to misleading advertising aimed at men searching for a quick solution to their low testosterone levels. The reality is that testosterone boosters are ineffective. Even high-quality pharmaceutical products may only provide a slight increase in testosterone levels. If you're experiencing low testosterone, no supplement will elevate your levels to a therapeutic range that produces noticeable benefits. Moreover, because the supplement industry is not regulated by the FDA, there’s no assurance regarding the purity or potency of these products. Proceed with caution.
The only reliable way to significantly raise your testosterone levels to enjoy its benefits is through bioidentical testosterone. Additionally, collaborating with an experienced provider to obtain a prescription for bioidentical hormones is often more cost-effective than spending money on testosterone-boosting supplements that ultimately offer no real help.
Erectile Dysfunction
Erectile dysfunction (ED) is defined as the inability to achieve and maintain a firm erection sufficient for sexual activity or intercourse. The underlying causes of ED can vary, but hormone imbalances are often a significant factor.
Men who regularly experience high levels of stress may produce excess cortisol, which can detrimentally affect testosterone levels. Elevated prolactin, a hormone produced by the pituitary gland, can also hinder the ability to attain an erection. When prolactin is produced in excess, it can lead to a decrease in testosterone, resulting in ED. Additionally, hypothyroidism is frequently linked to increased prolactin production.
Estrogen dominance, characterized by elevated estrogen levels, can also impair erectile function. Liver disease is one common contributor to estrogen dominance, but it can also arise when testosterone levels decline due to aging. Symptoms of estrogen dominance include weight gain, anxiety, gynecomastia, and loss of muscle mass.
Other conditions that cause vein constriction, diabetes, and certain blood pressure medications are also associated with ED. Unrestricted blood flow is essential for achieving an erection. When arousal occurs, the brain signals the release of nitric oxide, which relaxes the muscles of the penis and allows blood to flow into the organ. If nitric oxide is not released or if blood flow is restricted due to high plaque levels in the body, an erection may not happen.
Insufficient testosterone levels are linked to more serious health issues beyond sexual dysfunction. Research indicates that low testosterone can heighten the risk of cardiovascular disease, heart attack, stroke, and osteoporosis.
Kurtz Medical Aesthetic's providers collaborate with patients in developing a treatment plan that best fits your lifestyle and supports your journey toward achieving your personal optimization goals.
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Check out this patient seminar on Bio-Identical
Hormone Replacement Therapy by Dr. Cory Rice
The primary goal of Biote is to help balance hormones through bioidentical hormone replacement therapy using pellets. Hormone balance is crucial to leading a healthier and more fulfilling life. That’s why the mission of Biote is to help people live better, longer.
Bioidentical hormone replacement therapy (BHRT) may offer relief for many common and debilitating symptoms that medical providers often overlook.
Bioidentical hormone replacement pellet therapy is a personalized approach to hormone replacement. It allows a patient’s body to absorb the right level of hormones at the right time using a delivery method the body can process efficiently.Pellets are small capsules (about the size of a grain of rice) that contain bioidentical hormones like testosterone or estrogen. A bioidentical hormone is the exact molecular structure of hormones the body produces naturally.
The statements on this website have not been evaluated by the Food and Drug Administration. Information provided on our website or marketing is not intended to diagnose, prevent, treat, or cure any medical condition or disease. This information is for informational purposes only and should not be considered medical advice. Always consult with your healthcare provider before using any new products or treatments
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