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A New Approach to HRT for Women

By Christine Wideman, RN with Robert Grafton, MD

Hormone replacement therapy became controversial in 2002 after the Women’s Health Initiative identified cancer and other health risks connected to synthetic hormone replacement. Many consumers and physicians have since been searching for alternative therapies to prevent or mitigate the negative aspects of aging and menopause.

One Michigan physician has developed, and is offering, a bio-identical hormone replacement therapy. Dr. Grafton, a Rochester Hills, MI plastic surgeon, is one of a handful of physicians using bio-identical hormone treatments. His goal is to restore to women to the hormone levels they enjoyed in their thirties.

Dr. Grafton evaluates a woman’s reproductive hormone status by checking her levels of follicle-stimulating hormone, estrogen and testosterone. He also tests her thyroid levels.

“Bio-identical hormone therapy has been around since the 1930′s,” Dr. Grafton said. “It gives the body exactly what it is short of.” Instead of utilizing a ‘one-drug-fits all’ approach found with standard pharmaceuticals he prescribes a custom, individualized prescription for bio-identical hormones. With these individual results he customizes a unique prescription. A compounding pharmacy then creates a hormone pellet approximately 3/16″ in diameter which is inserted underneath the skin. The pharmacy utilizes bio-identical sources usually found in plants such as yams and soy according to Dr. Grafton.

The advantage of this type of administration, sub-cutaneous, is to avoid the oral route according to Dr. Grafton. Therefore, many of the previous negative side effects of HRT are prevented he said.

“The pellets provide a steady-state of hormone delivery which avoids the peaks and valleys associated with oral administration. Additionally, because this method bypasses the gastrointestinal tract and the liver, the stimulation of blood clotting factors are eliminated,” said Dr. Grafton.

This hormone absorption technique is both efficient and convenient because it lasts three to four months per dose rather than the chore of daily oral administration. Dr. Grafton uses local anesthetic to numb the area and makes a small incision to insert the pellet. They are usually placed in the buttock and are not noticeable. The pellets dissolve completely with no residual effects, according to Dr. Grafton.

Medical insurance does not cover the cost of this therapy yet. A treatment from Dr. Grafton costs between $450-$500 per dose. Many of his patients are satisfied with the results despite the cost. Dr. Grafton says that his patients report increased libido, and improvements in general health and well-being.

“People tell me they have improved mood, are mentally sharper, have improved metabolism and muscle tone and have more energy,” he said.

Hormone replacement therapy can be used with good results for both men and women, says Dr. Grafton. Although there have not been large controlled clinical trials to test this type of treatment at this time, he considers it to be safe. He has used the therapy himself for 8 years with gratifying results.

Christine Wideman, RN, has a degree in nursing and journalism.  She continues to work as a nurse and has written on a variety of topics for both local and national publications as a freelance journalist.

Dr. Robert Grafton is a Diplomate of the Canadian Board of Plastic and Reconstructive Surgery and earned his medical degree fom the University of Saskatchewan.  He has been practicing plastic and reconstructive surgery in Michigan since 1993.  He is an instructor at Michigan State University – Hurley Medical Center.