The Marion Gluck Clinic


Alternatives to HRT

Alternatives To HRT

We see many women in the clinic requesting alternatives to conventional HRT for symptoms of the menopause.

When we first see patients, there are a few things that we hear time and time again: that women don’t feel understood by their GP; that they don’t want a ‘one size fits all’ treatment; that they have tried conventional HRT but didn’t get on well with it due to side effects; that the application method didn’t work for them. Many women want to know about alternatives to HRT (conventional) because they are concerned with the associated side effects, including increased risk of breast cancer with synthetic progestogens and conjugated equine estrogen.

Dr Marion Gluck first saw a need for better understanding of hormone therapy and more widespread treatment options for women with hormone imbalances more than 20 years ago. The Marion Gluck Clinic offers an innovative and personal approach that can help women who are looking for an alternative to HRT tailored to their needs. We are committed to improving the wellbeing of every patient who walks through our doors, and our experience has shown time and time again that bioidentical hormone replacement therapy (BHRT) can be life-changing.

Alternatives To HRT: Bioidentical HRT

At the Marion Gluck Clinic, we offer a gold star service that centres on the bespoke use of BHRT for each patient. As specialists in the field, we do all that we can to ensure that a patient’s quality of life is improved through our treatments.

A non-synthetic approach: The hormones used in traditional HRT are synthesized in a laboratory, and whilst similar to our body’s own hormones, are slightly different to those naturally found in the body. Additionally, some synthetic estrogens are derived from pregnant horse urine. Conversely, BHRT is suitable for those looking for alternatives to HRT. It utilises hormones derived from the diosgenin in Mexican yams; these hormones have a chemical structure that is 100% identical to the hormones produced by the human ovary and adrenal gland. We explain more about the differences between HRT and BHRT here.

More flexibility in applications: In publicly funded clinics in the UK, bioidentical estrogen is available as a transdermal (absorbed through the skin) patch or gel in a limited range of doses.

Dr Ghazala Aziz-Scott, Doctor at the Marion Gluck Clinic, explains: “The gel needs to be applied along the whole arm which doesn’t make for the most convenient application. Additionally, because the dosage comes in standardised amounts, a patient may have to apply between 1 and 4 pumps of gel each day. Bioidentical or micronised progesterone is also only available in oral tablets and the dosage for these is currently restricted to 100mg. This means that tailoring the treatment to the patient’s exact needs can be difficult, and the treatment can become inconvenient for the patient.

“At the Marion Gluck Clinic, we can reduce or increase dosage of all hormones as appropriate, enabling us to provide a completely bespoke treatment for each patient. For example, we can compound your exact dosage into a single pump of high quality cream that is easily absorbed into the skin. We can also provide BHRT in a wider variety of applications, including lozenges, creams, gels, tablets and vaginal creams. We find that some patients do not absorb transdermal creams as effectively and we can target vaginal symptoms locally.”

Estrogen Dominance And HRT

When we are assessing a patient’s hormone balance, we can look at hormone production and how hormones are metabolised by the body.

When metabolism is working correctly, estrogen is detoxified within the liver, then excreted through the urine or stool. If this metabolism is not taking place correctly, or there is an imbalance in hormone production, this can lead to a build-up of estrogen in the body, causing estrogen dominance. This can lead to weight gain, hypothyroidism, fatigue, brain fog, headaches, infertility, insomnia, mood swings, severe PMS, fibroids, water retention, irregular periods, polycystic ovary syndrome (PCOS), and an increased risk of breast cancer. We can use the ‘DUTCH’ analysis (dry urine total comprehensive hormone analysis) to evaluate how the body is metabolising estrogen and we can assess if the body is producing the more favourable, less toxic estrogen metabolites that have lower breast cancer risk.

Estrogen dominance can also occur when the dosage of estrogen prescribed is too high or estrogen is not needed. We tend to see this in patients who have been prescribed conventional HRT without testing individual hormone levels and they actually feel worse.

Dr Aziz-Scott says: “Many women who are going through perimenopause will actually have adequate levels of estrogen, but progesterone is the first hormone to be depleted in this phase. The National Institute for Health and Care Excellence (NICE) currently states that blood tests are not necessary to diagnose perimenopause/menopause in women over 45 and that it’s not necessary to measure the levels of hormones in patients prior to prescribing HRT. This means that a woman may be prescribed a blanket estrogen/progesterone regimen when her estrogen levels don’t need topping up. At the Marion Gluck Clinic we take a different approach: we carry out comprehensive blood tests before prescribing any treatment. We frequently see patients who have tried conventional HRT but have experienced side effects and not tolerated it well. Our blood tests usually reveal the underlying hormonal reasons for this.”

With BHRT, we can compound only what is required – in perimenopausal women we may only replace the progesterone if this is all that is required to ensure our patients always feel their best. We also replace other hormones that are essential to health and wellbeing as appropriate such as testosterone and DHEA.

This is also a reason women tend not to experience side-effects on BHRT, when compared to regular HRT. We talk about this further, below.

Why Do Patients Have Fewer Side Effects On BHRT?

There are many side effects of HRT – from depression to weight gain – that we may be able to avoid with the use of BHRT. The reason that patients might not experience these side effects while taking BHRT from our clinic is because the preparations are more flexible and targeted to the precise hormone deficiency.

As we can tailor doses, we can better address symptoms that a patient might present with. For example, if a patient is prone to breast tenderness on estradiol treatment alone, they are likely to have very sensitive breast tissue. We can address this by prescribing Biest, which is a combination of estradiol (E2) and estriol (E3). Estriol has a weaker action on breast tissue and is much more tolerable for the patient. Doses can be adjusted in our follow-up. If a patient is experiencing anxiety and insomnia, increasing the proportion of progesterone in the treatment can be transformative.

Lifestyle Changes And Herbal Medicine

Making small improvements to all areas of your life can improve your quality of life and your menopausal experience. At the Marion Gluck Clinic, we look at the big picture; while we are specialists in BHRT, we also combine lifestyle, nutritional changes and supplements as part of our treatment plans to really help you optimise your health. These can involve adjustments to exercise, diet, vitamins, minerals and herbal adaptogens such as ashwaghanda, rodiola, siberian ginseng, and shatavari. Magnesium is also a very important mineral to ease menopausal symptoms.

Why Choose BHRT At The Marion Gluck Clinic?

Bespoke treatment – As specialists, we create bespoke hormone balancing treatment plans for each of our patients following extensive investigations and hormone profiling.

Personal attention – Your treatment at the Marion Gluck Clinic will involve a one-to-one treatment journey with our team of specialists. Your issues will be heard and all questions answered. We strive to ensure that all of our patients feel listened to, and that your concerns are taken seriously.

Trust and rapport – We guide our patients every step of the way. We monitor your hormone health and general wellbeing and tailor your treatment as your body’s needs change.

Comprehensive care – Because hormones can affect many aspects of health, we always check that our patients have kept up with their relevant routine screenings, such as mammograms, cervical smears and pelvic ultrasounds. We also look at both familial and individual medical history to ensure that we provide the best and most appropriate treatment.

Speak With One Of Our Doctors About BHRT For Menopause Symptoms

Take control of your menopause symptoms. Speak with one of our specialist doctors for a personalised treatment plan which is tailored to help balance your hormones and improve quality of life. We offer a fully remote service anywhere in the UK.




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