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Bioindetical Hormone Replacement Therapy Monica Carezani-Gavin, MD Diplomate American Academy of Anti-Aging Medicine See Last slide for contact information

Medical Spa - Defined “ A medical spa is a blend of a traditional doctor’s office and a day spa, providing medical consultations and FDA approved treatments for healthy skin and a healthy you, in a luxurious and pampering spa setting”

Location & Hours of Operation Azani Medical Spa CrownPointe Corporate Center 3101 Emrick Blvd, Suite 201 Bethlehem, PA Hours of Operation Tuesday 8am – 9pm Wednesday 1pm – 9pm Thursday 9am – 4pm Friday 9am – 5pm Saturday 9am – 3pm

Complimentary Aesthetic Consultation & Skin Analysis Private Parties Birthday Anniversary Bridal Shower Retirement Corporate

The Morning Call Readers Choice Voted Best in 2006 and 2007 and 2008 Best Medical Spa Best Patient Care Best Laser Hair Removal Best Aesthetic Physician Best Cosmetic Injectables Thank You Lehigh Valley

Dr. Monica Carezani-Gavin Owner & Medical Director In practice for 18 years Only physician in the Lehigh Valley who is a Diplomate of the American Academy of Anti-Aging and Regenerative Medicine Commissioned Major in the United States Air Force Clinical Professor University of Pennsylvania De Sales University First Medical Spa in the Lehigh Valley Founder - “Azani Free Acne Care Program for Adolescents from Low Income Families” 2007 TRACC Athena Award Recipient

Healthy Skin and Healthy You WELLNESS BHRT Personal Genetic Health Personal Nutraceutical Take Shape for Life Weight Management Program Arasys for toned muscles, inch loss and cellulite reduction HEALTHY SKIN Cosmoceuticals for skin health Non-invasive, no-downtime, FDA approved cosmetic medical treatments Pampering treatments

BHRT BHRP is complex I will give you the highlights

QUESTIONS Can you really feel better as you get older? Is aging without illness possible? Is your own internal fountain of youth waiting to be discovered? How can bioidentical hormones help fight the symptoms of aging? What are the differences between synthetic and bioidentical hormones? My memory is not what it used to be, can bioidentical hormones help me? How can bioidentical hormones help you reinvigorate your sex life? Will bioidentical hormones help with hot flashes and sleepless nights? My doctor knows nothing about these natural hormones… where do I go to find a doctor who can help me? Do I need a prescription for bioidentical hormones?

Bioidentical We mean that the structure of the hormone molecule is perfectly identical to the hormone produced in a person’s body It is like a key for a lock, the key has to be a perfect match to fit and open the lock What took so long for bioidentical hormones to come to play?

Pharma Pharmaceutical companies had to develop synthetic estrogens and progesterones in order to patent their drugs. You can NOT patent natural hormones Pharma had hoped that the changes they made to the molecule would not make a difference in the female body.

Pharma Who in the USA would be willing to fund a large-scale study on the safety of bioidentical hormones, which would cost millions of dollars? They can’t be patented, so no drug company will. In Europe, many such studies have been done

Synthetic hormones Because synthetic hormones are foreign to the human body, we lack the enzymes and cofactors to metabolize it safely Foreign estrogens are called xeno-estrogens Xeno-estrogens have dangerous side effects and are found in pesticides and plastic bottles

Synthetic additives Other chemicals that produce adverse effects are added to synthetic hormones to facilitate absorption and utilization by the body.

US Women’s Health Initiative Study to determine relationship between synthetic hormones and other health risks. 8000 women aged 50 to late 70’s received one dose of synthetic estrogen and progesterone Oral Premarin and Prempo 2002 came the results Overall increase of:100%of blood clotting, 41%stroke, 29% Heart attack, 26% breast cancer,100% Alzheimer

French Study International Journal of Cancer 2005 114:448-454 A 10 year study in France of 3175 women was conducted with bioidentical hormone replacement therapy. Transdermal estradiol and oral progesterone No increased risk of breast cancer, strokes, or heart attacks.

French Study “ BHRT is beneficial for quality of life, prevention of bone loss and cardiovascular risk profile, without the activation of coagulation and inflammatory proteins (responsible for strokes and heart attacks) measured in users of oral estrogens.” “ We were unable to detect an increase in the relative risk of breast cancer”

DES=Synthetic Estrogen NOT the right key for our hormone lock DES is a synthetic estrogen prescribed in Europe in the 1950, 1960, and 1970 to pregnant women to prevent miscarriages DES caused severe birth defects in the fetus DES caused cancer of the female reproductive tract in these children

Synthetic Vs Bioidentical The DES example and the WHI shows how synthetic hormones can be extremely dangerous Any estrogen taken orally is also NOT advisable. Oral estrogen goes directly to the liver and gets converted into dangerous byproducts Estrogen produced by the ovaries does NOT go to the liver, it gets secreted directly into the systemic circulation

Hormones are chiefs Hormones control every aspect of our body All our hormones decline with age Our biological clocks tells us to “shrink and die” after we have reproduced Why not live with the hormone levels we had when we were at our prime?

Self Test Please, take two minutes to take part of the self test. You can take the rest of it at home Take the Thyroid and the Testosterone quiz BHRT SelfTest

How did you score? BHRT can truly help!!! As Suzanne Somers puts it: “ The seven dwarfs of menopause: itchy, bitchy, sweaty, sleepy, bloated, forgetful and All-Dried-Up”

The spectrum Most women in their 40’s know that their bodies are changing, but are not sure if it’s early menopause or not. Unlike pregnancy, you can be just a little bit menopausal- sometimes for years!!! We see women in their mid 30’s, 40’s and 60’s with menopause symptoms. All of this leads to a lot of confusion and worry.

Spectrum “ Where there’s smoke, there’s fire”. I prefer to have my patients listen to their bodies, regardless of how old they are. Together, we design a plan just for YOUR needs.

Perimenopause Symptoms Irregular periods Heavy bleeding Hot flashes Sleep disruption Headaches Dry eyes Vaginal changes Hair loss Weight gain Extreme emotional distress

Menopausal Symptoms Short-term memory impairment Lack of focus Fuzzy thinking Lack of sexual desire Increased anxiety Fatigue/Loss of energy Depression Drastic mood swings

Andropause Men have declining levels of hormones Male andropause is much more gradual It starts in the 30’s and continues into the 80’s Bioidentical HRT is just as efficacious in men as it is in women Men experience: loss of muscle mass, increase weight, fatigue, loss of stamina, decreased sex drive, loss of memory, depression, etc. All can be improved with BHRT

Hormonal imbalance Can results from: Diet high in simple carbs Diet low in quality proteins Lack of essential nutrients and fats Chronic exposure to environmental toxins and artificial hormones Prolonged physical and emotional stress

Symptoms The severity of the symptoms are influenced by the weight of other burdens people may have placed on their bodies over the years. Poor nutrition, chronic stress, and a lack of exercise are three major amplifiers because they each play a significant role in the body’s ability to detoxify and maintain homeostasis.

Suzanne Somers She has brought BHRT onto center stage In her books, BreakThrough, Ageless and The Sexy Years she describes this approach. She makes it clear she intends to stay on BHRT for the rest of her life. I saw her personally at the Annual conference of the American Academy of Anti-Aging Medicine Suzanne looks great in her 60’s and she said she felt better and healthier than ever before

Personal BHR Therapy Bioidentical hormones are natural, and our bodies metabolize them as it was designed to do Synthetic hormones are very strong and often produce intolerable side effects Bioidentical compounded hormones can be matched individually to each person’s needs, something that is impossible with mass-produced products.

Talk to your doctor I want to continue living with the quality of life I had, but I am concerned that I am loosing it and need some help in getting what I had back. I have heard about BHRT and am interested in them. Can you help me? Remember you are the expert on your body and its symptoms, needs and feelings.

Solution Nobody needs to suffer with symptoms of hormonal imbalance, at perimenopause, menopause/andropause, or later. You can feel better and you can start right now.

Azani Medical Spa BHRT Therapy Individualized approach for both women and men Clinical symptoms Lab hormone level: Estrone, Estradiol, Estriol, Porgesteron, Pregnenolone, Testosterone, DHEA, TSH, Free T3, Cortisol, Melatonin, etc Prescribe a precise dose of bioidentical estrogen, progesterone, testosterone, thyroid, etc made up at a compounding pharmacy Appropriate vehicle: gel, cream, patch, sublingual, injections Careful monitoring

Choice My goal is to help inform patients about their choices, if necessary to improve their choices and then support their choices. The good news is that women and men can feel incredibly well right through menoupause/andropause and beyond.

Take control People take control of their health in stages. You begin by reading and increasing your awareness Next comes working with your practitioner, or finding a more appropriate practitioner You also begin to help yourself

Help Yourself Take action across your whole life to improve your nutrition and metabolism, reduce stress and make time for yourself These steps unlock your body’s ability to heal itself It is never to late to begin to heal

Anti-Aging Optimal nutrition Hormonal balance Mindful exercise Emotional support

Be informed Be as informed as possible This is smart proactive self-care I encourage you to learn as much as you can about your body and the options available

Thank You I want to thank all of you for your attention I am available for questions. Submit your questions to me by clicking ASK Dr. Gavin �� Request your BHRT consultation with Dr. Gavin

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