Bioidentical Hormone Replacement Therapy (BHRT)

 Bioidentical Hormone Replacement Therapy (BHRT) may be suitable for both women and men over the age of 18, depending on individual symptoms, health history and clinical need. There is no single “right age” to start BHRT — suitability is based on how hormones are affecting your health and wellbeing, rather than age alone.

For individuals seeking support for perimenopause or menopause in women, or peri-andropause and andropause in men, BHRT is most commonly considered from the mid-40s onwards, as this is when age-related hormonal changes typically begin to impact symptoms and quality of life. That said, hormonal decline and fluctuation can occur earlier or later than average, and many people experience significant symptoms well outside these typical age ranges.

BHRT may also be appropriate for younger individuals when hormone-related symptoms are linked to factors other than natural ageing. This can include conditions such as hormonal imbalance, menstrual or reproductive disorders, postnatal or stress-related hormonal disruption, thyroid dysfunction, or the effects of medical or surgical treatments that impact hormone production. In these cases, BHRT may be considered as part of a carefully assessed and monitored treatment plan, regardless of age.

At Skin&Spirit, suitability for BHRT is never assumed. We take a personalised, evidence-informed approach, considering your symptoms, medical history, blood results where appropriate, lifestyle factors and long-term health goals. Where BHRT is not suitable, or not the best first option, this will be discussed openly and alternative approaches may be recommended. Our aim is to ensure that any treatment offered is both clinically appropriate and aligned with your individual needs.

 Bioidentical Hormone Replacement Therapy (BHRT) may be used to support a wide range of women’s and men’s health and wellbeing concerns where hormonal imbalance is thought to play a contributory role.  Treatment is always personalised and based on a comprehensive clinical assessment.

Perimenopause and menopause in women
BHRT may help relieve common symptoms associated with hormonal fluctuations and decline, including hot flushes, night sweats, sleep disturbance, low mood, anxiety, brain fog, joint pain, changes in skin and hair, vaginal dryness and reduced libido. Treatment can also support longer-term health such as bone density and cardiovascular wellbeing.

Peri-andropause and andropause in men
Gradual declines in testosterone and other hormones can affect energy, mood, motivation, body composition, sexual function and cognitive performance. BHRT may help restore hormonal balance and support vitality, confidence and overall quality of life.

Sexual dysfunction
Hormonal imbalance can contribute to a range of sexual health concerns, including loss of libido, erectile dysfunction, premature ejaculation, vaginal dryness, discomfort during intimacy and anorgasmia. BHRT may help improve sexual desire, arousal, comfort and satisfaction in both men and women.

Testosterone Replacement Therapy (TRT)
Testosterone plays an important role in energy, cognition, mood, muscle strength, metabolic health and libido. BHRT-based TRT may be considered for both men and women where clinically indicated, potentially helping with fatigue, brain fog, concentration, memory, performance and sexual wellbeing.

Premenstrual Tension (PMT/PMS)
Hormonal fluctuations during the menstrual cycle can contribute to physical and emotional symptoms such as bloating, breast tenderness, headaches, irritability, anxiety and low mood. BHRT may help stabilise hormone levels and reduce symptom severity.

Premenstrual Dysphoric Disorder (PMDD)
PMDD is a severe, cyclical condition characterised by significant mood changes, emotional distress and physical symptoms linked to the menstrual cycle. In selected cases, BHRT may form part of a wider, carefully monitored treatment plan.

Polycystic Ovary Syndrome (PCOS)
PCOS is a complex hormonal condition that may involve irregular periods, acne, excess hair growth, weight changes, insulin resistance and fertility concerns. BHRT may be used alongside lifestyle and metabolic support to help address specific hormonal imbalances.

Depression and mental wellbeing
Hormones play a significant role in emotional and psychological health. BHRT may be considered as part of a holistic approach to low mood, anxiety and depression, including postnatal depression (PND), where hormonal factors are thought to contribute.

Osteoporosis and osteopenia
Declining oestrogen and testosterone levels can impact bone density over time. BHRT may help support bone health and reduce the risk of fractures when used appropriately and alongside other preventative measures.

Thyroid health and function
Thyroid hormones are essential for metabolism, energy, temperature regulation and cognitive function. Where appropriate, BHRT may support overall hormonal balance in individuals with thyroid-related concerns.

Skin and hair health
Hormonal changes can affect skin elasticity, hydration and clarity, as well as hair thickness and growth. BHRT may help improve skin quality and support healthier hair growth, including in cases of thinning hair, hair loss or acne linked to hormonal imbalance.

Perimenopause and menopause are natural life stages marking the gradual reduction and eventual cessation of a woman’s reproductive hormones, particularly oestrogen and progesterone.  

Perimenopause typically begins in the years leading up to menopause and can last several years, during which hormone levels fluctuate unpredictably.  Menopause itself is defined as the point at which menstrual periods have stopped for 12 consecutive months.  These transitions can occur at different ages and affect each woman differently.

Hormonal changes during perimenopause and menopause can give rise to a wide range of physical, emotional and cognitive symptoms. These may include hot flushes, night sweats, sleep disturbance, anxiety, low mood, brain fog, fatigue, joint pain, changes in skin and hair, reduced libido and vaginal dryness. For many women, symptoms can significantly impact daily life, relationships, work performance and overall wellbeing — yet they are often under-recognised or dismissed as “just part of getting older”.

Bioidentical hormone therapy (BHRT) aims to restore hormonal balance by replacing hormones that are structurally identical to those naturally produced by the body.  When prescribed appropriately and tailored to the individual, BHRT can help relieve many of the symptoms associated with perimenopause and menopause, supporting both short-term symptom relief and long-term health.

Treatment is personalised based on symptoms, medical history, risk factors and (where appropriate) hormone blood testing. By gently replenishing declining hormone levels, bioidentical hormone therapy may help improve sleep, stabilise mood, reduce hot flushes and night sweats, enhance cognitive clarity, protect bone health and support sexual and vaginal health. At Skin&Spirit, hormone treatment is delivered as part of a holistic, medically supervised approach, recognising that optimal wellbeing during midlife involves addressing lifestyle, nutrition, stress and overall health alongside hormone support.

Andropause, sometimes referred to as late-onset hypogonadism or age-related testosterone decline, describes the gradual reduction in testosterone and other key hormones that can occur in men from midlife onwards.  Unlike menopause, andropause does not involve an abrupt hormonal stop, but rather a slow and progressive change that can begin from the late 30s or 40s and continue over many years.

As testosterone levels decline, men may experience a range of physical, psychological and sexual symptoms.  These can include persistent fatigue, reduced muscle strength, increased body fat, low mood or irritability, poor concentration, reduced motivation, sleep disturbance, decreased libido and erectile difficulties.  Many men also report a loss of confidence or a sense of “not feeling like themselves”.  Because these changes often develop gradually, symptoms are frequently attributed to stress, ageing or lifestyle factors and may go untreated for years.

Bioidentical hormone therapy (BHRT) for men focuses on restoring testosterone levels using hormones that are structurally identical to those naturally produced by the body.  When clinically indicated and carefully prescribed, testosterone replacement can help alleviate the symptoms of andropause and support both physical vitality and mental wellbeing.

Treatment is individualised, based on symptoms, comprehensive assessment, blood testing and an individual’s overall health profile.  Optimising testosterone levels may help improve energy, mood, cognitive function, libido, sexual performance, muscle mass and body composition, while also supporting bone health and metabolic function. 

At Skin&Spirit, hormone therapy for men is delivered within a medically supervised, holistic framework — recognising that optimal outcomes depend not only on hormone balance, but also on nutrition, exercise, sleep, stress management and long-term health optimisation.

 Hormone replacement therapy (HRT) is available in several forms, and the terminology used can understandably cause confusion. Terms such as bioidentical, body-identical and synthetic are often used interchangeably, but they describe important differences in both the structure of the hormone and the way the medication is manufactured and prescribed.

Bioidentical hormones are hormones that are molecularly identical to those naturally produced by the human body and are derived from the same natural precursor sources used in pharmaceutical manufacturing.  When prescribed as compounded bioidentical hormone therapy (as we do at Skin&Spirit), the medication is prepared by a specialist compounding UK licensed pharmacy to a bespoke prescription for you, allowing the dose, combination and delivery format to be individually tailored.

Compounded bioidentical medicines are unlicensed, meaning they do not have a UK marketing authorisation as a finished product.  However, they are not unregulated. Compounding pharmacies operate within strict regulatory and professional frameworks, and prescribing requires clear clinical justification, informed consent and appropriate monitoring. This approach allows for greater flexibility, including careful titration, micro-dosing and adjustment over time in response to symptoms and clinical need.

Body-identical hormones are also structurally identical to human hormones and are derived from the same natural sources. The key difference is that these hormones are supplied as licensed pharmaceutical products, manufactured in standardised doses and formulations approved for widespread use.

While body-identical HRT is effective for many people, treatment options are limited to the formulations and dose ranges made available by pharmaceutical manufacturers. This can sometimes restrict the ability to finely adjust dosing, combine hormones in non-standard ways, or tailor treatment beyond a “one-size-fits-most” model.

Synthetic hormones are manufactured hormones that are not structurally identical to those produced naturally by the body. They may act differently at hormone receptors and can have a different side-effect profile for some individuals. Synthetic HRT remains appropriate for certain patients, but it is not always the preferred option where body-identical or bioidentical alternatives are suitable.

At Skin&Spirit, we recognise that hormone health is highly individual. Where clinically appropriate, we may recommend compounded bioidentical hormone therapy to allow for a more personalised, flexible and responsive approach than standard licensed options alone can provide.  This includes careful assessment, clear discussion of benefits and risks, informed consent, and ongoing monitoring to ensure treatment remains safe, effective and aligned with your changing needs.

 Hormone replacement therapy (HRT), including bioidentical hormone replacement therapy (BHRT), can offer significant benefits for many individuals experiencing symptoms related to hormonal decline or imbalance. However, like all medical treatments, it also carries potential risks.  

The decision to start hormone therapy should always be based on a careful consideration of individual benefits versus risks, guided by clinical assessment and ongoing monitoring.

When appropriately prescribed and monitored, BHRT and HRT may help to:

• Reduce vasomotor symptoms such as hot flushes and night sweats;
• Improve sleep quality, energy levels and overall vitality;
• Support mood, emotional stability and cognitive clarity;
• Improve vaginal, urinary and sexual health;
• Maintain bone density and reduce the risk of osteoporosis;
• Support muscle mass, metabolic health and body composition;
• Enhance quality of life, daily functioning and sense of wellbeing.
   

For many individuals, particularly those with moderate to severe symptoms, the benefits of hormone therapy can be life-changing and extend beyond symptom relief to longer-term health protection.

Hormone therapy is not without risk, and these risks vary depending on the type of hormone used, dose, route of administration, duration of treatment, and the individual’s medical history and risk profile.

Potential risks may include:

• Breast tenderness, bloating or fluid retention;
• Headaches, mood changes or skin reactions;
• Changes in bleeding patterns (in women with a uterus);
• An increased risk of certain conditions in specific populations, such as blood clots, stroke or hormone-sensitive cancers.
   

It is important to note that risk is not uniform. For many individuals — particularly when treatment is started at an appropriate time, tailored carefully and reviewed regularly — the overall risk remains low, and in some cases may be outweighed by the benefits.

There is no “one-size-fits-all” answer when it comes to hormone therapy.  What matters most is a personalised approach that considers symptoms, quality of life, personal and family medical history, lifestyle factors and individual health goals.

At Skin&Spirit, we take time to explore both the potential benefits and the possible risks, ensuring patients are fully informed and involved in decision-making.  Treatment plans are reviewed regularly and adjusted as needed, with a strong emphasis on safety, transparency and long-term wellbeing.  Hormone therapy is offered as part of a wider, holistic approach — recognising that optimal health involves more than hormones alone.

We are very transparent about the pricing structure for BHRT with Skin&Spirit.  Please see below for an itemised list.  

Skin&Spirit charge for the following:

• Initial prescription
• Repeat prescriptions
• Blood tests (although you can arrange for your own)

Unlike most specialist hormone clinics, Skin&Spirit does not charge for the following services:

• Initial comprehensive consultation (free)
• Monitoring and follow up (free)

You will pay the compounding pharmacy directly for your actual medication which starts at £70 for a single ingredient 3 month preparation.