Kylie Bunner, DNP, APRN, FNP-C, Institute for Hormonal Balance

Hormone Therapy

About the Expert

Dr. Kylie Bunner, FNP-C earned her Master of Science degree and completed the family nurse practitioner program at Texas Woman’s University. She went on to earn her Doctor of Nursing Practice degree from the University of Alabama. She is board certified by the American Academy of Nurse Practitioners and has been a certified BioTe provider since 2012.



What are bioidentical hormones?

Bioidentical hormones look exactly like your naturally occurring hormones. They can enter your body, go directly to the receptor site, and achieve the desired results. Synthetic hormones must be metabolized through the liver first, where they must convert to a different hormone and sometimes can cause the opposite effect then what’s desired. Where conventional hormone therapy is often only available in 1-2 set doses, bioidentical hormone therapy (BHRT) dosage can be tailored to the individual patient’s needs. BHRT can be administered through creams, patches, pills, or pellets. 

Why don’t more practitioners use bioidentical hormones? 

There was a — now discredited — study in 2002 called the Women’s Health Initiative, which incorrectly indicated that hormones were dangerous for women. This scared many providers and patients away from hormone therapy. The primary investigators in this study have walked back their findings, realizing they didn’t actually show bioidentical hormones to be dangerous for women. 

What are the benefits of BHRT?

Balanced mood, improved sleep, reduced brain fog, decreased hot flashes, decreased vaginal dryness, increased stamina and energy, increased muscle mass, decreased fat mass, increased libido, heart protection, bone protection, brain protection, and enhanced sexual response and desire.

How soon can I expect results from BHRT?

This depends on the type of hormone therapy you’re using. Typically, you should start to notice a difference within 7-10 days of starting a new therapy. With pellet therapy, you should notice a larger difference around 4-6 weeks. Sometimes adjustments to the treatment plan are needed. I ask new patients to commit to two rounds of pellets since dosage adjustments are sometimes needed to get patients feeling optimal. Following up with necessary blood work and communicating with your practitioner is imperative to achieving the best possible results.

How often will I need to follow up during my therapy? 

Hormone therapy is not black and white. We obtain initial lab testing, then test again 4-6 weeks after initiating therapy. The patient shouldn’t require labs again for another year unless we’re adjusting their dose. Most male patients need pellet therapy every 4-6 months. Most female patients need pellet therapy every 3-5 months. 

What about thyroid management?

Thyroid health is imperative to overall health status. Unfortunately, most practitioners only look at your TSH (Thyroid Stimulating Hormone). TSH does not give the full picture of thyroid status and looking at the Free T3 and Free T4 is necessary as well as looking at antibodies against the thyroid to determine if the patient has any autoimmune dysfunction causing the thyroid problem. 

Oftentimes, patients with low thyroid symptoms have labs that appear normal. Thyroid is involved in multiple aspects of health, including metabolism, temperature regulation, mood, and cardiac function, so finding a provider who will look at the whole picture is extremely important.

How much should I expect to pay?

Pellet therapy for women is $350 every 3-5 months. For men it ranges between $650 and $750 every 4-6 months

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