Business Hours

Mon-Thurs 9-4pm
Fri 9-3pm

Unit 2 Hemel & Aarde

Hermanus, 7201

071 536 1084

Book a Consultation

Best of Both Wellness
Holistic Medical Practice
Book Now!

Hormonal Health Harmony and Bio-identical
Hormone replacement information


As part of the menstrual cycle, the ovaries produce oestrogen and progesterone. They also produce androgens, which include testosterone. Hormone levels usually begin to change around the age of 40 and the perimenopause (the years just before menopause) is usually between 50 and 55. As hormone levels start fluctuating quite dramatically during perimenopause, women begin to have symptoms such as hot flushes, vaginal dryness, irregular periods and insomnia.

These hormonal changes are due to the ageing ovaries losing their ability to produce eggs and hormones. At this time, during the monthly cycle, women will have widely varying oestrogen levels as the ovaries continue to try to produce eggs. Often there will be cycles in which no ovulation occurs and no progesterone is produced. As a woman approaches menopause this can lead to irregular menstrual cycles with heavy or abnormal bleeding.

Hormone Therapy


At this point, the ovaries stop producing and releasing eggs (ovulating) each month and periods cease. The ovaries are no longer producing estradiol and progesterone (although they may continue to produce androgens). Menopause does not mean that there is no oestrogen in the body anymore. Women with more body fat will usually have more oestrogen than thinner women, because oestrogen is aromatised in fatty tissue. After menopause, there is much less oestrogen and testosterone in the body than before menopause, and very little progesterone.

This drop in hormone levels can have various effects, including the familiar symptoms of menopause such as:

  • Hot flushes
  • Night sweats
  • Vaginal dryness
  • Loss of libido.

Surgical menopause

A woman who has surgical menopause, in which her ovaries are removed (usually along with her uterus and fallopian tubes), will have a sudden drop in all sex hormone levels.

This sudden loss of hormones can cause severe symptoms and health problems, especially in younger women, unless adequate hormone replacement is provided.


In addition to protecting the uterus, progesterone:

Testosterone in Women

Testosterone is the hormone that provides women with muscle tone, sharp cognitive functions and libido. Due to declining ovarian and adrenal function, testosterone production tends to reduce with age, and women begin to experience confusion, weight gain and poor muscle tone, despite regular exercise. During menopause, levels will drop in excess of 33%. 

Hormone Therapy

Balancing testosterone with oestrogen produces serotonin, which supports emotional balance. Without this, a woman can experience emotional instability, anxiety, irritability and sleep disturbance.

An imbalance of testosterone can result in muscle atrophy, osteoporosis, muscle and joint pain. The role of testosterone in the body is to build muscle and promote muscle tone, increase libido, strengthen bone and, in some, it will improve mood and metabolism. There is an abundant amount of information supporting and rejecting the supplemental use of testosterone in hormone replacement therapy (HRT) for postmenopausal women. Theoretically, it makes sense that there are benefits of replacing all hormones that are decreased during menopause, including testosterone.

Further evaluation is needed to clearly determine the role of testosterone in postmenopausal women. If there is a family history of breast cancer, supplementation is not conventionally recommended, although some doctors believe that there may be a benefit in maintaining normal levels through supplementation. Testosterone supplementation is generally warranted in women complaining of low libido and sexual problems.

Hormone Therapy


The female hormone

Oestrogen is possibly the most important hormone for a woman. Without it, she has an increased risk for a number of health issues, including: premature ovarian failure, osteoporosis, heart disease, colon cancer, Alzheimer’s disease, tooth loss, impaired vision, Parkinson’s disease and diabetes.

Women have oestrogen receptors in a number of places throughout the body and brain. As a result, hormonal imbalance produces a variety of symptoms such as bone loss, mood changes, cognitive decline and loss of skin elasticity. When oestrogen levels rise, the amount of serotonin available in the brain increases, which improves mood.

About Oestrogen

The main forms of oestrogen found in a woman’s body are:

Estradiol, the main oestrogen made by the ovaries before menopause
Estrone, a weaker oestrogen produced in the ovaries and fat tissue. After menopause, this is the main oestrogen
Estriol, the weakest of the three main forms of oestrogen.

How Oestrogen functions in the body

Oestrogen stimulates a girl’s development into a woman who is capable of reproduction. Oestrogen travels in the blood to body tissues where there are oestrogen receptors. Oestrogen receptors are found in a number of parts of the body.

The effects of lower Oestrogen levels

When a woman’s oestrogen levels drop there are a number of negative effects. The end of menses is due, in part, to oestrogen levels that are too low to stimulate the lining of the uterus (endometrium).

Oestrogen loss can also cause

  • Hot flushes accompanied by night sweats and disturbed sleep
  • Vaginal dryness and loss of elasticity of vaginal tissue
  • Increased urinary tract infections and problems with urinary incontinence (difficulty holding urine)
  • Loss of sexual desire and function
  • Changes in mood, or depression
  • Memory problems
  • Breast changes, less firm
  • Thinner skin, less moisture
  • Loss of bone density, potentially leading to osteoporosis
  • Higher cholesterol levels.

DHEA (Dehydroepiandrosterone)

DHEA functions as a precursor to male and female sex hormones, including testosterone and oestrogen. Precursors are substances that are converted by the body into a hormone.

DHEA production peaks in the mid-20s and, in most people, gradually declines with age.

DHEA supplements can be made from wild yam or soy. There have been some interesting studies supporting the positive anti-ageing effects of DHEA supplementation.

DHEA supplementation is believed to increase the level of testosterone and oestrogen, and can have benefits such as: ​

Bioidentical hormones have exactly the same chemical and molecular structure as hormones produced in the human body.

Bio-Identical Hormones

The Endocrine Society has defined bio-identical hormones as ‘compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body’.

They are synthesised from a plant chemical extracted from yams and soy at a molecular level. They differ from synthetic hormones, which have a different molecular structure.

Hormonal imbalance

Typical symptoms related to hormonal imbalance are:

  • Low libido
  • Insomnia
  • Loss of muscle strength and tone
  • Poor concentration
  • Anxiety
  • Memory loss
  • Loss of confidence
  • Migraine headaches
  • Lack of energy


Bio-identical hormone creams

A doctor will prescribe the specific hormone dosage depending on the hormone test results and other health factors. Regular tests are required to ensure optimum levels.

The cream will release hormones into the bloodstream, which will provide relief for hormone deficiency symptoms.


Cream can be applied daily, as per the doctor’s instructions, either on the forearms, flanks, blushing areas or thighs. Vaginal application is also very effective.

Thanks to Fagron Compounding Pharmacy for information and references at

Book now to have your hormone levels and symptoms checked by Dr Julienne Fenwick. This forms part of all holistic medical consultations. 

Screening is done prior to prescribing bio-identical hormones: breast and pelvis ultrasound mandatory. 

Hormone blood levels are checked every 3 months (pathcare or lab of your choice) to ensure correct dosage until maintenance levels are achieved.