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Bioidentical Hormone Replacement Therapy

Inga Zilberstein, MD

Gynecology located in Upper East Side of Manhattan, New York, NY

Production of estrogen, progesterone, and testosterone can begin to fluctuate as many as ten years before menopause. This leads to irregular periods, a decrease in fertility, as well as hot flashes, mood disorder, loss of energy, and many other symptoms. Dr. Inga Zilberstein, MD, PLLC, on the Upper East Side of Manhattan in New York City, offers bioidentical hormone therapy to improve hormone balance and ease symptoms. To schedule a consultation with this board-certified OB/GYN, call the office or book an appointment online today.

Bioidentical Hormone Replacement Therapy Q & A

What is Bioidentical Hormone Replacement Therapy?

Bioidentical Hormone Replacement Therapy is a natural form of hormone replacement therapy (HRT). Dr. Zilberstein uses HRT to treat symptoms associated with menopause and perimenopause. 

Taking small amounts of estrogen, progesterone, or testosterone may help you feel better, maintain your mental acuity, and continue your demanding lifestyle. 

Bioidentical hormones are hormones that are manufactured according to the same chemical structure as the hormones our body makes. Though referred to as “natural” hormone replacement, it is important to remember that the only “natural hormones” are the ones that are produced by our bodies.

Am I a candidate for Bioidentical Hormone Replacement Therapy?

Dr. Zilberstein determines if you’re a candidate for bioidentical hormone therapy after a comprehensive evaluation.

The degree of fluctuation in hormonal production and the severity of its symptoms varies greatly among women. It is important to evaluate each woman’s symptoms individually, considering her weight, lifestyle, and level of stress, as well as personal and family history. 

Her attitude towards the treatment, along with the lifestyle changes she is willing to take, are also important factors that determine the treatment best suited to her specific needs.

You should schedule a consultation with Dr. Zilberstein if you’re experiencing symptoms of menopause or perimenopause such as:

  • Hot flashes
  • Night sweats
  • Mood changes
  • Insomnia
  • Lack of energy
  • Mental haziness
  • Depression
  • Low libido
  • Vaginal dryness
  • Decreased ability to achieve orgasm
  • Weight gain
  • Hair loss
  • Dry skin
  • Bone loss
  • Frequent vaginal or urinary infections 

How is Bioidentical Hormone Replacement Therapy given?

Dr. Zilberstein customizes each patient’s bioidentical hormone therapy to match her unique hormonal needs. She works with you and a compounding pharmacy to better match the dosage and combination of hormones your body needs to achieve the best results.

There are many different preparations of HRT available today. Estrogen can be prescribed in different doses, and in different applications: pills, creams, and patches. Bioidentical progesterone is available in intravaginal cream preparations and pills. Bioidentical testosterone can be administered transdermally.

When prescribing HRT, Dr. Zilberstein encourages lifestyle changes in addition to hormone therapy to get the best results, including eating a healthy diet, getting regular exercise, and finding healthy ways to manage stress. 

Dr. Zilberstein schedules regular follow-up appointments to monitor for side effects, as well as to check your symptoms and hormone levels so she can adjust your treatment as needed. 

Bioidentical hormone therapy may help you feel more like your usual, energetic self. Call the office of Dr. Inga Zilberstein, MD, PLLC, or book an appointment online to schedule your assessment and see if bioidentical hormone therapy makes the right choice for you.  


Where is the best place to apply estrogen cream?

The best places to apply estrogen cream are areas where the skin is thin and blood vessels are close to the surface, ensuring efficient absorption. Common application sites include:

Lower Abdomen: This area also has thin skin and is commonly recommended. Outer Vaginal Area: For local symptoms of menopause like vaginal dryness or discomfort, applying estrogen cream directly to the vaginal area can be effective. Inner Forearms: Some people use the inner forearms for convenience and effective absorption.

General Tips for Application:

Follow Prescription Instructions: Always follow the specific instructions provided by your healthcare provider or the product leaflet. Clean and Dry Skin: Apply the cream to clean, dry skin to ensure optimal absorption. Avoid Sensitive Areas: Do not apply the cream to broken, irritated, or sensitive skin unless directed by your healthcare provider. Wash Hands: After applying the cream, wash your hands to avoid unintentionally spreading the hormone to other areas or people. Always consult with your healthcare provider for personalized advice, especially regarding the frequency and exact application method suited to your health needs.

How to apply estrogen cream with finger

Applying estrogen cream with your finger is straightforward. Here are the steps to follow:

Wash Your Hands: Start by washing your hands thoroughly with soap and water to ensure they are clean.

Prepare the Cream: Dispense the prescribed amount of estrogen cream onto your fingertip. The dosage is typically specified by your healthcare provider.

Apply the Cream:

Inner Thighs/Lower Abdomen/Inner Forearms: Gently rub the cream into the skin until it is fully absorbed. Make sure to spread it evenly over the area. Outer Vaginal Area: If the cream is prescribed for vaginal use, apply it gently around the outer vaginal area (vulva) or as directed by your healthcare provider. Massage In: Use circular motions to massage the cream into the skin. This helps with absorption.

Wash Your Hands Again: After applying the cream, wash your hands thoroughly to avoid transferring the estrogen to other parts of your body or other people.

Tips for Effective Use:

Consistent Timing: Apply the cream at the same time each day to maintain consistent hormone levels. Avoid Sensitive Areas: Do not apply the cream to irritated, broken, or sensitive skin unless instructed by your healthcare provider. Follow Dosage Instructions: Use the amount of cream prescribed by your healthcare provider. Do not use more or less. Allow Time for Absorption: Give the cream time to absorb before dressing to avoid transferring it to clothing. Always refer to the specific instructions provided by your healthcare provider or the product leaflet for any additional or specific guidance related to your estrogen cream.

We offer treatment for Functional medicine, stress, sex hormones, Organic Acid Testing, and Gastrointestinal testing located in Manhattan, New York, NY. Call us to book your appointment today.