Bio-Identical Hormone Replacement Therapy

A combination approach to anti-aging, sexual health, and menopause symptoms

Most Insurance Accepted

Bio-Identical Hormone Replacement Therapy (BHRT)

Dr. Smitherman prescribes hormones that are identical to the hormones that are naturally in your body. Some hormones Dr. Smitherman prescribes include testosterone, estradiol, progesterone, thyroid, cortisol, DHEA, pregnenolone, and growth hormone (HGH) secretagogues.

Finding the right combination of hormones to replace decreasing levels as you age can help many women to restore their vitality, reduce menopausal symptoms, and provide protection against age related diseases.

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There are multiple ways to administer BHRT. Each way comes with its own distinct advantages and disadvantages. Dr. Smitherman has a discussion with each patient to help determine the right form of BHRT for them. Convenience, cost, preferences, lifestyle, and individual reactions all play a roll in determining the right type of BHRT for you. Below is an overview of each hormone and the available routes of administration, as well as a summary of each route of administration.


  • Estradiol: Pellet, Oral, Topical, Injectable
  • Progesterone: Oral, Topical, Injectable.
  • Testosterone: Pellet, Injectable, and topical.
  • DHEA: Oral and Topical
  • Thyroid: Oral
  • Pregnenolone: Oral
  • Cortisol: Oral
  • HGH secretagogues: Oral and injectable.

Routs of Administration

  • Pellet: Pellets are inserted every 4 months in office. The advantages are convenience, and steady hormone levels. The primary disadvantage is cost.
  • Oral: Oral administration of hormones is daily.
  • Injectable: Self administered injection into thigh, abdomen, or buttock.
  • Topical: A topical cream or gel can be administered once or twice per day. For estradiol, there is a patch that can be placed once or twice per week.

There are many options for how a person does BHRT. The most common options that Dr. Smitherman’s patients choose is estradiol tablet, progesterone tablet, and testosterone injection. The combination of these three hormones can be obtained for as little as 90 cents per day without the use of insurance. Office visits with Dr. Smitherman cost $150, and once a person has been on hormone replacement therapy for a while and things are running smoothly, office visits can be as little as every 6 months. Lab testing for a person who has been on therapy and things are going well can be as little as once per year. Lab testing out of pocket can be as cheap as $50. The lowest amount of money for a person who is doing all cash without insurance can be $715 per year. 

Vaginal Rejuvenation and Stress incontinance

PRP injections can help to improve vaginal atrophy, vaginal dryness, stress incontinence, pain with sex, clitoral sensitivity, arousal, and ability to orgasm. Dr. Smitherman will first clean, and numb the tissue of the vulva and vagina with a strong topical numbing medication. Then we take blood, and process it to concentrate the cellular compounds called platelets. These cells contain natural growth factors that can regenerate blood vessels, regenerate nerve endings, and regenerate soft tissue. The articles below explain more about PRP genital injections.

Sexual Arousal and orgasm

Many women suffer from hypoactive sexual desire disorder (HSDD). In addition to hormone management, some women may also require additional measures to improve sexual desire, enjoyment, and orgasm. Dr. Smitherman also offers compounded topical medications that improve the blood flow to the genital tissue. These custom formulations are affectionately referred to as “Scream Cream”, and “Yell-Gel”. The ingredients in these topicals include: Aminophylline, sildenafil, papaverine, and arginine. Additionally, Dr. Smitherman prescribed a subcutaneous injection called PT-141 which is known as the “female Viagra”.

General Womens Health statement

At this time, Dr. Smitherman is practicing specialty care in the areas outlines above. Dr. Smitherman does not practice primary care, or gynecology in a comprehensive fashion. Dr. Smitherman requires his patients to maintain their regular health check ups with their primary care, and/or gynecology physicians to maintain health and wellbeing.