Medical Services

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Bio-Identical Hormone Therapy (BHRT)

Balanced hormones are necessary for good health and disease prevention for both men and women as we age.


Hormones are chemical messengers made by the endocrine glands that act to control certain actions of cells and organs. When hormones are balanced you can expect to feel increased mental clarity, prevent age-related illness, regain energy and muscle strength, have a greater ability to lose weight, and feel younger and happier with an increased quality of life. Hormones are the body’s regulatory substances, which keep us functioning daily. Common hormones include estrogen, testosterone, progesterone, growth hormone, and insulin. While our hormones do a pretty spectacular job keeping us well regulated and functioning at our highest levels from day to day, as we age, these hormones can become imbalanced. Hormone imbalance can manifest in many ways and can significantly impair our daily lives. Hormones are the foundation of feeling good, therefore keeping them balanced is crucial when it comes to feeling our best every day. When there are issues with hormone imbalance, we treat this with bio-identical hormone replacement therapy or BHRT.


Bone density differences after being treated with Bio-identical hormone therapy pellets

Bone density differences after being treated with Bio-identical hormone therapy pellets

Estrogen, traditionally classified as the female sex hormone, is a steroid hormone produced predominately by the ovaries, but also in the adrenal cortex, placenta, and testes. Large amounts of estrogen are present in women and very small amounts are present in men, however estrogen plays a crucial role in both men and women. Estrogen has over 400 functions in the body. A few important body functions include controlling hot flashes, increasing serotonin and dopamine (the “happy” hormones in the brain), and maintaining bone density, memory, and collagen in skin.

Other functions of estrogen include, maintaining elasticity in the arteries, decreases wrinkles, decreases bad cholesterol and other risk factors for heart disease such as LDL and lipoprotein A. Estrogen also improves fine motor skill, improves insulin sensitivity, increases concentration, improves HDL (good cholesterol), increase water content in the skin which will help keep skin soft, maintains bone density, improves metabolic rate, protects against heart disease, and protects the eyes from macular degeneration and cataracts.


Testosterone, commonly considered the male sex hormone, is a steroid hormone that stimulates the development of male secondary sexual characteristics and is produced mainly in the testes, but also in the ovaries and the adrenal cortex. Testosterone functions in both genders. Testosterone provides signals to the body to make new blood cells, and to keep muscles and bones strong. It also enhances libido and regulates the release of luteinizing hormone and follicular stimulating hormone. While testosterone is present in large amounts in men and only small amounts in women, both men and women need testosterone.

A healthy level of testosterone provides major symptom relief and protects the bones, brain, breast, heart, and relationships. Men between 30-70 years of age will lose 1-3% of their testosterone producing ability per year and women between 20-40 years of age lose up to 50% per year. However, bio-identical testosterone treatment restocks the body with the testosterone it no longer produces.

Benefits that may be experienced from bio-identical testosterone therapy include increased energy, vitality and zest for life, improved overall well-being, depression and anxiety relief, improved cognitive clarity, memory, and focus, cardiovascular protection, increased bone and muscle strength, reduced body fat, lower cholesterol, enhanced libido and performance, and prostate and breast protection.

Women and Menopause

Menopause is a natural process that occurs in women 12 months after their last menstrual period and marks the end of menstrual cycles. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States. Menopause occurs when the ovaries progressively stop producing estrogen and progesterone due to the natural cessation of ovulation caused by aging. Women also experience decreased testosterone levels with aging, often before the depletion of estrogen and progesterone.

Men and Andropause

Andropause is the male equivalent to menopause that occurs as hypogonadism, which means the testicles don’t produce enough of the male sex hormone testosterone. Andropause occurs in two forms, primary or primary testicular failure, originates from a problem in the testicles, and secondary which indicates a problem in the hypothalamus or pituitary gland. The hypothalamus and pituitary gland are parts of the brain that signal the production of testosterone by the testicles. Hypothalamus produced gonadotropin releasing hormone signals the pituitary gland to produce follicle-stimulating (FSH) and luteinizing hormone (LH). The luteinizing hormone then signals the testes to produce testosterone.

Hormone Imbalance

As we age our hormones have a difficult time remaining balanced. Hormone imbalance often goes undetected and can manifest in many different ways. Common symptoms of hormone imbalance include, but are not limited to, difficulty sleeping, lack of energy and fatigue during the day, reduced mental focus and memory, weight gain and inability to lose weight, decreased muscle strength, reduced libido, muscle and/or joint pain, as well as psychological symptoms including anxiety and depression. Any combination of these symptoms with varying degrees of severity may indicate an imbalance in hormones. However, these symptoms are commonly managed using treatments that do not address the hormonal issue, therefore failing to target their root cause.

Bio-identical vs. Synthetic Hormone Therapy

Bio-identical hormones are natural medications that replace what your body is no longer producing. Pharmaceutical or synthetic hormone replacement has not been identical to what the body naturally produces. The use of synthetic estrogens or progesterones and testosterone can be very dangerous. The pharmaceuticals are not the same chemical structure as what the body produces and therefore, the metabolites (breakdown products) can lead to many of the unwanted effects.

With the use of bio-identical hormones, we try to mimic nature and replace what the body is no longer producing or producing in suboptimal levels. The bio-identical hormones are the same chemical structure that is made by the body. For example, there are 3 estrogens produced by the body: estrone, estradiol, and estriol. When replacing these hormones, we use the same chemical formula, thus they are ‘identical’ to what nature provided.

Bio-identical Hormone Therapy with Pellets

Real patient testimonial: Treay — Low Testosterone therapy with BHRT pellets

Myth vs Facts & Truth of hormone therapy pellets, used since 1939

Myth vs Facts & Truth of hormone therapy pellets, used since 1939

Pellets are a medium in which bio-identical hormones are delivered to the body. They are natural, plant derived compounds with the same molecular structure as human hormones. Hormone pellets are the most widely studied form of natural hormone replacement and studies show that hormone therapy using pellets lasts longer than other hormone therapy treatments. In fact, pellet therapy is the only hormone therapy that delivers sustained hormone levels throughout the day for up to 3 to 5 months. Hormone pellets are created by a compounding pharmacist who fuses estrogen or testosterone into small cylinders, depending on what your body needs. Each pellet is individually dosed after a simple blood test determines exactly what you need. The pellets, which are very small in size, are placed in the fatty tissue just beneath the skin mimicking the actions of healthy ovaries and testicles by releasing a steady stream of hormone to the bloodstream.

For best results, Dr. Portales and the OC Medical Tustin office has partnered with BioTe Medical to obtain our high-quality hormone pellets and have 97% accuracy in first-time dosing.

To get started, you will need a simple blood test to determine if you are a candidate for Bio Identical Hormone Therapy (BHRT).  Schedule an appointment now, or call us at (714) 442-6642 or request an appointment online.

To learn more about BioTe, go here