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How long does it take for BHRT to start working?

By the time a patient-client reaches GenAge, he/she has typically had noticeable signs and symptoms of dropping gonadal (primarily testosterone and estrogen) hormone levels for months, if not years. Many doctors still don’t know enough about menopause and andropause to attribute signs and symptoms to the condition correctly. Laboratory testing is often incomplete, creating a “false negative.” Worse yet, the accepted “normal” ranges do not consider the alarming drop in North American testosterone levels over the past 50 years. This affects men particularly. Since 1980, male T levels have dropped between 32 and 38%, depending upon which literature one reads. Finally, the standards for clinching the diagnosis of hypogonadism are very low indeed. Many insurance companies require two morning total testosterone tests showing levels below 300ng before treatment with synthetic testosterone will be authorized. Aside from the fact that synthetic testosterone is NOT the ideal treatment for low testosterone, waiting for the total T to hit 300ng can entail years of feeling poorly, with low energy, low libido, increasing body fat and decreasing muscle mass.


At GenAge, we can typically diagnose hypogonadism at the patient’s first appointment. The signs and symptoms are almost never subtle. Still, we obtain extensive bloodwork to more fully assess the presentation and to see if other deficiencies are contributing to the misery. Two weeks after that first appointment, we almost always know where we can start to help. In both men and women, we begin the recovery process with testosterone supplementation, nutraceuticals to reverse vitamin deficiencies and an exercise program that actually works.

Our patient-clients can expect to start feeling better within 4-6 weeks. GenAge utilizes only bioidentical therapies to avoid problems associated with synthetic hormone replacement (e.g., increasing cholesterol levels, increasing insulin resistance, higher visceral fat levels, increased risk of vascular disease, etc). Bioidentical hormones come in the form of implanted pellets, topical creams, and oral lozenges/troches. While oral preparations have the fastest onset, they also have the shortest duration of action. Using one lozenge every 8 hours boosts hormone levels for roughly 12 out of 24 hours. The creams, applied twice daily alongside the scrotum or labia, build up a depot in the subcutaneous tissue, which gives them longer durations of activity. Activity from the bioidentical creams takes about 2-3 weeks to take hold, which is roughly what the implanted pellets require. However, it’ll be 4-6 weeks until physicians can consistently see improved blood levels and the patient-client can consistently feel the difference.


It takes 12-18 months for the full benefits of BHRT to manifest. Dropping body fat, building muscle mass, rediscovering a healthy sex life, and establishing the battery of healthy behaviors that will change things takes patience and discipline, but the rewards make the effort worthwhile.


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