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Bio-Identical Hormones Georgia Atlanta Athens

The New Image Approach to Female BHRT at Any Age

  Female hormone imbalance happens at any age, not just menopause. 
  The average woman suffers with a female hormone imbalance for over 10 years PRIOR to menopause. 
  Cyclic Symptoms, Heavy Periods, Hot Flashes, Headaches, Mood Swings, and Fluid Balance are just a few of the symptoms related to Female Hormone Imbalance. 

Precise Salivary Testing

… assures we get the right dose of each hormone every time customized to your unique needs.

Board-Certified OB/GYN

… with over 16 years’ BHRT experience individually designs and manages your treatment.

On-Site Compounding Lab

New dose? No problem!  Get your refill at your visit.
No Painful Shots or Pellets.

Female BHRT Video Library

Produced by New Image
BHRT Medical Director, Gregory Zengo, MD


Atlanta & Athens Bio-Identical Hormone Treatment for Women

At New Image, Female BHRT has been a core service since 2002.  It all begins with accurate salivary hormone testing to truly identify which hormones are deficient and by how much.  This is correlated with your symptoms to create the most bio-identical treatment for you.  However, it takes treating thousands of patients to realize that female hormones alone are not usually the only cause of your symptoms.

Our philosophy, which has been backed up with decades of research on salivary hormone testing, is that imbalance between the ovarian hormones estradiol, progesterone, and testosterone can lead to cyclic symptoms, and most symptoms attributed to menopause in later life. Too much estradiol, too little estradiol, or too little progesterone can all contribute to hot flashes, vaginal dryness, breast tenderness, PMS, and irregular periods among other symptoms. Testosterone is also an important female hormone that can preserve bone and be cardioprotective.  It’s proper testing and replacement is a cornerstone of all of our treatments. Therefore, accurate testing of all 3 major ovarian hormones is needed to find the true deficiency.

Stress, even a small amount, can upset the delicate ovarian balance long-term.  It is hard-coded into our DNA.  A stressed mammal should not reproduce, and that leads to changes in progesterone and testosterone, in addition to estrogens.  Therefore, at the first visit, we carefully select testing of other likely systems that are affected by stress.  This includes the Thyroid and Adrenal body clock assessment.  Anyone who claims they can get women feeling their best with female hormones alone does not understand human physiology and most likely uses dangerous overdosing of sex steroids.  Our dosing is always at or below the pharmaceutical FDA-approved estrogen, progesterone, and testosterone products for women.

Anyone can order a large, expensive list of testing at all new patient visits.  We use decades of experience to order the right tests for you and save you hundreds of dollars in your initial assessment.  Customized lifestyle and nutritional counseling is always incorporated into the treatment plan from the initial visit and at every follow-up.  GI, Neurotransmitter, and Genomic analysis can also be used in more complex cases when needed.

Did you know that there is no drug FDA-approved for female hormone imbalance either in menopause or before? That’s right. Menopausal pharmaceutical hormones are FDA approved only for treatment of hot flashes, not for restoring a normal balance.  Bio-identical medicine has the only real and rational correction of the true hormone deficiencies that lead to your symptoms.  Since the approval of Prozac in 1991, too many women have had their cyclic symptoms managed with antidepressants.  We NEVER use anti-depressants or birth control pills for managing cyclic symptoms.  Those mask the symptoms instead of treating the source.  Instead, we do the salivary test on the most symptomatic day of the cycle to diagnose the deficiency and replace what is missing.

Our on-site Compounding Lab can fill your prescription at your visit for maximum convenience and accuracy.  For many patients, the monthly cost of their entire hormone treatment is less expensive than a single drug copay.

All of these benefits are yours for NO monthly fee, and NO membership costs of any kind.

The New Image Path to Wellness
Saliva Testing and Stress Hormone Balancing Program

Bio-Identical Medicine means replacing EXACTLY what the body is missing due to age, stress, or both.  This non-drug form of therapy means there are no side effects since the therapy is not a foreign substance in the body.  Bio-identical therapy restores balance, and we can prove that balance is restored by checking subsequent hormone levels.  When was the last time someone offered you an Ambien level, Premarin level, or a Zoloft level?  Those levels don’t exist.   BHRT medicine is simply more precise.  Unlike many drugs, the breakdown metabolites of these natural hormones are also active in the body, and serve to support many more unseen pathways.  For example, giving Zoloft for depressive symptoms can suppress the natural sleep hormone Melatonin.  Testing and giving back the right amount of a serotonin precursor instead can support Melatonin production.

Many patients use this kind of testing and treatment to come off of stimulants and antidepressants which never helped in the first place.  At the conclusion of testing, many patients realize that they do not have any “diseases”, but they learn about their very real, and measurable, stress-induced imbalances that are directly responsible for their symptoms.

All office visits are billable to most private insurance plans except Kaiser and Ambetter.  We offer reasonable cash visit prices for these patients and ones who have Medicare or Medicaid.  We accept HSA cards for payment.  For patients without insurance or have high deductibles, we have low cost live and even cheaper online visits for your ongoing care and needs.

At your first visit, you will meet with Dr. Zengo to discuss and prioritize your symptoms over time.  Based on this initial assessment, the appropriate testing will be ordered.  This can include blood tests for detailed thyroid function ($50 if not billed to insurance), salivary adrenal and gonadal performance ($105-$219), GI testing ($319 and up), and/or Neurotransmitter testing ($209).

Your results will be reviewed at your second visit and targeted bio-identical therapy will be prescribed.  This often involves nutritionals and vitamins.  In some cases, bio-identical hormones will be prescribed.  Some of these will be available at your local pharmacy since many bio-identical hormones are still regulated as prescriptions even though they are not “drugs”.  Others will need to be compounded creams and all of our patients are eligible to receive compounded prescriptions at a deep discount from our in-house compounding lab.

At follow-up visits every 6-12 weeks, progress is assessed using many indicators.  Only rarely will repeat salivary testing be necessary in the first 6 months.  Many patients graduate our program and no longer need any prescription therapy after 12 months.  Others who continue with our program (menopause, andropause, and more chronic cases of higher stress exposure) typically need repeat salivary testing every year and thyroid testing after every medication or dose change.

Frequently Asked Questions about Female BHRT

What Does BHRT Testing and Treatment Cost?

There are clinics all over Atlanta who do not take insurance and cost you over $1,000 to get in the door.  They do a bunch of unproven, expensive, high-profit testing followed by a prescription of proprietary supplements that can set you back hundreds of dollars a month.

All of our office visits are billable to insurance.   We do not bill Medicare but offer low cash pay pricing.  Yes, our salivary kits are much cheaper than the ones you can buy online.  Nobody in the entire country offers these tests cheaper than we do for our patients.  The majority of patients do the $219 saliva panel and the thyroid bloodwork (billed to insurance) at the first visit.

No compounded cream we sell costs more than $40 per month.  All of our testing and supplements are priced well below advertised list prices, and you are never required to purchase anything from our office.  We have the most economical, yet complete approach to stress-induced hormone imbalances anywhere.  You cannot afford NOT to find out your stress hormone levels and learn the simple steps to fighting back the stress-induced symptoms we so often write off as aging.

Why Test Hormones in Saliva?

Salivary Hormone testing was first described in 1959. There have been over 1,000 papers published that have confirmed the validity of salivary testing for steroid hormones in saliva. Steroid hormones include all hormones produced by the adrenal gland, the ovary, or the testes. Steroid hormones are made in very small quantities throughout the day and tend to be 98-99% absorbed in their first pass through our circulation. Therefore most of the hormone we make or absorb into our bodies at any given moment never makes it into the vein that we draw blood from.  Venous blood is like the trash of the circulatory system, and precious free steroid hormones are not thrown into the trash by our bodies. So any attempt to measure any steroid hormone in the venous blood, may not reflect the true body tissue levels where the hormones are supposed to work.

There is a capillary bed in the saliva gland so the newly made steroid hormones will be deposited into the gland (as they are absorbed by every other key body tissue) and then into the mouth to be accurately measured. We use salivary hormone testing to obtain accurate baseline hormone levels and also to monitor our patients dosing while on bio-identical hormone therapy to ensure that we have restored the normal balance that stress has taken away.

What is Bio-Identical Therapy?

Bio-Identical hormone therapy involves replacing a missing hormone to achieve normal levels by giving back the exact missing hormone in the proper dose.  In order to know what hormone and what dose to give, we need accurate testing of levels, and this is why salivary levels are so important for Cortisol, DHEA, Estrogens, and Testosterone.  And why we also need more thyroid testing than the standard TSH level.

But we take Bio-Identical Hormone therapy to another level. Our experience has enabled us to find the ultimate balance between the restoration of normal hormone levels and the relief of symptoms.  Other clinics can relieve symptoms very rapidly using Bio-Identical Hormones but they use doses that are anything but bio-identical. The doses in these pellets and injections are borderline toxic.  This form of hormone overdose leads to a feeling of well-being and symptom relief for a few short time, then the symptoms often return even worse as the body becomes addicted to the hormone, craving higher and higher doses.  Any provider that does not administer repeat salivary testing while on therapy is not ensuring your health and protecting you from potential overdose.  Patients at New Image are not overdosed.  We do not use hormones as drugs like the expensive Anti-Aging centers and the drug industry.

What is Adrenal Fatigue and Why Test the Adrenal?

The adrenal gland is our first responder to stress.  It is also one of the most ignored glands by conventional medicine.  Emergency conditions that cause an extreme over production or underproduction by the adrenal gland (Cushing’s and Addison’s diseases) are rare and treated aggressively by endocrinologists.  However, more subtle elevations and depressions of adrenal function are still not recognized by many physicians as a treatable condition.  Research over the last 100 years has shown that conditions induced by stress….. adrenal over-activity and adrenal fatigue are very real and treatable entities. We even have research linking stress-induced adrenal fatigue to chronic fatigue syndrome, fibromyalgia, “adult ADD”, cancer mortality, and early death from heart attack.

We have also established that the 4-point salivary cortisol test is a valid indicator of adrenal status during the entire day.  Since its discovery in 1959, this test is truly the closest thing we have to a test for your stress level. Elevated cortisol in the early stages of stress can result in mental fog, overeating, weight gain, inability to fall asleep, and anxiety.  Interestingly, chronic stress that leads to adrenal fatigue also has similar symptoms except that victims tend to have mental fog most of the day and struggle to get through the day both mentally and physically.  It is estimated that 60-80% of American adults have some kind of stress-induced adrenal imbalance.  And this is why the establishment of medicine will never treat adrenal fatigue as a disease.  It is just too common, so they just attribute adrenal fatigue to “normal aging”.

Almost every adult American with any symptoms on the hormone checklist owes it to themselves and their family to get tested and optimize their adrenal function with simple treatments that can improve energy, sleep quality, and mental clarity in weeks to months. The best thing about this treatment is that adrenal dysfunction is not a disease and does not require a lifetime of treatment. So what are you waiting for?  Most patients who feel like they are “getting old” in their 30’s-50’s most likely have stress-induced adrenal fatigue.  Get your stress test now! 

Why test the Thyroid along with Salivary Hormone Testing?

Cellular metabolism depends on the thyroid gland for its regulation. The Hypothyroid symptomsdelicate regulation of the thyroid can be upset by stress in its many forms.  Often this stress masks the diagnosis since the most common diagnostic test, the TSH level often remains in the normal range.  In addition to using a strict and very narrow “bullseye” range for your TSH, we depend on Free T4 and Free T3 levels to make our diagnosis.  We also check for thyroid-attacking autoantibodies and help these patients before they become symptomatic.  We have treated over a thousand patients with thyroid replacement whose results are in the “normal range” for TSH with outstanding improvement of symptoms.

Our treatment includes such options as giving T3 or the more complete thyroid substitute, Dessicated Thyroid (Armour, Naturethroid, NP)  instead of just Synthroid or Levothyroxine. If you are one of those patients who were diagnosed hypothyroid and are just not feeling better on your therapy, you owe it to yourself to get tested and see if something in your treatment regimen is missing.

In addition, adrenal dysfunction can also bring the thyroid function down with it. That is why testing all systems at the same time yields the fastest and most dramatic results.

My Nurse Practitioner says salivary testing does not work, why do you use it?

Sex steroid hormones only work when they enter the cell.  And the only sex hormones that CAN enter the cell are ones that are freshly made/absorbed and unbound in the blood.  Serum testing looks at venous waste and is contaminated with bound hormones.  No matter how hard they try to calculate/estimate a free hormone level, it has a huge error range.

Serum is the testing of choice for overdosers (pellets and injections) since the massive hormone overload of the tissues (saliva) is masked in the venous waste and falls inside the massive “normal” ranges for venous waste.  See this video for more information and then check out this video for even more details.

Salivary testing has support from the medical literature for 60 years, yet it is not part of a nursing school curriculum.  Here is more information on the validity of salivary testing.  All labs we use are fully CLIA-Approved, which is the highest standard for labs in the USA.

I have had dried urine testing (Dutch test) before, can I use that with you?

Dried urine is a reasonable test to look at estrogen metabolites in special cases.  However, there are ZERO published papers on dried urine as a test of active hormones.  If anything, it correlates to venous blood which we have already established is useless for testing active steroids.

Will I feel as good on daily dosed creams as I do on my injections or pellets?

Daily dosed creams give the ultimate, consistent levels and mimic ovarian production better than anything that is dosed less frequently.  While the highs on shots and pellets are “higher” you are literally overdosed to feel that high and pay for it later as your receptors become “numb” to even normal levels of hormones.  Consistency over months is what allows patients to feel their best instead of riding on a dose/withdrawal rollercoaster.

What can you do for perimenopause symptoms while still having cycles?

Perimenopause is the time when the delicate cyclic hormone balance changes, often due to lower fertility.  This results in irregular cycles and amplified cyclic symptoms.  Perimenopause can start as early as the mid-30’s and last up to 15 years.  Our salivary testing is the best way to see where you stand in this transition.  We will continue to test and adjust your replacement as indicated by repeat levels done as symptoms and time warrant.

We have found that the best way to control perimenopausal symptoms is to balance all of the key stress inputs outside of the female reproductive system, since sex steroid production is more heavily influenced by stress inputs now than when you were age 20 or 30.