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Dr Pickens Gantt M.D.

Board Certified Reproductive Endocrinologist.

Tri Cities
Virginia, Tennessee

Infertility doctor.
Male menopause.
Female menopause.
IVF doctor.
Tubal Reanastomosis.
Natural Hormones.
HGC Diet
Male Hormones.
Testosterone Treatment.


Dr Gantt, Board Certified Reproductive Endocrinologist

Serving the Tri Cities Area.


Any woman entering peri-menopause, menopause or post-menopause should consider natural hormone replacement therapy to relieve the symptoms associated with menopause and for its many benefits:

Natural hormone replacement therapy is not the same as taking the commercially available prescription hormone medications.  Natural hormones match your own hormones exactly, and are not associated with the many side effects of conventional hormone replacement therapy.  The bio-identical plant-derived hormones are the proven safe alternative to Premarin and Provera.


The term natural can be confusing. When referring to hormones, natural means the chemical structure is identical to the hormone that your body made prior to menopause.  Just because a product is natural does not mean that you can go out and buy it in the health food store.  Dr. Gantt prescribes only pharmaceutical-grade hormones derived from plant sources to make your hormone replacement medications.  These natural hormones are a drug and do require a prescription.

Most medications used to treat menopausal symptoms in the past have used synthetic hormones.  A synthetic hormone has a synthetic similar to your own hormones, but it is not structurally identical.  The synthetic hormone will act differently in your body often causing troubling side effects.  Natural and synthetic hormones should not be considered interchangeable.

Prior to menopause your body makes estrogens, progesterone and testosterone.  Most regimens include one or more of these.  There is not one specific combination that works for everyone.  Each woman is different and will have special needs.


Most women know that their body makes estrogen, but did you know that “estrogen” is actually a family of hormones?  Women make many different types of estrogen.  Natural hormone therapy can include a single estrogen, two estrogens (Bi-Est = estriol 80% with estradiol 20%) or all three estrogens (Tri-Est = estriol 80%, estradiol 10% and estrone 10%).  The three major estrogens that all woman produce are:

Estrogen taken alone can cause the cells of the uterus to become malformed.  Progesterone is used in conjunction with estrogen to control this effect and protect you from endometrial abnormalities.  You can choose between synthetic progesterone called “progestins” or natural progesterone.


Progesterone is a naturally occurring female hormone that is produced in the ovaries.  Progesterone functions in the body include:

Women often think they do not need progesterone if they no longer have a uterus.  This is not true.  Your body still has progesterone receptors in other areas of your body that still need progesterone to produce the effects listed above.
The progesterone used in natural hormone therapy is derived from soybeans or wild yam.   It is chemically and biologically identical to your own body’s progesterone and therefore functions the same way.   An oral form of natural progesterone is not commercially available in the U.S., but can be compounded by specialty pharmacies.


Testosterone is a hormone most women think is only for men.  Testosterone is an androgen, or hormone produced in both men and women.  The normal ovary makes testosterone in small amounts even after menopause.  If the ovaries are removed or stop producing testosterone, a deficiency will result in loss of sex drive, decreased energy levels, decreased bone and muscle strength, breast tenderness and hot flashes.   A balance of estrogen, progesterone and testosterone is required to prevent unwanted body changes, such as weight gain after menopause.  Natural testosterone is available by prescription only.


Women who take natural progesterone and/or natural estrogens in physiologic doses report virtually no unwanted side effects.   A small number of women may develop reactions such as agitation and breast sensitivity, but these symptoms go away after a couple weeks of treatment.  Drowsiness can also occur, but usually goes away without the need for dosage adjustment.

Tri-Est may not be strong enough for some women, such as immediately following hysterectomy or those changing from higher doses of the commercial hormones.  A Bi-Est combination may need to be used for 3 to 4 months before converting to Tri-Est.  Menstrual bleeding does not usually occur if the natural progesterone and natural estrogens are taken continuously.  If breakthrough bleeding does occur it usually stops two to three months after the therapy begins.

Too much testosterone can cause oily skin, acne, facial hair growth, excess body hair growth and anxiety.  Starting with small dose of testosterone and increasing the dose if necessary avoids these side effects.


Some women do not want to take supplements because they feel that menopause is a natural part of life.  This is very true; every woman will go through menopause if she lives long enough.  But our current life-styles are anything but natural.
Over the past few decades our society has drastically changed the way in which we live.  Most of these changes have been detrimental to our health.  We now live in a polluted environment, eat processed and synthetic foods and get very little physical exercise, consequently, menopause is starting to occur earlier in life than in previous decades.

Women often need to take medications to correct other natural processes associated with aging.  These medications are often very unnatural and are not without risks.  So why resist the idea of taking something for menopause?  For any woman who wants to take good care of her self, keeping her hormones in balance is just as important as diets and exercise.


Symptoms include fatigue, decrease sex desire, loss of mental acuity and in some cases depression either directly from hormone decrease or from other symptoms.  You may find yourself irritable or grumpy to both family members and others.  The hormone deficiency is mainly manifested by decrease in testosterone, but also may include deficiency in growth hormone and DHEA produced by the adrenal glands.  Originally testosterone replacement was thought to increase risk for prostate enlargement and/or prostate cancer.  However to date no convincing studies have proven hormone replacement in men to be harmful.  Benefits can only be determined by measuring baseline laboratory studies and a trial of therapy when deficiencies are found.  Dr. Gantt, as a reproductive endocrinologist, has pursued this aspect of medicine diligently and has many years of experience as well as the training necessary to provide proper care.



Natural hormones can be compounded in many different systems; creams, gels, nasal sprays, capsules, implantable pellets or suppositories.  What you choose is based on your preference.  Creams and gels are applied to those areas of your body where the skin is thin and the hormone can be absorbed easily through the skin (i.e., inner wrist, inner arm, stomach, breasts, and neck and inner thigh).  Transdermal creams and gels bypass your liver’s first-pass removal process, by going directly into your blood stream.  If you have gastrointestinal or liver problems, you should use the transdermal creams or gels.

If you prefer oral medications, micronized hormone powders will be used.  Micronized means that the medication has been broken down into a very small particle and is then compounded into a slow-release capsule.  This allows a slow steady release of the hormone into your circulation.



If a drug is FDA approved it does not mean that it is the safest or most effective treatment.  So what does FDA approved mean?

The FDA does not test drugs themselves.  Drug manufacturers submit the results of their own studies to the FDA.  The FDA then reviews the data and decides whether the company has shown that the drug is effective and without serious side effects.  The FDA does not compare the drug to the other drugs to determine if there is a safer or more effective drug available.

The average cost to test a single drug is about 112 million dollars. Natural hormones cannot be patented because they are naturally occurring substances.  So if a drug company spent the 112 million to do research it could not protect its investment because it could not patent it.  Once approved, every other drug company could then manufacture that natural hormone and steal away profits from the original company.

With the exception of estriol, all of the natural hormones are FDA approved.  The brand name drug Estraceâ is the plant-derived estrogen, estradiol, which is approved for menopausal indications.  The estradiol used in compounded hormones is the same ingredient.  Estrone is also FDA approved, but commercially available only as an injection.  Natural micronized progesterone, as an injection also has FDA approval. Licensed pharmacists using FDA approved ingredients do not require separate FDA approval to compound the oral form.

Plant derived estriol is a USP approved substance, which means that it has met the strict standards for products sold in this country set by the US Pharmacopoeia.  Estriol is not specifically approved for any particular condition, but your doctor can prescribe it. 



Unfortunately, although the ideal natural substances for hormone replacement therapy are readily available, most doctors are unaware of these unpatented hormones and how to prescribe them.  A survey done at Harvard Medical School revealed that physicians learn 90% of their prescribing habits from pharmaceutical salespersons.  Since natural hormones are plant-derived and cannot be patented, manufacturers lack financial incentive to fund research and development costs to commercially market these substances.  And therefore, physicians receive little information on natural progesterone, estriol, estradiol, and estrone.

We realize that your time is very precious, and it can be quite time consuming to do the research needed to feel comfortable with a new therapy.  Dr. Gantt is here to fill the void of information about Natural Hormone Replacement Therapy.  New research is emerging monthly.  As baby-boomer women are entering menopause, they are no longer willing to accept the risks associated with synthetic hormones, and they are searching for safe alternatives.  An estimated two million women are now benefiting from natural “plant-derived bio-identical” estrogens and progesterone, we want to work with you to optimize your Natural Hormone Replacement therapy.  If you’re interested in seeing Dr. Gantt, please call our office for an appointment or consultation.  Thank you for expressing an interest in improving your health and well being through Natural Hormone Replacement Therapy.  We have a genuine interest in your health and look forward to working with you in achieving optimal health.

Best of health to you,
Dr. Gantt

Dr Pickens Gantt M.D. Infertility doctor, male menopause, female menopause, menopause, IVF doctor, tubal reanastamosis & natural hormones