Bio-Identical Hormone Replacement Therapy

A better approach to balanced hormones

Dr. Tracy Tranchitella, ND – Sunrise Functional Medicine

For many women, the transition into perimenopause and menopause can feel like someone quietly changed the operating system of their body. Symptoms rise and fall, energy shifts, sleep becomes unpredictable, and the sense of “normal” you once counted on starts to wobble. And yet, every woman’s experience is different. That’s why hormone care is never a one-size-fits-all process—especially within functional medicine, where your whole health story shapes the treatment plan.

At Sunrise Functional Medicine, Tracy Tranchitella, ND, takes a personalized, whole-body approach to hormone health. Bio-identical hormone replacement therapy (BHRT) is one of her specialties—offering a natural, evidence-based way to support women (and men) experiencing hormone decline, imbalance, or disruption. When used thoughtfully and monitored closely, BHRT can ease symptoms, support long-term health, and restore a sense of steadiness during life’s hormonal transitions.

What Makes BHRT Different?

Hormones are your body’s chemical messengers—tiny molecules that influence everything from metabolism and cardiovascular function to mood, cognition, and sexual health. When hormones shift or decline, you feel it.

BHRT uses hormones that have the same molecular structure as the ones your body naturally produces. Because they are bioidentical, your body recognizes and processes them efficiently, making them a more physiologic option than many synthetic forms.

BHRT can be used for:

• Perimenopause and menopause symptoms
• Post-menopausal support
• Low testosterone in men
• Adrenal dysregulation or chronic stress
• Thyroid dysfunction (as part of a broader plan)

Unlike synthetic hormones developed in the lab, bioidentical options match your natural chemistry, which may contribute to better tolerability and, for some patients, improved outcomes.

Why Hormones Become Imbalanced

Modern life asks a lot from the endocrine system. Hormone imbalance can stem from:

• Chronic stress
• Sleep disruption
• Environmental toxins and endocrine disruptors
• Gut health issues
• Nutrient deficiencies
• Genetics
• Natural age-related decline

As estrogen, progesterone, testosterone, cortisol, and thyroid hormones fluctuate, a wide range of symptoms can show up: hot flashes, night sweats, brain fog, weight changes, irritability, low libido, anxiety, depression, sleep problems, and changes in insulin sensitivity—just to name a few. That’s why hormone therapy shouldn’t be reactive; it should be strategic.

What the Research Shows About Menopausal Hormone Therapy

The past two decades of research have clarified a key point: for healthy women under age 60 or within ten years of menopause, the benefits of menopausal hormone therapy (MHT) generally outweigh the risks. Studies suggest:

• Women who enter menopause early or prematurely may benefit even more, as long-term hormone deficiency increases lifetime risk for osteoporosis, cardiovascular disease, and cognitive decline.
• The type of hormone matters. Bioidentical estradiol and micronized progesterone appear to have different safety profiles compared with older synthetic or equine-derived hormones.
• Timing influences outcomes. Starting hormone therapy earlier in the menopausal transition may offer greater cardiovascular and cognitive benefits.

Breast Cancer

Risk varies by preparation, duration, and whether combined estrogen-progesterone therapy is used. Longer duration typically increases risk more than shorter-term use.

Cognitive Health

Several studies suggest hormone therapy—when started earlier—may reduce long-term dementia risk by roughly 10–30%. Timing and type of hormones influence this benefit.

Cardiometabolic Health

Research has found that hormone therapy can improve insulin resistance, fasting glucose, and lipid markers in many peri- and postmenopausal women. The route of administration (oral vs. transdermal) also impacts cardiovascular risk. This is why personalization isn’t just ideal—it’s necessary.

The Functional Medicine Approach: Personal, Whole-Body, and Data-Driven

In Tracy Tranchitella’s practice, hormone therapy starts well before any prescription is written. The goal is to understand why your hormones shifted, how your symptoms show up, and what your body needs to restore balance.

A Comprehensive Evaluation Includes:

• Symptom review – from sleep patterns and cycle changes to mood, cognition, metabolism, and energy
•  Hormone testing – blood, saliva, and/or urine testing depending on what hormones need evaluating
• Lifestyle and nutrition history – because stress, sleep, and diet drive hormone metabolism
• Cardiometabolic and thyroid markers – to get a full picture of your internal environment

This broader lens helps ensure that your hormone therapy is safe, targeted, and aligned with your long-term health goals.

BHRT Is Not a One-Size-Fits-All Solution

Two women can present with identical symptoms but need completely different treatment strategies. One may benefit from estradiol and progesterone support; another may need adrenal rebalancing and thyroid optimization first. Lifestyle factors—nutrition, exercise, sleep, stress, gut health—shape hormone metabolism more than many people realize. That’s why Tracy builds individualized plans that often include:

• Bioidentical reproductive hormones (estradiol, progesterone, testosterone when appropriate)
• Thyroid or adrenal support when indicated
• Nutrition strategies that stabilize blood sugar, lower inflammation, and nourish hormone pathways
• Exercise prescriptions that balance metabolism and preserve muscle
• Stress-resilience tools like breathwork, mindfulness, or restorative practices
• Targeted nutraceuticals, including phytoestrogens and herbs with evidence for menopausal symptom relief

Hormones work best when the terrain of the body is supported.

Lifestyle Is Still the Foundation

Before—or alongside—BHRT, Tracy addresses the core pillars that consistently improve hormone function:

Nutrition

A diet centered on proteins, colorful vegetables, healthy fats, and minimal sugar supports steady blood sugar and reduces inflammation. Some patients do well with a more paleo-leaning approach, while others need gut-focused adjustments.

Movement

A mix of strength training, aerobic activity, and flexibility work supports cardiovascular health, metabolism, and mood. Even small daily habits can shift symptoms meaningfully.

Sleep

Consistent, restorative sleep is one of the strongest regulators of hormones. Addressing sleep early often accelerates progress.

Stress Management

Chronic stress disrupts estrogen, progesterone, testosterone, thyroid hormones, and cortisol. Techniques like meditation, yoga, breathwork, and mindfulness can be as impactful as medication for certain symptoms.

Is BHRT Right for You?

Bioidentical hormone therapy can be life-changing—when personalized and monitored by someone who understands the full complexity of functional endocrinology.

BHRT may be a good fit if you’re experiencing:

• Significant menopausal symptoms
• Mood changes or brain fog
• Sleep disruption
• Weight or metabolic shifts
• Low libido or vaginal dryness
• Fatigue, burnout, or adrenal strain
• Early or premature menopause
• Post-menopausal health concerns

The key is not just replacing hormones, but restoring balance across your entire physiology.

A Thoughtful Path Back to Balance

Menopause and midlife transitions can be challenging, but they also offer an opportunity: a chance to understand your body more deeply and support it with intention. With functional medicine, the focus isn’t solely on symptom management—it’s on long-term vitality, prevention, and whole-body function.

For women (and men) navigating hormonal changes, BHRT can be a powerful part of that journey. With Tracy Tranchitella, ND, you’ll have a partner who listens, evaluates thoroughly, and designs a plan that supports not just your hormones, but your entire sense of well-being.  Learn more and request a consultation >>