Part IV: Complexities of Hormone Replacement Therapy: An Evidence Based Protocol Review - November 2018


Course Details




This course has been approved for 21 AMA PRA Category 1 Credits, 21 Nursing Contact Hours (21 pharmacologic hours), 21 Hours Pharmacy Credit (knowledge based).

Prerequisites:  Part I, II and III

One would think that 3 courses on HRT would be all that is needed to adequately practice BHRT. However attendees have requested that they want more, but with more complexity and problem solving as opposed to didactic. Hence Part IV.

Although there are new articles, research, updates, literature critiques, and sarcasm (of course), the majority of this course will be problem solving, case management, mistakes to avoid, and tricks of the trade. The audience will consist of those with significant experience, questions, and issues that make for an excellent experience for both me and participants as we all learn from patients and ourselves. Extensive literature review in Parts I, II, & III have not allowed me to present all the interesting and complicated cases and situations that I have encountered in the last 15 years of practice. I have included 60 of my most complex and problematic cases from the last 15 years but it will require you to have masterful understanding of Parts I, II, and III in order to understand the reasoning behind the treatment and management of these problematic cases.
First we will review the latest NAMS recommendations. It is a step in the right direction. However I will use the medical literature to, of course, prove to them what they should have said and done as opposed to their sole reliance on the WHI trial. It should be the summation of all available data that should dictate our treatment, not just one study. We will then review the evolution from testosterone causes prostate cancer to maybe it protects against cancer to now where we prescribe it to men with active cancer. Although commonly (incorrectly) thought to cause prostate cancer, estrogen has been a mainstay to treat and protect against prostate cancer. In fact it may be through aromatization that testosterone can protect against prostate cancer. We will also review at what level of estradiol results in a flip of the lipids that then become cardio-protective. Although it has been customary and fashionable to utilize aromatase inhibitors to block aromatization of testosterone to estrogen, the most recent study demonstrates using an AI increases gynecomastia, visceral and subq fat, cholesterol, and sexual dysfunction.
Please read the agenda and course outline for a more complete synopsis of topics and objectives. So bring your tough cases, comments, thoughts and ideas and have another fun weekend with your talented peers. This will be a collection of the most talented and experienced physicians in this industry. Caution: Part IV will be thought provoking, intense, and very complex. And just maybe you’ll be able to pass that Certification Exam.


  • When

  • Friday, November 30, 2018 - Sunday, December 2, 2018

  • Where

  • Hilton Salt Lake City Center
    255 S West Temple
    Salt Lake City, Utah 84101



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