Hormone Therapy

Hormonal Problems Self-Assessment Information


We work these cases up carefully for two reasons: a) they can disrupt a patient’s life and make them appear to have “psychiatric” symptoms when in fact they have a hormonal issue, and b) unfortunately, this system is poorly worked up elsewhere, if at all.

The endocrine system of the human body is infinitely varied, complex, and beautiful in its function. The height of its functioning is when you are in your 20’s.  After that, it tends to be “all downhill”. Both men and women have the same hormones, but their levels vary with sex and the main problems that men and women have can also vary.

  • Testosterone – a hormone not typically thought of in women but one of critical importance – can begin dropping as early as the ’20s, leaving the woman with a decreased sense of energy and libido (sex drive).  It can also contribute to, or precipitate, a depressive episode in extreme cases.  Poor levels of testosterone cause mental fatigue, lack of mental clarity, and decreased “drive” in life to get things done, as well as an insidiously developing loss of libido.
  • Progesterone can start dropping in the 30’s and ’40s, well in advance of menopause  (or surgical removal of the ovaries) leading to “hot flashes”, sleep problems, and mood upsets.  Usually, in fact, it is progesterone that drops FIRST with natural menopause – not estrogen, contrary to popular belief.  This hormone is critical for restful sleep and good mood.  It is literally the “feel good” hormone of pregnancy.
  • Estrogen drops after menopause and after the ovaries shut down (or when they are surgically removed).  A drop in estrogen can be experienced with sudden onset depression (when the woman has never been depressed before in her life!), irritability, temper, cloudy thinking, and decreased concentration.
  • Thyroid hormone problems seem to be more common in women.  Unfortunately, most women never have their complete thyroid axis checked, with conventional medical practice insisting only on the “TSH” test.  This leaves many women undiagnosed with hypothyroidism, or functional, sub-clinical hypothyroidism.   

Symptoms of low thyroid include:

  • Tiredness and fatigue

  • General lack of energy

  • Mental cloudiness and dullness

  • Inability to lose weight or inexorable weight gain despite exercising an appropriate diet

  • Decreased libido

  • The outside portion of your eyebrows falling out.

  • Unusual sensitivity to cold.

Excess thyroid production, usually from either a tumor or an autoimmune reaction, can produce:

  • Flushing

  • Heart palpitations

  • Elevated pulse and blood pressure

  • The feeling of being hot

  • Rapid, unusual, and impossible to account for weight loss (such as 15 – 20 pounds in a month without even trying to lose weight).

  • Racing thoughts and appearing to be “manic.”

In men, the usual hormonal deficiency that gets their attention is low testosterone.  This frequently produces problems with erectile difficulty as well as loss of libido.  The “ADAM” questionnaire is useful for self-scoring. 

Low testosterone in men usually results in decreased enjoyment of life, decreased energy, increased fatigue and lethargy, a tendency to sit around like a couch potato, decreased muscle tone, and decreased performance in the gym as well as the bedroom.

  • DHEA and cortisol are critical hormones secreted by the adrenal glands that sit on top of the kidneys. They help you deal with stress. If you are perpetually stressed, these glands can become exhausted, leading to “adrenal burnout,” or simple exhaustion in the prime of your life. There are very good, simple, painless “spit in the tubes” tests to check out your adrenal hormones with saliva samples, and these work very well.  These are almost ridiculously easy to improve with supplementation, and with a resultant dramatic restoration of function, but they have to be measured and you have to be diagnosed, first!
  • Insulin and cortisol – these are like two kids on either side of a teeter-totter.  One (insulin) makes the blood sugar go down, and the other (cortisol) makes it go up.  Over-consumption of sugary foods and simple carbohydrates can spike insulin, make you “hyperinsulinemic” and pre-diabetic.   Excess stress can make your cortisol stay up, and then the two hormones will duke it out.  There are excellent lab tests to assess this.  Frequently, at CWI we see patients who are having severe psychiatric-appearing symptoms due to simple blood sugar issues involved in the disrupted balance between these hormones.
  • In some cases, growth hormone is low, manifested by a low level of “IGF-1.”  Treating this is controversial, but there is a recognized condition called “Adult-onset growth hormone deficiency.” Usually, a patient’s IGF-1 level is fairly reasonable.
    NOTE: We do not use human growth hormone here at CWI and are certainly not a growth hormone clinic. If necessary, we will use more holistic methods to naturally enhance IGF-1.

A low level of growth hormone (measured by IGF-1), however, is associated with:

  • The decline in mental function and “sharpness”

  • Loss of enjoyment in life

  • The decline in muscle mass

  • Increase in fat around the middle

  • Decreased libido and sexual performance

  • Increased depression

ADAM (Androgen Deficiency in the Aging Male) Questions:

  1. Do you have a decrease in libido (sex drive)?

  2. Are your erections less strong?

  3. Do you have a lack of energy?

  4. Do you have a decrease in strength and/or endurance?

  5. Have you lost height?

  6. Have you noticed a decreased “enjoyment of life?”

  7. Are you sad and/or grumpy?

  8. Have you noticed a recent deterioration in your ability to play sports?

  9. Are you falling asleep after dinner?

  10. Has there been a recent deterioration in your work performance?

If you answered “yes” to either of the first two questions OR if you answered, “yes” to three other questions, you have androgen deficiency (low testosterone).

Adapted from Morley et al. Metabolism. 2000;49(9):1239-1242.  Questions reordered by Cady for clarity and ease of scoring.

Bio-Identical Hormone Therapy


At CWI, Dr. Cady and Dr. Whitney Gabhart, a naturopathic doctor, collaborate on complex cases.  The doctors utilize FDA approved bio-identical medications as well as compounded forms of estrogen, progesterone, and testosterone.

All too frequently, women are told that poor sex drive is “normal for their age.” It is almost uniformly not checked by their OBGYN. In men, symptoms of low T decline at an imperceptible rate. In some cases, testicular function can be recovered and men can once again produce testosterone adequately. Over the counter medication will likely not be effective. We use stronger medication.

Drs. Cady and Gabhart work closely with a patient’s Ob-gyn and family physicians to ensure that all mammograms and gynecological exams are monitored, as well as any extenuating circumstances are factored in for optimal treatment for both men and women. 

All types of hormonal assessment and intervention are done with strict compliance with the current dictates of peer-reviewed literature and current research.
Lab values of all patients are carefully monitored. 

For Women: Managing Menopause Symptoms

  • menstrual changes

  • sleeplessness

  • depression

  • irritability/ mood swings

  • bone loss

  • thinning skin

  • weight gain

  • hot flashes/ night sweats

  • fatigue

  • sugar cravings

For Men: Managing Andropause Symptoms

  • poor recovery from exercise

  • pain/ stiffness in joints and muscles

  • forgetfulness

  • anger

  • weight gain

  • loss of drive and competitive edge

  • loss of sex drive

  • inability to concentrate

  • loss of muscle strength

Your First Step:

Your first step towards reclaiming your life and vitality is to schedule a consultation with our hormone intake specialist, Whitney Gabhart, ND, at the Cady Wellness Institute.  Louis B. Cady, MD will order labs to determine your individual hormone level, and both doctors will collaborate to select the bioidentical hormone solution that best suits you.


Boost Your Libido with Bio-Identical Hormone Pellet Therapy 

Bio-identical hormone pellet therapy may be just what you need to rediscover a more vital, younger you. It has been shown to help people dealing with a wide range of problems connected to a decrease in their body’s hormone production. It has been especially beneficial for individuals who have been battling with low libido.

Bio-identical hormone pellet therapy is the treatment of choice for both men and women who want to increase the number of hormones in their body without needing to apply creams or take pills every single day as well as avoid the side effects that they cause.


The subcutaneous pellets are designed to provide consistent hormone levels throughout the day for up to six months. One of the nice things about the way these hormones are released is that they do not have the roller coaster effect. There are no spikes and valleys in the levels of hormones in your body, which makes the entire process much easier for you.

Bioidentical hormone therapy is designed to provide your body with the hormones it cannot make on its own. Increasing the level of hormones in your body allows you to age in a natural and healthy way while drastically decreasing the symptoms of menopause and andropause.

Even a small hormone imbalance can have devastating effects on your energy, your mental clarity, and your libido. It can leave you feeling like you have no energy, you’re unable to focus, and your life does not have the same joy as it did before.

Bio-identical hormone pellets are designed to match your unique needs. The feeling of rejuvenation, vitality, and energy you experience when using bio-identical hormone pellet therapy is indescribable.

Depending on your specific needs, pellets can have estrogen or testosterone. They are put together using strict guidelines laid out by the federal government. Your treatment plan will be developed with the careful collaboration of Dr. Gabhart and Dr. Cady.

Each pellet is about the size of a grain of rice and is inserted just underneath your skin. These pellets will mimic the job that is usually done by healthy ovaries and testicles. They will slowly release hormones into your bloodstream, helping you feel like your regular self again. The hormone pellet is very easy to implant and can be performed right here in our office.


In your mid-20’s and early 30’s, you may start to notice a decline in hormone production. This leads to a decrease in sexual drive and performance. In addition, you may feel anxious, depressed and irritable. Pellet implants have been shown to reverse many of these symptoms.

For men, a reduction in testosterone production can result in a loss of libido and difficulty maintaining or achieving an erection. However, bio-identical hormone pellet therapy can increase the level of testosterone in a man’s body to what would be produced by normally functioning testicles.

 If you feel that low hormone levels are negatively affecting your libido, talk to our trained experts at the Cady Wellness Institute. Everyone at our center is passionate about what they do. Dr. Cady, Dr. Gabhart, Margaret Johnson, and Liz Neel can help you make the most of your personalized bio-identical hormone pellet therapy. Margaret and Liz both take a specialized holistic approach to health and wellness, and they make it their mission to help our patients feel their best.