Are there any side effects related to taking troches?

Side effects are extremely  uncommon but do occur even with natural hormones. The most common side effects are gum irritation from the troche, occasionally fluid retention when initally commencing the troche.

Are their any other methods of taking bio-identical hormones apart from troches?

Hormone can also be incorporated in a slow release capsule. This tends to be used if women have a gum irritation from the troche or if they find the taste of the troche unpleasant.Hormones can also be incorporated in a cream but from experience I have found troches and capsules are more effective than creams and dosage can be more accurately controlled.

I have read several books and articles suggesting saliva testing is more accurate than blood testing to monitor hormone levels?

This is an interesting question and depends which doctor you consult for bio-identical hormones. From my own experience over the last 15 years I have used both methods but from personal choice now favour blood testing. Blood tests have to be done at specific times as the level of hormone in the blood does vary according to when the troche or capsule is taken.

How long do I need to stay on bio-identical homone replacement?

Current medical opinion suggests continuing oestrogen for 2 years only. After this period of time we suggest slowly weaning off the oestrogen. Progesterone and Testosterone replacement  are probably safe to continue for a longer period of time and confer definite advantages both in relation to control of menopausal symptoms and having anti-ageing benefits.

Does testosterone have side effects?

The most common side effects observed with testosterone are hair growth and acne. In my experience these side effects occur in approximately 3 out of 10 women. These effects are reversible on ceasing the testosterone. 70% of women who take testosterone have no side effects.

Are there risks factors with respect to breast cancer from taking bio-identical hormones?

For medicolegal purposes we have to assume risk factors for bio-identical hormone replacement are similar to those associated to using synthetic HRT. However there are some studies suggesting bio-identical oestriol which is used as the majority of the oestrogen in troches is perhaps safer than synthetic oestrogen. This combined with blood testing to ensure the minimum amount of oestrogen is used to control symptoms would perhaps confer an increased level of safety when using bio-identical hormone replacement. Further studies are probably necessary to confirm the above information.