Hormones and Health:

Dr. Kajal Roy on Aging Well

Our stress levels over the past 18 months have been among the highest in recent memory. If you’re a woman in her mid- to late 30’s or older, such stress added to simple aging can lead to hormone imbalances causing symptoms like insomnia, fatigue, brain fog, inability to build muscle or lose weight, lowered sex drive and just plain not feeling yourself. Dr. Kajal Roy of Niyan Medspa ( says many such symptoms may be effectively treated just by optimizing the balance of the hormones in your system.

Stress, in particular, can lead to drops in levels of Testosterone, which is key to protecting all the body’s organs – in women AND men. Gary Donovitz, MD, in his book, “Testosterone Matters...More! The Secret to Healthy Aging in Women,” writes, “Women make more Testosterone daily than they do Estrogen; in fact, in your twenties and thirties, you make fifty times more Testosterone than Estrogen.” And, he adds, “As you progress through the seasons of your life, Testosterone is your source of youth and vitality.”

Dr. Roy, an internist, says hormone levels naturally decline up to 10 percent annually as we age. It’s this imbalance which makes us feel out-of-sorts. Thankfully, medical science has come a long way towards being able to precisely measure not only our existing hormonal levels, but the right dosage of replacement hormone therapy needed to bring everything back in alignment.

Your diet also can help increase your Testosterone levels, particularly good fatty foods like avocados, nuts and healthy oils, but by the time you’re experiencing the symptoms above, the impact of diet alone is marginal, Dr. Roy says. “What I recommend is bioidentical hormone replacement with pellets.” The hormones are made naturally from plants, and are identical in composition to the hormones in our own bodies. The pellets, inserted underneath the skin, release more hormones when your heart rate is elevated, when you’re working out, and when you’re stressed, and fewer hormones when you’re sleeping or relaxing – simulating exactly how your body would naturally respond in its need for these hormones.

Though some doctors prescribe hormone cream, Dr. Roy says, “The problem with creams is you don't know how much is actually getting absorbed. The thickness of your skin may be different from the thickness of my skin, so we would obviously absorb different amounts at a different rate.” Likewise oral medications have to first pass through your liver and into your bloodstream. “Here again, you can't really control the rate at which it's the dosing that you're getting. That's why I prefer pellets,” she says.

Dr. Kajal has herself experienced the treatment, sparked in 2021 by a need to better concentrate to study for her board exams. “I just intuitively knew that something was off; I just didn't feel right. So, I actually got my hormone levels checked and found out that my Testosterone level was [extremely low]. And that's when I started pellet therapy.”

Note that step one involves getting your hormone levels tested because precision dosing is key to addressing each patient’s individual symptoms. Testosterone and/or Estrogen 2 must be administered in the proper proportion to address each person’s deficit in these hormones to effectively restore balance. For patients considering hormone therapy, Dr. Roy provides a free consultation, then prescribes a quick and comprehensive blood test. The results of the blood test, covered by most health plans, deliver results that are then processed with BioTE’s proprietary dosing platform. This process makes sure that only the hormones you need are inserted into your customized pellets.

One specific test Dr. Roy routinely prescribes in advance of pellet therapy is a test for the two DNA markers for breast cancer: BRCA1 and BRCA2. The absence of such markers – showing that a patient is not pre-disposed genetically to develop breast cancer – allows physicians more flexibility in adding both Estrogen 2 and Testosterone to a patient’s regimen, in addition to Progesterone, thyroid medication, pro-biotics, vitamin B and D and other nutrients. (Sometimes, just finding out that you may be clear of these DNA markers is worth all the hormone therapy in the world!)

In Dr. Roy’s own experience, having undergone bioidentical hormone replacement therapy when working seven days on then seven days off at the hospital in her earlier practice, the treatment enabled her to sleep like a baby off-shift and to wake up refreshed. She had much more energy to complete her rounds and, she says with a smile, “My marriage has gotten a lot better.... I can work out, see real results and I’m actually not hungry,” she added. 

The only way to determine whether you’d benefit from similar therapy is to consult Dr. Roy, have your blood work analyzed. “Then we sit down and come up with a plan, including an insertion if that’s indicated.”

Women receive new insertions every 3-4 months, men every five to six months – and, YES, it works for men too. Success is defined by the return of a feeling of well-being that’s hard to describe for both men and women, but is very appreciable. For menopausal women, additional benefits like cessation of night sweats and hot flashes are a bonus, along with a kind of sustained energy that is nothing like the feeling of being hopped up on caffeine.

Since Dr. Roy has begun administering hormone therapy in this manner, she’s observed how integral hormone balance is to health and wellness. Examining their levels, “forces you to really take inventory of what your body is doing and how you're feeling. What's your body telling you? Instead of compensating for the things that bother you like tension, stress, anxiety and insomnia, you’re getting the things your body needs to be at its best.... All of those things, including anxiety, can be attributed to a lack of hormones. I have even been able to get some patients off of their anxiety and antidepressant medications!”

She adds, “I think we're at a point where we throw a pill at everything, and I just don't think that that's the right way to do medicine. I think we need to address the underlying issues. My goal is to try and get people off of their medications including diabetes medications, blood pressure medications, all of those things. If you can make a healthy body by optimizing your hormones, and decrease your blood pressure, start losing the fat and building the muscle you need to function – then you can begin to live a better life without medication, and without their side effects.”

She explains, “My vision of what it means to be an internist has evolved and changed. There came a point in time where I thought, this isn't right, what we're doing, overmedicating people. Take diabetes for instance – it's a completely preventable disease. If people aren't willing to make the necessary changes in their lives, that's where medications come in. But, if you truly want to live a life where you don't have to have medication as a part of it, it is possible. I love my profession, but I feel like sometimes we get stuck in this rut of just prescribing because that's what we've always done.”

“We've never really taken two giant steps backwards and looked at the big picture. We've become too accustomed to treating a symptom and not really going after the root cause of that symptom. I feel that, if we take more of a preventative approach, we can we can stop writing so many prescriptions that cause a multitude of side effects, which are then treated with more prescriptions. I'm an internist within a different vision for my patients.”

Dr. Roy now considers hormones essential building blocks to health because they have so many beneficial properties for all the body’s systems. “I definitely think that your chronological age doesn't have to dictate how you feel. I have I've seen people in their 90’s who are so much more active than people in their 50’s. We can do better. Absolutely, 100%, we can do better.”

Because women business owners often experience high stress levels, Dr. Roy will be speaking on the subject of hormones and health at the Women’s CEO Summit ( October 7 at the Washington Dulles Airport Marriott.

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