Bioidentical Hormone Training Optimization & Testing (Female, Male, Thyroid, Adrenal)
BHRT Training Course CME Accredited for MD, DO, PA, NP and RN’s.
Fully Streaming Online
Updated course is streaming NOW: All New 11 Hours CME AMA or ANCC plus 7.0 Pharmacotherapeutic Hours effective 10/1/26. Reserve your course now and begin watching the 2027 version today!
Since 2008, PracticalCME’s Bioidentical Hormone
Fully CME-Accredited Online BioIdentical Hormone Certification Course
Moreover, the presentation is backed by the support of peer-reviewed literature sources. Upon completion of the online post-test, attendees can download and print their Accredited CME certificate worth 11 AMA PRA Category 1 Credits for physicians and PA’s or 11 ANCC Contact Hours plus 7.0 Pharmacotherapeutic Hours. Stream the course at your own pace. Since the field is always changing, this is the only course that pushes free updates to all registered users for 2 years after purchase. Finally, our expert MD faculty are always available by email, phone or live online chat with any questions you might have during the training process or while implementing your new service.
🛒REGISTER NOW: Bioidentical Hormone CME Training and Wellness Certification Packages
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ONLINE COURSE Modern BHRT Optimization (Female, Male, Adrenal, Thyroid) (11 AMA or ANCC CME Credits plus 7 ANCC Pharma Hours)
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VIDEO WELLNESS TRIPLE (SAVE $1,100) All 3 Wellness Video Courses (BHRT, Weight Loss, NT/GI)
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VIDEO WELLNESS BLOCK (SAVE $400) Choose Any 2 Wellness Video Courses (BHRT, Weight Loss, NT/GI)
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BHRT, Weight Loss ONLINE Wellness Block. SAVE $500 plus 1-hour LIVE Consultation with Dr. Zengo
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📃BHRT Certification Training Course Outline
- 7 sections covering female, male, thyroid and adrenal hormone optimization
- 50+ linked citations to the primary medical literature
- 11.0 AMA Category 1 or 11.0 ANCC CME/CEU credit hours plus 7.0 ANCC Pharmacotherapeutic Hours, streaming and self-paced. Print your certificate upon completion.
- 2 years of access, with downloadable clinical reference tools
Section 1 — BHRT Foundations
Definitions, compounding regulation, and the measurement problem- What “bioidentical” actually describes — and the three criteria: right substance, right dose, right duration
- Bioidentical versus synthetic, and where the two terms get misused in marketing
- Compounded versus FDA-approved preparations, and when each is the right choice
- Section 503A eligibility, USP monographs and bulk drug substance lists
- Marketed unapproved drugs, and what “grandfathered” really means
- Off-label prescribing — what it is, what it is not, and what it requires of you
- Vetting a compounding pharmacy and reading a certificate of analysis
- Saliva, serum and urine testing compared, with the strengths and limits of each
- Total versus free hormone, and what binding globulins do to a number
- Immunoassay cross-reactivity — the drug that shows up on the report as a hormone
- Reference ranges versus optimal ranges, and why the distinction matters clinically
Section 2 — Female Hormone Therapy
Perimenopause through postmenopause, and the cycling patient in between- The reproductive axis winding down — anovulatory cycles and why the luteal phase fails first
- Perimenopause, menopause and postmenopause defined, and which symptoms are hormonally answerable
- Surgical menopause as a fundamentally different problem
- The three estrogens and their relative receptor activity
- Estrogen delivery routes compared — binding proteins, first-pass metabolism, and the consequences you can measure
- Contraindication screening before the first estrogen prescription
- The November 2025 labeling revisions and exactly what they changed
- Progesterone versus progestins — receptor behavior and clinical consequence
- Oral versus transdermal progesterone, and what the endometrial outcome data actually show
- The saliva progesterone result that looks reassuring and is not
- Unscheduled bleeding — the rules that are not negotiable, and the biopsy indication your own protocol can generate
- The cycling patient: low progesterone-to-estrogen ratio, luteal-phase strategy, and how long to wait before judging one
- Structural causes hormones will not fix — fibroids, polyps, adenomyosis
- Genitourinary syndrome of menopause: when local estrogen is enough, plus compounded vaginal estriol’s legal status and safety data
- Testosterone in women — the one indication with Level I evidence, dosing targets, and the effects that do not reverse
- Pellets in women: pharmacology, and the pros and cons
- Writing a compounded hormone prescription properly
Section 3 — Male Hormone Therapy
Diagnosis, contraindications, monitoring, and the regulatory frame- Symptoms that point to the axis, and the many that point somewhere else
- What actually establishes hypogonadism — and how many morning measurements it takes
- Total, free and bioavailable testosterone, plus timing, fasting state and diurnal variation
- Primary versus secondary hypogonadism — the workup that changes management
- Age-related decline and the labeling language that still governs it
- Fertility: the conversation that has to happen before the first prescription
- The contraindications that stop you — PSA thresholds, erythrocytosis, untreated sleep apnea, cardiac and thrombotic exclusions
- Delivery routes compared, including pellet pharmacology, FDA approval status, and the pros and cons
- Preventing transfer to partners and children
- The February 2025 FDA class labeling changes — what was removed, and what was added
- Hematocrit, PSA and blood pressure monitoring — schedules, and the numbers that trigger referral
- Schedule III realities: refills, expiry, monitoring program obligations, and telemedicine instability
- Writing a compounded testosterone prescription properly
Section 4 — Thyroid Optimization
Diagnosis, thresholds, combination therapy, and a changing regulatory picture- The thyroid axis, peripheral conversion, and the deiodinases
- What TSH measures — and what it demonstrably does not track
- The published clinical score that correlates with tissue effect but not with TSH
- Signs and symptoms that discriminate, and the familiar ones that do not
- Physical examination findings worth ninety seconds
- Free T4, free T3 and antibodies — when each one changes management
- Treatment thresholds, and how to defend yours to a skeptical colleague
- Subclinical hypothyroidism and the proportion who normalize untreated
- Pregnancy and preconception, where the guidelines are explicit
- Sequencing thyroid against adrenal treatment, and the safety reason why
- Levothyroxine absorption: timing, food, coffee, iron, calcium and acid suppression
- When T3 belongs in the regimen, and at what T4-to-T3 ratio
- What happens to free T4 and TSH when T3 is added — and why that is expected rather than alarming
- Desiccated thyroid: content, lot-to-lot variability, the 2025 and 2026 FDA actions, and full conversion arithmetic with a dosing table
Section 5 — Adrenal and HPA Axis
The longest section in the course, and the one most fully rebuilt- The adrenal cortical zones and what each one answers to
- The cortical-medullary relationship and the enzyme that links them
- Three responders on three timescales
- Central rhythm generation, from light to cortisol
- Why the evening cortisol value carries information the morning value does not
- Cortisol production rates, DHEA and DHEA-sulfate — and what the salivary assay actually measures
- DHEA as a marker of chronicity rather than a target in itself
- Pregnenolone and precursor supplements, and uncontrolled downstream conversion
- Cushing’s and Addison’s as the boundaries — recognition, referral, and the result that is exogenous steroid rather than disease
- The adrenal fatigue controversy examined in full: the 2016 systematic review, its own evidence base, and the moderator analysis that explains the contradictions
- Selye and the staged stress model, plus the literature linking cortisol rhythm to defined clinical syndromes
- Four-point saliva cortisol collection, and the collection errors that manufacture a result
- Curve shape as the unit of interpretation — six patterns, examined one at a time with worked examples
- Medications that distort the curve: steroids by route, opioids, progestins, oral estrogen, stimulants and beta blockers
- Assay interference — the high value that is a drug in the tube
- Lifestyle as first-line: sleep, diet, exercise, light, caffeine, alcohol and cannabis
- Sympathetic overactivity versus cortisol deficiency, compared side by side
- Vitamins, adaptogens and herbals examined individually, with the dose ranges actually studied
- Adrenal glandulars — the analytical study of what is in them, and the arithmetic that settles it
- Licorice root: mechanism, dose thresholds, and the interference it creates in your own testing
- Hydrocortisone: indication, ceiling, off-label status, consent, sick-day rules and a planned exit
- Retesting, tapering, relapse, and knowing when to stop
Section 6 — The Clinical Visit
Everything between the first phone call and the chart note- The intake history that does the work before you enter the room
- The surgical history question most intake forms get wrong
- The safety screen that precedes any hormone prescription
- How to open the visit, word for word
- The three questions that direct the rest of the hour
- Redirecting the patient who answers with diagnoses instead of symptoms
- Psychiatric diagnoses — continuity, referral, and where our scope ends
- Which systems to test, and when to hold a test rather than order it
- Expectations, timelines and costs in writing — the conversation that prevents complaints
- Weight loss expectations, and how they change the entire plan
- The follow-up visit and separating benefit from attribution
- Long-term monitoring on compounded preparations, and the elevated level that is contamination or household transfer
- Advertising a BHRT practice: what may be said, and what may not
- Staff scripting, and the single call that must reach you directly
- Dispensing supplements — the AMA ethical framework and its requirements
- Coding office visits correctly under the current CPT rules
- Documenting off-label use, informed consent, and a planned endpoint
Section 7 — BHRT Case Series
Real presentations, real results, and the reasoning in between- Cases spanning gonadal, thyroid and adrenal systems, in both sexes and across age ranges
- When the history pointed one way and the hormone testing pointed another
- Saliva cortisol curves reproduced as reported, with the interpretation walked through
- Patients already on therapy from another clinician, and how to take that over safely
- Ambiguous results — what to do when everything is normal and she still feels terrible
- Cases that did not respond, and what was learned from them
- When to refer, and how to hand a patient off well
Where the Citations Come From
Clinical claims in this course are linked to primary sources and to current professional society guidance, on the slide where the claim is made rather than in a bibliography at the end.- Guidelines and societies — American Thyroid Association · Endocrine Society · ACOG · The Menopause Society · British Menopause Society · European Menopause and Andropause Society · AACE · American Medical Association
- Journals — JCEM · The Lancet · New England Journal of Medicine · BMJ · Annals of Internal Medicine · Mayo Clinic Proceedings · Climacteric · Maturitas · Molecular and Cellular Endocrinology · Journal of Human Hypertension · Psychological Bulletin · Stress · Cochrane Database of Systematic Reviews
- Regulatory and primary documents — FDA drug labeling and safety communications · FDA compounding guidance and bulk drug substance lists · Federal Register notices · USP monographs · GAO reports · DEA and HHS prescribing rules · manufacturer package inserts
🏅CME Accreditation Statement
- Saliva Testing and Bioidentical Hormone CME Certification up to 8 hours as approved by AAFP.
The AAFP has reviewed Saliva Testing and Natural Hormone Balancing, and deemed it acceptable for AAFP credit. Term of approval is from 10/01/2025 to 09/30/2026. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Modern Bio-Identical Hormone Optimization and Testing (Female, Male, Thyroid, Adrenal)
This course is approved for 11.0 ACCME, AMA Category 1, or 11.0 ANCC credit hours with 7.0 pharmacotherapeutic hours for Nurses and Nurse Practitioners.
Accreditation dates: October 1, 2026 through October 1, 2028
Joint Accreditation Statement
In support of improving patient care, this
team.
Amedco Joint Accreditation Provider Number: 4008163
Professions in scope for this activity are listed below.
Physicians
Amedco LLC designates this material for a maximum of 11.0 AMA PRA Category 1 Credits for physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
Amedco LLC designates this activity for a maximum of 11.0 ANCC contact hours including 7.0 pharmacotherapeutic hours.
🖥️BHRT Training Video and Eligibility
Watch our PracticalCME Bioidentical Hormone Certification Training Overview Video...
Eligibility for Training…
- Doctors (MD’s and DO’s)
- Nurse Practitioners
- Physician Assistants
- Registered Nurses
- Naturopathic MD’s
Other providers can take the course and receive the certificate, but legal scope of practice in your location is determined by your licensure, not a single training course.
⏩ About Our Interactive Online Training
First, Reserve your Online Training Seat in Evidence-Based Weight Loss or Bundle with Saliva Testing/BHRT and/or Neurotransmitter/GI training.
You will have 2 Years of Unlimited Online Access wtih Free Updates pushed to your account periodically as needed and new drugs are approved.

Then Watch the Online training at your own pace. Follow clickable links and interact with our faculty for any questions you have. When finished, complete the online post-test.
DOWNLOAD/PRINT CME CERTIFICATE
No training course alters the legal scope of practice as defined by the medical/nursing boards in your home state/country. Please review all state/country requirements for supervision for these procedures prior to adding them to your practice.
BHRT as the Foundation for Modern Wellness Practice
Peptide therapy is one of the fastest-growing areas of interest in functional and regenerative medicine, but peptides do not replace hormone optimization. They work alongside it. Compounds like sermorelin, ipamorelin, CJC-1295, and BPC-157 modulate growth hormone, tissue repair, and recovery pathways, but their effectiveness depends on a properly balanced endocrine baseline. Providers who prescribe peptides without first assessing testosterone, estrogen, thyroid, and cortisol levels are working blind.
This BHRT certification course gives you the hormone testing and prescribing foundation that responsible peptide practice requires. Once you understand salivary hormone assessment, adrenal fatigue, thyroid optimization, and BHRT protocols for male and female patients, you have the diagnostic framework needed to evaluate whether peptide therapy is appropriate, safe, and effective for any given patient — and to monitor results objectively rather than by symptom alone.
Why Hormone Balancing Should Come Before Peptides
- Growth hormone peptides (sermorelin, ipamorelin, CJC-1295) work downstream of thyroid and cortisol — untreated hypothyroidism or adrenal dysfunction will blunt peptide response.
- BPC-157 and tissue repair peptides are commonly prescribed for recovery, but chronic cortisol elevation (assessable via saliva testing) impairs the healing they’re meant to accelerate.
- Sexual function peptides like PT-141 are often prescribed for symptoms that originate in untreated testosterone or estrogen imbalances — issues that BHRT addresses at the source.
- Patient safety requires baseline hormone testing before introducing any modulating compound. Peptides without hormone testing is the same mistake as prescribing antidepressants without checking thyroid.
- Insurance and regulatory environment for peptides remains unsettled. BHRT is established, accredited, and defensible — a stable practice revenue line that complements peptide offerings without depending on them.
Frequently Asked Questions: BHRT Certification Training Course
About the Course
Is this BHRT training course CME accredited?
Yes. This bioidentical hormone replacement therapy training is accredited continuing medical education. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
How many CME credits does the BHRT course provide?
The course provides 11.0 AMA PRA Category 1 Credits™ or 11.0 ANCC contact hours, including 7.0 pharmacotherapeutic hours. Credit is claimed after completing the post-test, and your certificate is available to download and print immediately.
Who is this bioidentical hormone training course for?
The course is written for licensed prescribers and clinical staff who want to evaluate and treat hormone imbalance in their own practice: MD, DO, PA, NP and RN. It assumes clinical training but no prior experience with bioidentical hormone therapy or saliva hormone testing.
Do nurse practitioners and physician assistants receive credit?
Yes. Nurse practitioners and registered nurses may claim ANCC contact hours, and physician assistants may claim AMA PRA Category 1 Credit™, which the NCCPA accepts.
Do I receive a BHRT certification or a certificate of completion?
You receive an accredited CME certificate documenting completion of the activity and the credits earned. BHRT is not a recognized medical specialty and no organization confers board certification in it, so no course, including this one, can grant a specialty credential. What the certificate documents is verifiable accredited education in hormone optimization and testing.
Is this a live course or self-paced online training?
It is entirely self-paced streaming video. There is no live attendance requirement, no scheduled session and no travel. You can start, stop and revisit any module, and most learners complete it across several sittings rather than in one.
How long do I have access to the BHRT course?
Enrollment includes two years of unlimited access. Updates published during your access term are included at no additional cost, which matters in a field where drug labeling and regulatory guidance change frequently.
Do I need prior hormone therapy training to take this course?
No. The course begins with definitions, regulatory structure and testing methodology before any treatment is discussed, so a clinician new to bioidentical hormone therapy can follow it from the first module. Experienced prescribers generally find the adrenal and thyroid modules the most substantive.
What does the BHRT certification course cost?
The course is {{PRICE}}, which includes all seven modules, the case series, the downloadable clinical reference tools, the post-test and the accredited CME certificate, with two years of access.
Is there a post-test?
Yes. A post-test follows the curriculum and must be completed to claim credit. It is drawn directly from the material taught, and you may review any module before taking it.
What is included with enrollment?
Seven video modules covering female, male, thyroid and adrenal hormone optimization; a worked case series; downloadable clinical references including a saliva cortisol curve pattern sheet and a desiccated thyroid conversion table; the post-test; and your accredited CME certificate.
How is this edition different from the previous version of the course?
Every module was rewritten against the current literature and the current regulatory landscape. Clinical claims now carry linked citations on the slide where the claim is made. Several positions taught previously have been revised or removed, and those changes are identified explicitly with the source that prompted them. The adrenal and thyroid modules in particular bear little resemblance to the prior edition.
What the Course Covers
Does the course cover female hormone therapy and menopause?
Yes. Module 2 covers female hormone physiology, perimenopause and menopause, estrogen replacement therapy and delivery routes, progesterone therapy and endometrial protection, the cycling patient with cyclic symptoms, genitourinary syndrome of menopause and vaginal atrophy, and testosterone therapy in women.
Does the course cover testosterone replacement therapy in men?
Yes. Module 3 covers diagnosing low testosterone and male hypogonadism, the contraindications that should stop you from prescribing, delivery routes and transfer precautions, current FDA labeling, hematocrit and PSA monitoring schedules with the specific numbers that trigger referral, and the prescribing and telemedicine rules that apply to a Schedule III medication.
Does the course cover thyroid diagnosis and treatment?
Yes. Module 4 covers thyroid physiology and lab interpretation, the signs and symptoms that actually discriminate hypothyroidism, treatment thresholds and how to defend them, pregnancy and preconception, levothyroxine and liothyronine dosing, T4 and T3 combination therapy, and desiccated thyroid including its content, its current regulatory status and full conversion arithmetic.
Does the course cover adrenal function and cortisol testing?
Yes, extensively. Module 5 is the longest in the course and covers adrenal anatomy and HPA axis physiology, cortisol production and DHEA, Cushing’s and Addison’s as the diagnostic boundaries, the adrenal fatigue controversy examined in full including the critical literature, four-point saliva cortisol testing, cortisol curve pattern interpretation, medications that distort the curve, and treatment in sequence from lifestyle through vitamins, herbals, DHEA and hydrocortisone.
Does the course teach saliva hormone testing?
Yes. Saliva hormone testing is taught throughout rather than as a separate topic: collection technique, the errors that manufacture a false result, what saliva measures that serum does not, where salivary measurement is well supported and where it is not, and how to interpret a four-point cortisol curve by shape rather than by individual values.
Does the course cover compounded hormones and FDA regulation?
Yes. Module 1 covers the regulatory architecture in detail: FDA-approved products versus compounded preparations, Section 503A eligibility, USP monographs and bulk drug substance lists, marketed unapproved drugs, off-label prescribing, and how to evaluate a compounding pharmacy and read a certificate of analysis.
Does the course cover coding, documentation and compliance?
Yes. Module 6 covers the new patient visit and intake history, setting expectations, the follow-up visit, coding office visits correctly under current CPT rules, advertising limits, staff scripting, the ethics of dispensing supplements in the office, and documenting off-label use and informed consent.
Are real patient cases included?
Yes. Module 7 presents de-identified cases drawn from clinical practice across gonadal, thyroid and adrenal systems in both sexes and across age ranges, with the testing and reasoning shown as they occurred, including cases where the initial impression was wrong and cases that did not respond.
About Bioidentical Hormone Therapy and Testing
What is bioidentical hormone replacement therapy (BHRT)?
Bioidentical hormone replacement therapy uses hormones that are structurally identical to those the human body produces, such as estradiol, progesterone and testosterone, to replace hormone levels that have declined or become dysregulated. The term describes the molecule, not the source and not the manufacturing route: a bioidentical hormone may be FDA-approved or compounded.
What conditions is bioidentical hormone therapy used for?
BHRT is used in the management of menopausal and perimenopausal symptoms, andropause and symptomatic low testosterone in men, cyclic menstrual symptoms, hypothyroidism, and disturbances of the cortisol rhythm including sleep and body clock complaints. Appropriate use depends on testing, diagnosis and the clinical picture rather than symptoms alone.
Are bioidentical hormones the same as natural hormones?
“Bioidentical” means the molecule is identical to the one the body makes. It does not mean natural, and the two words are frequently confused in marketing. Many bioidentical hormones are synthesized in a laboratory, and many plant-derived preparations are not bioidentical at all. The course spends its first module untangling exactly this.
Are bioidentical hormones safer or more effective than synthetic hormones?
That claim is made frequently and it is not established. Head-to-head outcome data comparing bioidentical and synthetic preparations are limited, and the FDA has specifically cautioned against marketing compounded hormones as safer or more effective. What can be said is that some bioidentical preparations have different receptor and metabolic behavior than some synthetics, and that the course teaches you to describe those differences accurately rather than to overstate them.
What are the risks of bioidentical hormone therapy?
The same risks that apply to any hormone therapy apply here, and they are real. They include endometrial risk when estrogen is given without adequate progestogen protection, thromboembolic and cardiovascular considerations, contraindications in patients with a history of hormone-sensitive cancer, erythrocytosis and prostate monitoring obligations in men, suppression of fertility with exogenous testosterone, and virilizing effects that may not reverse. A substantial portion of the course is devoted to screening for these before the first prescription and monitoring for them afterward.
What is salivary hormone testing?
Salivary hormone testing measures the unbound, biologically available fraction of a hormone that has left the circulation and entered tissue, using saliva collected by the patient at specified times. Because saliva reflects free rather than protein-bound hormone, the result is not affected by changes in binding globulins the way a total serum level is.
Is saliva hormone testing accurate?
It depends on which hormone and which question. Salivary cortisol is well established and is the standard method for assessing the cortisol rhythm across the day, which a single blood draw cannot do. Salivary measurement of sex steroids is more variable and is not endorsed for every purpose by every professional body. The course teaches where salivary testing is well supported, where it is not, and how collection technique itself can create a false result.
Which hormones can be measured in saliva?
Cortisol, DHEA, estradiol, estriol, progesterone, testosterone and melatonin are commonly measured in saliva. The four-point cortisol curve, collected across a single day, is the measurement the adrenal module is built around.
Does insurance cover BHRT or saliva hormone testing?
Coverage varies widely by payer, by hormone and by indication, and saliva hormone panels are frequently not covered. The course addresses how to discuss cost with patients in advance, and how to code the office visit itself correctly, which is a separate question from whether the testing is reimbursed.
Getting Started
How do I enroll in the BHRT training course?
Order the course online. You will receive an email with your login credentials, and the full curriculum is available immediately. There is no waiting period and no application.
Can I start the course and finish it later?
Yes. Progress is saved, and you have two years of access. Most learners work through it over several weeks rather than in a single sitting, and many return to specific modules as clinical questions come up in practice.
Order you PracticalCME’s BHRT Certification Training Course Now and Begin Learning Today
$3,190.00 Original price was: $3,190.00.$2,690.00Current price is: $2,690.00.
$2,695.00 – $2,995.00Price range: $2,695.00 through $2,995.00
$5,085.00 Original price was: $5,085.00.$3,985.00Current price is: $3,985.00.
$1,695.00 Original price was: $1,695.00.$1,295.00Current price is: $1,295.00.