Transdermal Patches
Estradiol patches provide steady absorption through the skin and avoid first-pass liver metabolism.
Women’s Hormone Health
Bioidentical Hormone Replacement Therapy Personalized BHRT for Women
Thoughtful, individualized care for women navigating perimenopause, menopause, and other hormone-related concerns. Your treatment plan is guided by your symptoms, health history, laboratory findings, and personal goals.
- Individualized evaluation
- Evidence-based guidance
- Ongoing clinical monitoring
Understanding Menopause
What Is Menopause?
Menopause is confirmed after 12 consecutive months without a menstrual period when there is no other medical explanation. It most often occurs between ages 45 and 55, although timing varies.
Perimenopause is the transition leading up to menopause. Changing hormone levels during this period may contribute to hot flashes, night sweats, sleep disruption, vaginal symptoms, mood changes, and changes in menstrual cycles.
You do not have to wait until periods have stopped for a full year to seek care. Evaluation and treatment can begin during perimenopause when symptoms are affecting sleep, comfort, relationships, work, or quality of life.
Important: New, severe, or unexplained
symptoms and abnormal bleeding should be evaluated by a
qualified healthcare professional.
Signs and Symptoms
Are Menopause Symptoms Affecting Your Daily Life?
Perimenopause and menopause can affect physical, emotional, sexual, and metabolic well-being. Symptoms may be mild for some women and disruptive for others.
- Hot flashes
- Night sweats
- Sleep disruption
- Mood changes
- Low energy
- Vaginal dryness
- Discomfort during intercourse
- Changes in sexual desire
- Changes in menstrual cycles
- Difficulty concentrating
Treatment Considerations
Modern Hormone Therapy: Benefits, Timing, and Safety
Menopausal hormone therapy is the most effective treatment for hot flashes and night sweats and can also support vaginal health and help prevent bone loss. For many healthy women with bothersome symptoms, the benefit-risk profile is most favorable when treatment begins before age 60 or within 10 years of menopause onset.
Hormone Therapy May Help
- Reduce hot flashes and night sweats
- Improve menopause-related sleep disruption
- Relieve vaginal dryness and discomfort
- Reduce pain associated with vaginal symptoms
- Prevent bone loss in appropriate patients
- Support quality of life when symptoms improve
Body-Identical Options, Selected Thoughtfully
“Bioidentical” describes hormones with the same chemical structure as hormones made by the human body. FDA-approved 17-beta estradiol and micronized progesterone are body-identical options available in standardized doses. Depending on the patient, they may offer practical advantages over older formulations, including flexible dosing and nonoral delivery.
The route matters. Transdermal estradiol—delivered through a patch, gel, or spray—avoids first-pass liver metabolism and may have a lower effect on clotting pathways than oral estrogen. When the uterus is present, progesterone or another appropriate progestogen is generally added to protect the uterine lining.
“Bioidentical” does not automatically mean safer, and compounded products have not been proven superior to FDA-approved therapy. The best regimen is selected from the patient’s symptoms, age, health history, uterus status, preferred route, and treatment goals, then refined through follow-up.
Hormone therapy is not appropriate for everyone, but risk
is not the same for every woman or every formulation. A
history of certain hormone-sensitive cancers, blood clots,
stroke, unexplained vaginal bleeding, or significant liver
disease requires careful review and may change which
options are appropriate. Dose, route, timing, and duration
all matter.
Updated FDA labeling: In February 2026,
the FDA approved removal of cardiovascular disease, breast
cancer, and probable dementia language from the boxed
warnings of an initial group of menopausal hormone therapy
products. This important update corrects overly broad
messaging and can help more women have informed discussions
about treatment. Product-specific warnings and
contraindications still apply, and the boxed warning for
endometrial cancer remains on systemic estrogen-alone
products.
Treatment Options
HRT Options Designed Around Your Needs
Hormone therapy is not one-size-fits-all. We offer multiple delivery methods so treatment can be selected according to your symptoms, medical history, preferences, and clinical needs. Your provider will review the advantages and limitations of each option before recommending a formulation, dose, and monitoring plan. When systemic estrogen is appropriate, we generally favor a transdermal route over oral estrogen because it avoids first-pass liver metabolism and may have less effect on clotting pathways.
Understanding the Evidence
Why the Original WHI Results Were Often Misapplied
The Women’s Health Initiative was a landmark set of trials, not a “bad study.” The problem was that early headlines and clinical reactions often generalized its findings to all women, all ages, and every type of hormone therapy. That is broader than the trials were designed to support.
An older study population
Participants had an average age of about 63, and many began therapy well beyond the usual onset of menopause symptoms.
Specific older formulations
The principal trials studied oral conjugated equine estrogen, with or without medroxyprogesterone acetate—not every formulation or route used today.
A prevention-focused question
The trials primarily evaluated chronic-disease prevention, rather than symptom treatment started during perimenopause or early menopause.
Longer follow-up showed that outcomes differ according to age, timing, whether estrogen is used alone or with a progestogen, and the outcome being studied. The combined estrogen-plus-progestin trial did identify an increased breast cancer risk, while the estrogen-alone trial produced different breast cancer findings. These results remain important, but they should not be treated as proof that every modern hormone regimen carries the same risk.
Current decision-making considers the individual woman, treatment timing, dose, route, formulation, and personal risk factors. For many healthy women with bothersome symptoms who begin therapy before age 60 or within 10 years of menopause, major menopause guidance finds the benefit-risk profile favorable when contraindications are absent.
Support Through Change
You Don’t Have to Navigate Menopause Alone
Menopause can influence sleep, energy, comfort, relationships, and emotional well-being. Your concerns deserve to be heard and evaluated without dismissal.
Our medical team reviews your symptoms, health history, laboratory information when clinically appropriate, and treatment preferences before discussing available options.
Care can begin during perimenopause. Starting an appropriate therapy earlier in the menopause transition may provide a more favorable benefit-risk profile than first initiating systemic treatment many years after menopause, although the right timing remains individual.
Hormone Education
Understanding Hormones During Menopause
Hormone levels and symptoms can change throughout the menopause transition. Testing and treatment should be ordered only when clinically appropriate.
Estrogen
Estrogen levels fluctuate during perimenopause and decline after menopause. Systemic estrogen can reduce hot flashes and night sweats and help prevent bone loss in appropriate candidates. Low-dose vaginal estrogen may be considered when vaginal or urinary symptoms are the primary concern.
Progesterone
For women who have a uterus and use systemic estrogen, a progestogen is generally included to reduce the risk of endometrial overgrowth and cancer. The appropriate medication and schedule should be selected after reviewing medical history and treatment goals.
Testosterone
Women naturally produce testosterone, and levels may change with age and ovarian function. Testosterone is not a routine treatment for every menopause symptom. Its use requires careful evaluation, a specific clinical indication, appropriate dosing, and ongoing monitoring.
DHEA
DHEA is produced primarily by the adrenal glands and serves as a precursor to other hormones. Testing may be considered when clinically relevant. Routine systemic supplementation is not appropriate for everyone, while prescription vaginal DHEA may be an option for certain menopause-related vaginal symptoms.
Talk With a Menopause Care Provider
Schedule a consultation to discuss your symptoms, medical history, and the hormone and nonhormonal treatment options that may be appropriate for you.
Book Your ConsultationThis content is for general educational purposes and does not replace medical advice, diagnosis, or treatment. Hormone therapy requires an individual medical evaluation. Treatment eligibility, benefits, risks, and results vary.
Women’s Hormone Health
Ongoing BHRT Care With Predictable Membership Pricing
Receive coordinated hormone care with consultations, individualized laboratory monitoring, prescribed treatment, necessary supplies, and continued support.
- Initial and follow-up consultations
- Hormone-related laboratory monitoring
- Clinician-directed hormone therapy
- Necessary treatment supplies
- Standard delivery
- InBody analysis and membership benefits
Monthly Option
$349
per month
Annual Option
$3,490
per year
Annual membership saves $698—the equivalent of two months.
View Membership PricingA one-time setup fee may apply. Program eligibility, medication selection, and treatment recommendations require medical evaluation and appropriate laboratory review.
