The Process:

1st visit - "moderate" level (see price list), labs ordered (if needed). 

2nd visit - when labs return (included in first visit fee) to decide best next steps. Rx sent (if needed).

Thereafter - "quick visit" (see price list) level visits with or without labs every 2-3 months until labs/dose are stable, then visits every 3-6 months. 

​

Memberships are required for hormone therapy. This can be a basic hormone membership or a direct primary care membership. 

​

Cost and frequency of labs depends on each individual's needs, insurance coverage, medications and prior lab results. Cash pay initial labs are ~$200, subsequent labs are $30-$120.

​

Female Hormone Therapy: A Real, Balanced Path (Not a One-Size-Fits-All)
​
Female hormone therapy isn’t a magic bullet. It’s a tool. Like any tool, it must be used with precision, respect, and humility. We don’t pretend it’s safe for everyone or appropriate for every case. WWe don’t bury risks in tiny text. We offer clarity and choice.

 

How much are medications? Find out here.
​
Why consider hormone therapy?

As women age (or due to surgical menopause, premature menopause, or other causes), drops in estrogen and progesterone can trigger a variety of symptoms: hot flashes, night sweats, vaginal dryness, mood swings, weak bones, changes in skin and lipid profiles, and more. For many, hormone therapy can meaningfully improve quality of life.

But: not everyone is a candidate. The goal is smarter balance, not blind normalization.

What we do differently (and the risks we don’t hide)

1. Individualization over protocols
We don’t rigidly follow “guidelines” as though they apply universally. We look at you — your symptoms, risk factors, desires, lab results, and preferences. We aim for the minimal effective dose, and we reassess frequently.

2. Transparency about risks
Yes, hormone therapy carries risks. Research from the Women’s Health Initiative (WHI) found that combined estrogen-progestin therapy increased risks of breast cancer, stroke, and venous thromboembolism in some women (Rossouw et al., 2002). While most of us know now that this study was riddle with issues that contributed to very incorrect conclusions - there are still risks. Age at initiation, type of hormones (bioidentical vs. synthetic, route of administration), baseline risk, and duration of therapy all modulate risk (Manson et al., 2017).
We explain that risk in terms you can grasp  not to scare you, but so you can decide knowingly.

3. No unnecessary testing
We don’t order sprawling hormone panels or exotic markers unless results will materially change management. Baseline labs might include estradiol, FSH, LH, lipid panel, liver/kidney function, and relevant risk screens (e.g. mammography, DEXA if bone health is a concern). We avoid panels that lead to chasing numbers that don’t change treatment. If number are your thing and you want extra testing like the DUTCH test - we are happy to help!

4. Limited profit incentives
We won’t push you on infusions, high-cost supplements, or proprietary “hormone packages.” We don’t profit from labs or endless upselling. If a simpler, safer option exists, we’ll recommend it.

5. Ongoing review and flexibility
Therapy isn’t “set and forget.” We reevaluate symptoms, side effects, labs, and risk profile annually (or more often). If benefits no longer outweigh risks, we taper or discontinue.

Types & delivery routes

Estrogen is only offered transdermally (patch, gel) or as a pellet estrogen may have lower risk of clotting than oral in certain populations (Canonico et al., 2007).

Micronized Oral progesterone is inexpensive, bioidentical and variable at commercial pharmacies and carries less risk than progestins. Progesterone is also available as a topical cream. 

Testosterone is not well studied in women but many women choose to have their testosterone replaced for better libido and to help improve bone or muscle mass. Testosterone is available as a topical, injection or pellet. 

Pellets-  We ARE able to do pellets even though we do not recommend them due to the development of scar tissue and permanence of the dosing. That said, your body, your choice - we are here to help. 

Bioidentical hormones are often marketed as safer, but the evidence is still mixed. The form, dose, quality, and route all influence outcomes.

Generally favorable candidates might be:

• Younger women (e.g. under ~60) started soon after menopause

• Women with moderate to severe symptoms impairing quality of life

• Women with low bone density risk, without contraindications

 

May proceed with caution:

• History of breast cancer, estrogen-sensitive cancers

• Uncontrolled hypertension, hypercoagulable states, prior thromboembolism

• Stroke, coronary artery disease

• Severe liver disease

 

These aren’t automatic disqualifiers - just red flags that demand extra caution, shared decision-making, or avoidance.

 
Practical considerations & monitoring

• Start low, go slow.

• Monitor symptoms but also lab values that matter (lipids, liver enzymes, etc.).

• Reassess risk vs benefit periodically.

• Use nonhormonal adjuncts when helpful (lifestyle changes, diet, exercise, sleep hygiene).

• If you opt out or discontinue therapy, we support you through that transition.

 

Our promise to you

• We won’t push “bioidentical hormones are always safer” as gospel

• We won’t overtest just to generate billable results

• We won’t hide the risks

• We will show you what we actually believe will benefit you (even if that means recommending no therapy).

If you’re thinking about female hormone therapy, we offer clarity, safety, and integrity - no fluff, no spin.

 

References

Canonico, M., Oger, E., Plu-Bureau, G., Conard, J., Meyer, G., Levesque, H., … Scarabin, P.-Y. (2007). Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the E3N‐EPIC Study. Circulation, 115(7), 840-845.

Manson, J. E., Kaunitz, A. M. (2016). Menopause Management — Getting Clinical Care Back on Track. New England Journal of Medicine, 374, 803–806.
 

Rossouw, J. E., Anderson, G. L., Prentice, R. L., LaCroix, A. Z., Kooperberg, C., Stefanick, M. L., … Writing Group for the Women’s Health Initiative Investigators (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA, 288(3), 321–333.