Hormone Replacement Therapy
Menopause Doesn't Have to Define You.
What It Treats
How It Works
Bioidentical estradiol and progesterone replace declining ovarian hormones. Estrogen restores thermoregulation, bone metabolism, and neurological function. Progesterone protects the uterine lining and supports sleep. Available as pellets, creams, troches, or injections.
Mechanism of Action
During perimenopause and menopause, declining estrogen and progesterone levels trigger a cascade of symptoms: hot flashes, night sweats, mood changes, brain fog, vaginal dryness, bone loss, and disrupted sleep. Bioidentical HRT restores these hormones to physiological levels using molecules identical to what your body naturally produces. The ELITE trial published in the New England Journal of Medicine showed that when HRT is initiated within 6 years of menopause onset, it actually reduces atherosclerosis progression — the "timing hypothesis" that has transformed how we prescribe HRT. We offer pellets, creams, troches, and injections — personalized to your hormone panel and symptom profile.
In 643 postmenopausal women randomized to estradiol or placebo, women who started HRT within 6 years of menopause showed significantly reduced progression of carotid artery intima-media thickness (a marker of atherosclerosis) compared to placebo. Women who started HRT 10+ years after menopause showed no benefit. The ELITE trial provided definitive evidence for the "timing hypothesis" — that HRT is cardioprotective when initiated early.
Cumulative 18-year follow-up of 27,347 WHI participants showed that hormone therapy was not associated with increased all-cause mortality during either the intervention phase or post-intervention follow-up. In the estrogen-alone group, there was actually a trend toward reduced breast cancer incidence and mortality. The study established that the risks of HRT were substantially overstated by initial WHI reports, particularly for women who start therapy in their 50s.
The Results
The WHI follow-up study published in JAMA — tracking women for 18 years — finally settled the HRT safety debate. For women who started HRT in their 50s (the typical perimenopause window), there was no increased risk of all-cause mortality, and estrogen-alone users actually showed reduced breast cancer incidence. A 2020 study in the BMJ across 80,000 women further confirmed that bioidentical hormones (transdermal estradiol and micronized progesterone) carry the lowest risk profile. Our patients consistently report dramatic improvement in sleep, mood, energy, and cognitive clarity — often describing it as "getting themselves back."
Nested case-control study of 98,611 women confirmed that bioidentical hormones (transdermal estradiol combined with micronized progesterone) carry the lowest breast cancer risk of any HRT regimen — with no significantly increased risk for up to 5 years of use. Transdermal delivery avoids first-pass liver metabolism, and micronized progesterone is safer than synthetic progestins. The study provided the strongest evidence to date for preferring bioidentical over synthetic HRT formulations.
Ideal For
Women in perimenopause or early menopause (typically 40-60) experiencing vasomotor symptoms, mood changes, sleep disruption, or cognitive decline. Best outcomes when started within 10 years of menopause onset.
Your Protocol
Delivery method matched to patient preference: pellet insertion every 3-4 months, topical estradiol cream daily, sublingual troches daily, or injection. Progesterone added for women with intact uterus. Labs at baseline, 6 weeks, then quarterly.
Ready to Start Hormone Replacement Therapy?
Add to your plan and bundle with other services to save 15%. Or book directly.
Cancellation Policy: A $50 non-refundable deposit is required to confirm your appointment for all consultations — our front desk will reach out to collect it after you book. The deposit is applied toward your visit cost. We require at least 24 hours' notice for cancellations or changes. No-shows or late cancellations will forfeit the deposit. By booking, you agree to these terms.
Business hours: Mon–Thu 8am–6pm · Fri 8am–12pm
