Hormone Replacement Therapy Services
Restore Balance & Vitality with HRT
Our comprehensive hormone replacement therapy program offers personalized treatment to help you manage symptoms of hormonal changes and improve your quality of life. We provide evidence-based care for both women experiencing menopause and men with testosterone deficiency.
Hormone Replacement Therapy for Women
How It Works
As women approach menopause, the ovaries gradually produce less estrogen and progesterone. This hormonal decline causes the symptoms many women experience during perimenopause and menopause. Hormone replacement therapy (HRT) supplements these declining hormones to relieve symptoms and support your health.
Estrogen relieves hot flashes, night sweats, vaginal dryness, and other menopausal symptoms by replacing what your body no longer produces in sufficient amounts.
Progesterone or Progestin is added for women who still have a uterus to protect the uterine lining and prevent abnormal growth that could lead to cancer.
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Estrogen Only Therapy
For women who have had a hysterectomy
Available as pills, patches, gels, sprays, or vaginal rings
No need for progesterone protection
Combined Estrogen Progesterone Therapy
For women with an intact uterus
Available as combination pills or patches
Protects the uterine lining while relieving symptoms -
Oral (Pills)
Estradiol tablets
Conjugated equine estrogens
Combination estradiol plus progesterone capsules
Taken once daily
Transdermal (Patches)
Applied to skin once or twice weekly
Delivers steady hormone levels
May have lower risk of blood clots than pills
Good option for women with obesity or high triglycerides
Gels and Sprays
Applied to skin daily
Absorbed through the skin
Flexible dosing
Vaginal Preparations
Creams, tablets, rings, or suppositories
Primarily for vaginal dryness and urinary symptoms
Low systemic absorption
Can be used alone or with systemic therapy
Bioidentical Hormones
FDA approved bioidentical hormones (estradiol and micronized progesterone) are chemically identical to hormones your body produces. These are available by prescription and are safe, effective options. We do not recommend compounded bioidentical hormones, as they are not FDA approved and lack quality control and safety data. -
Symptom Relief
75% reduction in hot flashes and night sweats
Relief typically begins within 2 weeks for standard doses
Improved sleep quality
Relief from vaginal dryness and painful intercourse
Reduced urinary symptoms
Bone Health
Increased bone mineral density
Reduced risk of fractures, including hip and spine fractures
Protection against osteoporosis
Quality of Life
Improved mood and energy
Better sexual function
Enhanced overall well being
Reduced impact on daily activities and work productivity -
Common Side Effects (usually mild and temporary)
Breast tenderness
Bloating
Headaches
Nausea
Mood changes
Irregular bleeding (especially in first few months)
Managing Side Effects
Start with the lowest effective dose
Switch between oral and transdermal formulations
Adjust the type of progesterone
Take medications with food
Use continuous rather than cyclic dosing to avoid monthly bleeding
Serious but Less Common Risks
Blood clots (venous thromboembolism). Risk is higher with oral estrogen than transdermal
Stroke. Small increased risk, especially in older women
Breast cancer. Increased risk with long term combined estrogen progestin therapy (5+ years)
Gallbladder disease
Dementia. Possible increased risk if started after age 65
Important Note on Timing
The risks and benefits of hormone therapy depend significantly on your age and how long it has been since menopause began. Women who start therapy within 10 years of menopause and before age 60 generally have a more favorable benefit to risk profile than older women.
Who Should Not Use Hormone Therapy
Hormone therapy is not recommended if you have
History of breast cancer or other hormone sensitive cancers
History of blood clots or stroke
Active liver disease
Unexplained vaginal bleeding
Known or suspected pregnancy
History of heart attack -
Oral Medications
Take at the same time each day
Can be taken with or without food
Swallow whole with water
Transdermal Patches
Apply to clean, dry skin on lower abdomen, hip, or buttock
Rotate application sites
Change once or twice weekly depending on the product
Avoid applying to breasts or waistline
Can shower and swim with patch in place
Gels and Sprays
Apply to clean, dry skin (usually arms or thighs)
Allow to dry completely before dressing
Wash hands after application
Avoid skin to skin contact with others for several hours
Do not apply to breasts
Vaginal Preparations
Insert into vagina as directed (usually daily initially, then 2 to 3 times weekly)
Use applicator provided
Best applied at bedtime
Wash applicator after each use
Testosterone Replacement Therapy for Men
How It Works
Testosterone is the primary male sex hormone responsible for sexual function, muscle mass, bone density, energy levels, and overall vitality. As men age or develop certain medical conditions, testosterone levels may decline, leading to symptoms that affect quality of life. Testosterone replacement therapy (TRT) restores testosterone to normal levels, improving symptoms and overall health.
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TRT is appropriate for men with confirmed low testosterone levels (typically below 300 ng/dL on two separate morning measurements) and symptoms such as:
Decreased sex drive
Erectile dysfunction
Fatigue and low energy
Reduced muscle mass and strength
Increased body fat
Mood changes or depression
Difficulty concentrating
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Injectable Testosterone:
Testosterone cypionate or enanthate
Injected into muscle every 1-2 weeks
Most cost-effective option
Provides reliable testosterone levels
Transdermal Gels:
Applied to shoulders, upper arms, or abdomen daily
Absorbed through the skin
Provides steady testosterone levels
Must avoid skin contact with others until dry
Transdermal Patches:
Applied to skin daily
Delivers consistent hormone levels
May cause skin irritation
Subcutaneous Pellets:
Implanted under the skin every 3-6 months
Provides long-lasting, steady levels
Requires minor office procedure
Nasal Gel:
Applied inside the nose 2-3 times daily
Convenient but requires multiple daily doses
Oral Testosterone:
Newer formulations available
Taken twice daily with food
Avoids injections but requires consistent dosing
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Sexual Function:
Improved libido and sexual desire
Better erectile function (when combined with other treatments if needed)
Enhanced sexual satisfaction
Physical Changes:
Increased muscle mass and strength
Reduced body fat
Improved bone density
Better physical performance
Mental and Emotional:
Improved mood and reduced depression symptoms
Increased energy and vitality
Better concentration and mental clarity
Enhanced overall quality of life
Other Health Benefits:
Correction of anemia in some men
Improved metabolic markers
Better insulin sensitivity
Timeline: Most men notice improvements in libido within 3 weeks, with continued improvements in sexual function, mood, and energy over 3-6 months. Changes in body composition and bone density take 6-12 months.
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Common Side Effects:
Acne or oily skin
Breast tenderness or enlargement
Fluid retention and swelling
Increased red blood cell count
Reduced sperm production (can affect fertility)
Testicular shrinkage
Sleep apnea worsening
Managing Side Effects:
Adjust dose to maintain testosterone in mid-normal range (450-600 ng/dL)
Monitor and manage elevated red blood cell counts
Use topical treatments for acne
Consider dose reduction if side effects are bothersome
Serious Risks to Monitor:
Blood clots and pulmonary embolism (rare but serious)
Possible increased risk of atrial fibrillation
Worsening of sleep apnea
Possible increase in cardiovascular events (data are mixed)
Important: TRT does not increase the risk of prostate cancer based on current evidence, but men should be monitored regularly.
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TRT is not recommended if you:
Are planning to father children in the near future
Have breast or prostate cancer
Have a prostate nodule or elevated PSA without evaluation
Have severe untreated sleep apnea
Have uncontrolled heart failure
Had a heart attack or stroke within the past 6 months
Have significantly elevated red blood cell count
Have a history of blood clots
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Injectable Testosterone:
Injected into the muscle of the thigh or buttock
Can be self-administered or given in the office
Typical schedule: every 1-2 weeks
Rotate injection sites
Steps for Self-Injection:
Wash hands thoroughly
Clean injection site with alcohol
Draw prescribed dose into syringe
Remove air bubbles
Insert needle at 90-degree angle into muscle
Inject slowly and steadily
Remove needle and apply pressure
Dispose of needle in sharps container
Transdermal Gels:
Apply to clean, dry skin of shoulders and upper arms
Use the amount prescribed (usually 1-2 pumps or packets)
Allow to dry for 3-5 minutes before dressing
Wash hands immediately after application
Cover application area with clothing
Avoid swimming or showering for 2-6 hours
Avoid skin-to-skin contact with others until area is covered or washed
Patches:
Apply to clean, dry skin on back, abdomen, upper arms, or thighs
Apply at the same time each evening
Rotate application sites
Do not apply to scrotum
Pellets:
Implanted by your healthcare provider during an office visit
Small incision made in hip or buttock area
Pellets inserted under the skin
Lasts 3-6 months
Minor soreness at insertion site for a few days
Ready to Feel Like Yourself Again?
Contact us today to schedule a consultation and learn if hormone replacement therapy is right for you.