MENOPAUSE REPLACEMENT THERAPY

How the Program Works

Dr. Rogers’ hormone replacement team will work with you to personalize a blend of bio-identical hormones to fit your individualized needs and lifestyle. Simply put or goal is to restore your hormone levels to where they were during your early reproductive years and when you felt your best.

The hormone replacement program is designed to conveniently meet the needs of patients in office and virtually. Lab work can be completed on site as well.

Menopause Hormone Deficiencies

Estrogen Deficiency Symptoms

Hot flashes, night sweats, vaginal dryness, bladder problems, difficulty concentrating and moodiness are symptoms usually attributed to low estrogen levels during menopause. In addition, the incidence of disease processes such as cardiovascular disease, stroke, and osteoporosis increase during menopause, while the basal metabolic rate declines causing abnormal weight gain.

Progesterone Deficiency Symptoms

Irritability, anxiety, insomnia, headaches, and water retention is usually related to low progesterone levels. Production starts to decrease when a woman begins to enter menopause. Progesterone is given to prevent endometrial cells from growing due to unopposed estrogen supplementation.

Testosterone Deficiency Symptoms for Females

Testosterone is produced in the ovaries of all women; however, like estrogen, testosterone levels decrease in women going through menopause. Sign of this occurring includes low libido, decreased vitality, dry skin, and loss of muscle mass.

Hormone Replacement Strategies for Menopause

Dr. Rogers’ hormone replacement team keeps it simple and safe with multiple combinations of blended options. Pellet therapy has become the most popular option for both estrogen and testosterone therapy secondary to the immediate effectiveness after placement and resolving symptoms while enhancing lifestyles.

Estrogen Replacement option

Treatment Options:
Pellets, creams, vaginal rings, troches, oral preparations, and transdermal patches are all available in natural hormone formulations.

Cost:
Pellet- $350 (placed every 3 months)- Can contain both estrogen and testosterone. Pellets are convenient; supply a consistent hormone therapeutic level and best of all no cross exposure of hormones to other family members.

Compounded cream 30 day supply- $35
Compounded cream 90 day supply- $85
Compounded oral or vaginal RDT/Troche- $45-$55 a month

Estradiol Transdermal patches- Apply patch either weekly or 2 x’s a week- $95 to $135 per month. Insurance coverage – $25 to $50 depending on insurance tier.

Progesterone Replacement Options

Treatment Options:
Oral progesterone compounded in the sustained release capsule form or prometrium capsule form is the best option for insomnia described as not being able to stay asleep all night.

Progesterone in the sub-lingual rapid dissolve tablet form is the best compound for insomnia described as not being able to fall asleep.

Cost:
Prometrium- oral progesterone capsule

  • Limitations: Contraindicated if you have a peanut allergy.
  • Limitations: Only formulated in the 100mg and 200mg dose.

30 day supply- cash pay- $63 and with insurance coverage @ $10.

Compounded forms:
Capsule SR release- 30-day supply – $45 and 90 day supply @ $105.
Liquid form 30 day supply – $55 and limited by a bitter taste.
Cream based form – $45.
Vaginal troche form – $55

Testosterone Deficiency Symptoms for Females

Cost:
Insurance will not cover testosterone treatment for females.

Pellet – $350 (placed every 3 months)- Can be just testosterone. Pellets are convenient; supply a consistent hormone therapeutic level and best of all no cross exposure of hormones to other family members.

Compounded Cream 30 day supply – $45.
Compounded Cream 90 day supply – $105.
Rapid dissolve troche for vaginal or by mouth dosing -30 day supply – $45.

Note: Typically if estrogen and testosterone are combined in the cream form, the price will decrease per compounding pharmacy rates. The 90 supply of estrogen and testosterone in combination will be @ $100-$150 dollars.

Intramuscular injections are dosed once a week. Injections can be administered in the clinic or at home.

  • Your medication stored at the clinic- $10 per injection
  • Dr. Rogers Centers supplies medication- $20 per injection

IM Testosterone- @ $75 a month or @ $125 for a 3 month supply. Testosterone for females must be compounded at a specialty pharmacy.

Menopause Lab Draw Considerations

HRT lab work does not require fasting.

Pellet Therapy – Prior to the patient’s first hormone pellet treatment, lab work will be completed in order to determine the pellet dose to be inserted. Thereafter, lab work will be completed, as needed usually one or two months after insertion.

Creams – Prior to beginning hormone replacement cream therapy, lab work must be completed in order to determine the individual’s initial hormone levels. Thereafter, when lab work is ordered, do not apply the hormone replacement cream on the arms until your lab has been drawn for the day. Lab work must be drawn one week before scheduled appointment to have results in time for discussion at follow-up in clinic or virtually.

Troches/RDT – Labs should be drawn at least 4 hours after taking the troche. This timing gives us a snap shot of your peak levels. The lab needs to be drawn at least one week before planned hormone visit.

Testosterone Injections– Lab needs to be drawn at least one week before planned hormone visit. The timing of the lab draw is important. The lab should be drawn before next dosing.

Example: If you administer your injection on Saturdays then draw your lab on Friday.

Where Can I Apply The Hormone Cream?

Hormones creams are very versatile meaning they can be applied to various surfaces areas such as the inner surface of the forearms, behind the knees, on top of the feet, or vaginally. Please note: we suggest that patients do not apply creams mixed with testosterone to hairy areas because it may promote unwanted hair growth.
The vaginal cream does not have to be inserted directly into the vaginal opening unless desired. The cream can be applied directly to the outer surface of the vaginal and clitoris area for best absorption.
You do not want the cream to come into contact with others.

How Do I Take My Troche or RDT?

Both the troche and the RDT need to completely dissolve in the mouth when taken orally. Most patients either place the troche or RDT under their tongue or between their check and gum. You should only swallow your salvia and none of the troche or RDT to prevent liver distress.

The troche or the RDT may be dosed once or twice a day to maintain consistent levels of hormone.

Some patients prefer the troches for vaginal insertions. Patients typically place the troche vaginally at night after bathing.

Considerations for Hormone Replacement Therapy

Patient’s with a history of breast, uterine and/or ovarian cancer or high risk of getting breast, uterine or ovarian cancer should consider a consult with an oncologist to determine the risk/benefit ratio of HRT.

Persons with a history of blood clots or a family history of blood clots may need to be evaluated by a hematologist to determine the risk/benefit ratio of HRT.

Maintaining a normal weight, cholesterol and blood pressure during therapy will reduce the risk of blood clots, stroke and heart attacks while on HRT.

Side effects of estrogen can be bloating, headaches, breast tenderness, blood clots and ob/gyn cancers.

Side effects of progesterone can be morning sleepiness and increased risk of ob/gyn cancers.

Side effects of testosterone can be scalp hair loss, hair growth on the face, acne, enlargement of the clitoris, and personality changes.

Blood donations may be required because testosterone therapy can increase the red blood cell count, which can increase the viscosity of the blood creating an increased risk for heart attack and stroke.