Menopause Replacement Therapy

Understanding Menopause Replacement Therapy

Our Menopause Replacement Therapy program is designed to address hormone deficiencies commonly experienced during menopause. Led by our expert hormone replacement team, we customize each program to suit your unique needs and lifestyle.

By utilizing a blend of bio-identical hormones and personalized consultations, we aim to restore your hormone levels to those of your early reproductive years. Simply put, our goal is to restore your hormone levels to where they were during your early reproductive years.

Identifying Menopause Hormone Deficiencies

1. Estrogen Deficiency Symptoms

Low estrogen levels during menopause can lead to various symptoms such as hot flashes, night sweats, vaginal dryness, bladder problems, and mood swings. Additionally, women may experience an increased risk of diseases like cardiovascular disease, stroke, and osteoporosis, along with weight gain due to a decline in basal metabolic rate.

2. Progesterone Deficiency Symptoms

Symptoms like irritability,
anxiety, insomnia, and headaches may indicate low progesterone levels, which
start decreasing during menopause. Progesterone supplementation is crucial to
prevent the growth of endometrial cells due to unopposed estrogen supplementation.

3. Testosterone Deficiency Symptoms for Females

Low libido, decreased vitality, dry skin, and loss of muscle mass are signs of low testosterone levels in women, which also decline during menopause.

Estrogen Replacement Option

Treatment Options

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


  • Pellet- $299-$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 forms

  • 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 times a week- $95 to $135 per month. Insurance coverage - $25 to $50 depending on the insurance tier.

Progesterone Replacement Options

Treatment Options

Oral progesterone capsules or sub-lingual rapid dissolve tablets are effective options to alleviate symptoms. This option helps with insomnia.


  • Limitations: Contraindicated if you have a peanut allergy.
  • Limitations: Only formulated in the 100mg and 200mg dose.
  • 90-day supply- cash pay- $125 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 for a 30-day supply.

Testosterone Replacement Options

Treatment Options

Pellets, creams, or rapid dissolve troches are available, with costs varying based on the chosen method.


  • Insurance will not cover testosterone treatment for females.
  • Pellet- $299-$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.
  • Cream 30-day supply - $45.
  • Cream 90-day supply - $105.
  • Rapidly dissolve troche for vaginal or by mouth dosing -30 day supply - $45.

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

Compounded forms

  • 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.
  • 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

Unlike some medical tests, hormone replacement therapy (HRT) labs do not require fasting.

Pellet Therapy

For patients undergoing pellet therapy, the provider schedules lab draws one or two month post-insertion to assess the appropriate dosage. Once the dosage is established, subsequent labs are drawn as needed.


Lab work for patients using creams should be done at least a week before their hormone visit. It's important to ensure no cream residue remains on the arms during the draw. Consider skipping cream application on the day of the lab draw to prevent interference.


For individuals using troches or rapid dissolve tablets (RDT), labs should be drawn at least four hours after administration to capture peak hormone levels. This should be done at least one week before the scheduled hormone visit.

Testosterone Injections

Lab work for patients receiving testosterone injections should be completed at least one week before their hormone visit, ensuring it's done before the next scheduled dose.

For example, if administering injections on Saturdays, labs should be drawn on Fridays.

Application of Hormone Creams

Versatile Usage

Hormone creams offer versatile application options. They can be applied on the inner surface of the forearms, behind the knees, on top of the feet, or vaginally. However, it's advisable to avoid applying creams mixed with testosterone on hairy areas to prevent unintended hair growth.

Optimal Vaginal Application

For vaginal cream, direct insertion into the vaginal opening is not necessary unless desired. Instead, it can be applied to the outer surfaces of the vaginal and clitoral area for optimal absorption. Care should be taken to avoid accidental contact with family members.

Troche or RDT Administration

Proper Dissolution

Both troches and RDTs should be completely dissolved in the mouth when taken orally. Patients typically place them under the tongue or between the cheek and gum. It's essential to avoid swallowing the troche or RDT to prevent potential liver issues.

Dosage and Frequency

Troches or RDTs may be dosed once or twice daily to maintain consistent hormone levels. Some patients prefer using troches for vaginal insertion, typically done at night after bathing.

Considerations for Hormone Replacement Therapy

Consultation with Specialists

Patients with a history of breast, uterine, or ovarian cancer, or those at high risk, should consult with an oncologist to assess the risk/benefit ratio of HRT. Similarly, individuals with a history of blood clots or a family history may need evaluation by a hematologist.

Maintaining Overall Health

Maintaining normal weight, cholesterol, and blood pressure during therapy is crucial to reduce the risk of complications such as blood clots, stroke, and heart attacks.

Understanding Side Effects

Patients should be aware of the potential side effects of estrogen, progesterone, and testosterone therapy, which may include bloating, headaches, breast tenderness, blood clots, and various gynecological cancers, among others.