An Integrative and Holistic Approach to Wellness

 We offer a variety of modalities for hormone management, including oral, transdermal, sublingual, and injectable options. The best one is determined via shared decision making between the provider and the patient. We do not offer pellets at this practice. Hormone therapy (HT) is used to treat menopause symptoms. HT replaces the hormones that drop at menopause. You may start to get relief from these symptoms within weeks of starting HT. HT may contain one or both of the hormones estrogen and progesterone. HT comes in a variety of modalities, and For genitourinary syndrome of menopause (GSM) , a vaginal cream, a tablet, or ring may be used to relieve dryness to the tissues in and around the vagina and vulva. This can also be beneficial for prevention of urinary tract infections (UTIs) and symptoms of overactive bladder. Vaginal estrogen HT has little to no risks at all and is extremely beneficial.
Like all medicines, HT has some risks. It is important to always stay up to date on general health screenings while on HT. Risk/benefit ratio will be determined at your consultation.
HT is indicated for the treatment of VSM (vasomotor symptoms of menopause), including hot flushes and night sweats. It is also indicated for GSM (genitourinary syndrome of menopause), and osteopenia (weakening of the bones/precursor to osteoporosis). HT can also be helpful for sleep problems, mood symptoms, and decreased sex drive. When HT is started in early menopause or perimenopause, it may reduce the risk of colon cancer, type 2 diabetes, and cardiovascular disease. The benefits generally outweigh the risks when started within 10 years of menopause in healthy women.
The risks of cardiovascular events, breast cancer, blood clots, and stroke is increased when starting HT 10 or more years after menopause/last use of hormone therapy. Common side effects of estrogen include breast pain, headache, and nausea. You may also experience mild cramping or spotting if you have a uterus. If this occurs, we would like to see you for a follow up as this may indicate a need for hormone adjustment, or a further workup.
Starting HT earlier in menopause has much less overall risk, and provides greater overall benefit. If you have a uterus, you must take progesterone in addition to estrogen for uterine protection. If you have had a hysterectomy, you may take estrogen alone. Side effects of progesterone include nausea, irritability, breast tenderness. Progesterone is often beneficial for sleep as it may slightly reduce occurrence of night sweats, though not as significantly as estradiol. Progesterone can be used with or without a uterus. 
Some women benefit from testosterone therapy, and this is only indicated for hypoactive sexual desire disorder (HSDD). However, many women report improvement in overall mood, energy level, muscle mass and bone density, and cognitive function. Side effects of testosterone therapy may include unwanted facial hair or scalp hair loss, acne, lower voice, or clitoral enlargement.