Bioidentical Hormone Replacement Therapy
Care that starts with your symptoms, history and goals.
Hot flashes, night sweats, vaginal dryness and changing periods can signal the menopause transition. Poor sleep, fatigue, brain fog, mood changes or lower desire may also bring you in. These symptoms deserve attention, but they are not all caused by low hormones. We consider other explanations rather than assume hormone therapy is the answer.
At Arcadia, Beth Panoff, FNP reviews your symptoms, health history, medications and goals, including bleeding patterns, previous treatment and personal or family risk factors. Testing is selected when it can clarify a question or change care. Menopause in otherwise healthy women over 45 is usually identified from symptoms and menstrual history, without routine hormone testing.
Treatment begins with a shared decision about benefits, risks and alternatives. Hormone therapy can help appropriate patients manage menopause symptoms; it is not prescribed simply to reverse aging or prevent heart disease or dementia. Your $275 Comprehensive Consultation is a 60–90 minute visit to understand what has changed and decide which next steps make sense for you.
What Are BioIdentical Hormones?
What “bioidentical” means: A hormone has the same molecular structure as one made by the body. FDA-approved estradiol and micronized progesterone are examples. The term does not mean a medicine is risk-free, and it does not mean it must be compounded. Compounded products are not FDA-approved and are not automatically safer or more effective. We discuss the evidence for the specific product and your options.
Treatment options: Systemic estrogen may be given through the skin, such as a patch or gel, or by mouth. People with a uterus generally need a progestogen with systemic estrogen to protect the uterine lining. For vaginal dryness or discomfort, local vaginal treatment may be considered. The route, dose and whether a hormone is appropriate depend on symptoms, preferences and risk factors. Thyroid disease requires a separate evaluation; thyroid medicine is not a general menopause or weight-loss treatment.
What to expect: We agree on the symptoms to track, likely benefits, possible side effects and how to follow up. Improvement varies, and the initial choice may need adjustment. Guidance recommends a review around three months after starting treatment and annually thereafter, with earlier review when symptoms, bleeding or side effects require it. Follow-up testing is selected for a clinical reason, rather than promising a fixed panel for everyone. Tell your clinician about new or unexpected bleeding.
Is hormone therapy safe? There is no single answer for everyone. Age, time since menopause, medical history, formulation and route affect the balance of benefits and risks. We review concerns such as blood clots, stroke, breast cancer and unexplained bleeding before prescribing. Some people need another approach or specialist input. Hormone therapy can reduce menopause symptoms and help prevent bone loss while it is used, but it should not be presented as a way to prevent heart disease or dementia.
What if hormones are not the whole answer? We also consider sleep, medications, mood, nutrition, activity and metabolic health. Brain fog, fatigue, weight changes and low desire have several possible causes. Hormone therapy is not a stand-alone fat-loss plan. If ongoing care is appropriate, Metabolic & Hormone Optimization brings treatment review together with practical attention to strength, body composition and long-term health. Start with your Comprehensive Consultation; additional testing and treatment costs are explained before you commit.