Bio-Identical Hormone Replacement Therapy (BHRT) in Walnut Creek

Hormone Replacement Therapy: What I Offer

What I prescribe depends on what your labs and your symptoms show, so the combination differs from one client to the next.

Many of the women I see are in perimenopause or past menopause — hot flashes, night sweats, broken sleep, mood and weight changes — and that is where bio-identical hormones are most often used. For women, see our page on perimenopause and menopause treatment.

These are the hormones I work with:

• Testosterone, as injections or creams
• DHEA
• Estrogen and progesterone, as creams
• Levothyroxine, for thyroid
• Other hormones where your labs show a need

I prescribe these as creams, gels or patches, depending on the hormone and your preferences.

I do not offer hormone pellets. This is not only my preference: the American College of Obstetricians and Gynecologists advises against pellet therapy, because once a pellet is placed, hormone levels that run too high cannot be brought back down.¹

1. American College of Obstetricians and Gynecologists. Compounded Bioidentical Menopausal Hormone Therapy: ACOG Clinical Consensus No. 6. Obstetrics & Gynecology, 2023.

Signs Your Hormones May Be Declining

Hormone levels fall gradually, so the signs tend to creep in rather than arrive all at once. These are the ones I hear about most:

• Low energy and fatigue
• Poor sleep
• Hot flashes and night sweats
• Mood changes, irritability or low mood
• Anxiety
• Brain fog and trouble concentrating
• Weight gain, especially around the middle
• Loss of muscle tone
• Low libido
• Vaginal dryness
• Irregular or changing periods
• Thinning hair
• Dry skin
• Joint aches
• Slower recovery from exercise

Having several of these does not by itself mean hormone therapy is the answer. It means it is worth a conversation, and worth checking your levels.

How It Works, Step by Step

The sequence is the same for everyone; the plan inside it is not.

1. A one-hour first visit: the consultation, your history, and a physical examination. Nothing else happens at this visit.
2. Lab work. You take a kit home and send it to the lab. Saliva testing goes to ZRT Laboratory; if blood tests are needed, they go to a standard lab such as Labcorp.
3. Treatment starts once your results are in, and we have gone through them together.
4. A follow-up visit at one month.
5. If all is well, follow-up every three to six months after that.
6. Labs are repeated at three to six months, then every six to twelve months unless something changes.

That is a tailored plan, not a fixed rule — the intervals move with how you respond.

Is Hormone Therapy Right for You?

Hormone therapy is not the answer for everyone, and I would rather we find that out at the consultation than after months of treatment. If your history or your labs show a reason not to treat, I will not treat. You will hear exactly why. If they show that your symptoms are coming from somewhere else, we will talk about that instead. When they do point to declining hormones, we will agree on a plan together. You will know what each step is for before we take it.

Fees

I would rather you know the numbers before you book.

• Consultation: $150, waived if you proceed with treatment
• Initial lab work: $200, if you proceed
• Ongoing care: $150 per month
• Repeat labs: $200 to $350 each time your levels are rechecked, depending on which labs are checked
• Medications are separate, and are not included in the monthly fee

If anything about the plan changes, we will go over the cost of it before it does.

Hormone Therapy Questions

Ready to Talk About Your Hormones?

Book a consultation, or call the office if you would like to talk it through first. We will go through your symptoms, check your levels, and decide together whether hormone therapy is the right step for you.

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