Bio-identical hormone replacement.
Hormonal transitions — perimenopause, menopause, premature ovarian insufficiency, hormonal imbalances at any life stage — are among the most under-addressed clinical realities in conventional medicine. Symptoms get attributed to "stress" or "aging." Lab work is often not run. Treatment, when offered at all, is often a one-size approach.
The practice's HRT program is structured to do this differently. Comprehensive baseline bloodwork. Symptom-driven treatment selection. Frequent reassessment based on response. Bio-identical hormones — molecularly identical to what the body produces — selected and dosed individually rather than from a protocol.
Indications and what's offered
- — Perimenopausal symptom management
- — Menopausal hormone replacement
- — Hormonal imbalance evaluation at any life stage
- — Estradiol, progesterone, testosterone (when indicated for women)
- — Multiple delivery routes — oral, transdermal patches and creams, and pellet therapy where clinically appropriate
- — Symptom tracking and dose adjustment based on response
Testosterone replacement therapy.
Age-related decline in testosterone is real. So is the over-prescription of TRT in patients who would be better served by addressing sleep, weight, and lifestyle drivers first. The practice's approach is to evaluate carefully, treat appropriately, and monitor responsibly.
Indications and what's offered
- — Symptom-driven evaluation (low energy, libido, mood, body composition)
- — Lab-driven candidacy assessment (total and free testosterone, with appropriate timing)
- — Lifestyle assessment first — diet, sleep, stress, weight, exercise — as a frequent first lever
- — Testosterone replacement protocols when indicated — injection, transdermal, or pellet, individualized to the patient
- — PSA, hematocrit, lipid, and estradiol monitoring per protocol
- — Symptom-tracking and dose adjustment
What we look at.
HRT and TRT decisions are only as good as the data behind them. Standard panels often miss the picture; comprehensive panels reveal the picture. Members receive a full hormonal evaluation at baseline and at protocol-driven intervals afterward.
Lab draws are sent out to LabCorp and Quest based on patient insurance and clinical needs — no in-house lab.
- — Sex hormones (estradiol, progesterone, testosterone — total and free)
- — Thyroid (TSH, free T4, free T3, sometimes thyroid antibodies)
- — Adrenal (cortisol — timed, sometimes DHEA-S)
- — SHBG (sex hormone binding globulin) for accurate free hormone assessment
- — Metabolic and cardiovascular markers — relevant to HRT/TRT safety
- — Annual reassessment cadence built into the program
Hormone optimization needs frequent adjustment.
HRT and TRT are highly individual. Two patients with identical lab values often need different doses; the same patient often needs different doses six months apart. The medicine works best when patient and physician can iterate quickly — a symptom report on Tuesday leads to a dose adjustment by Friday. That kind of responsiveness is exactly what the concierge structure is designed to make possible.
For members, that means hormone care is not a quarterly check-the-box visit. It is an ongoing conversation, with direct provider access between scheduled visits, and dose adjustments made when they need to be made — not when the next available appointment slot opens.
Risk discussion is part of the care.
Hormone replacement therapy carries real risks alongside real benefits. The cardiovascular, oncologic, and metabolic risk profiles are different for different patients and different protocols. Before HRT or TRT begins, the practice's protocol includes a complete informed-consent discussion: what the evidence supports, what is uncertain, what monitoring is required, and what symptoms should prompt re-evaluation.
Members are not "started on HRT" by default. They are evaluated, advised, monitored, and given the information to make an informed choice. The medicine is responsive, not prescriptive.
Related.
Schedule a hormone consultation.
Members typically begin with comprehensive baseline bloodwork before any treatment decisions.
or call our office line · (949) 404-4444