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Hormones & Menopause Care

Evidence-Based Menopause & Perimenopause
Hormone Treatment

Thoughtful, individualized hormone therapy guided by science, symptoms, and long-term health including bone, metabolic, and cardiovascular risk.

Our Approach

Hormonal changes during perimenopause and menopause can affect energy, sleep, mood, weight, bone density, and overall quality of life. At Vitality, we provide medically appropriate hormone therapy grounded in careful evaluation, shared decision-making, and individualized care.

Our Philosophy

Much of the confusion around menopause hormone therapy comes from outdated information and one-size-fits-all thinking. Our approach is grounded in current evidence and individualized to you:

Hormone therapy is not about chasing youth or prescribing hormones to everyone. It is about treating real symptoms, improving quality of life, and thoughtfully considering long-term health especially bone and metabolic health.

Who This Care Is For

We commonly work with women who are experiencing:

Symptoms We Treat
Hot flashes & night sweats Sleep disruption Mood changes & anxiety Brain fog Cycle irregularity Low libido Vaginal dryness & urinary symptoms Weight & body composition Fatigue & low energy
Also Relevant For
Bone loss or osteopenia Metabolic health concerns Evidence-based care seekers Post-diagnosis support

You do not need to be "miserable enough" to deserve care but hormone therapy is also not automatic. We help you decide what makes sense for you.

Schedule a Menopause Consultation

If you're experiencing perimenopause or menopause symptoms and want an evidence-based approach to hormone therapy, we're here to help.

Start Your Vitality Discovery

What Makes Vitality Different

Unlike hormone-only clinics, our recommendations are informed by the full picture:

What We Factor In
  • DXA bone density and body composition data
  • Metabolic and cardiometabolic risk factors
  • Family history and personal health history
  • Objective laboratory data when appropriate
What We Don't Do
  • Prescribe hormones without evaluation
  • Use supraphysiologic dosing
  • Promise anti-aging or cosmetic outcomes
  • One-size-fits-all protocols

Bone health is a central consideration in menopausal care not an afterthought. Hormone therapy can play an important role in bone preservation for some patients, and we integrate that into decision-making when appropriate.

Our Hormone Therapy Options

What May Be Included
  • Estrogen therapy oral or transdermal
  • Progesterone when medically indicated
  • Vaginal estrogen for genitourinary symptoms
  • Careful consideration of dose, route, and timing
What We Prioritize
  • Evidence-based formulations
  • Routes that align with individual risk profiles
  • Ongoing reassessment and adjustment
  • FDA-approved options over compounded hormones

How Care Works

A detailed history, symptom review, and discussion of goals. Laboratory testing and imaging are used when helpful not reflexively.

We review risks, benefits, and alternatives together. Hormone therapy is one option not an obligation.

If hormone therapy is started, we monitor symptoms, tolerance, and overall health over time adjusting as needed.

Frequently Asked Questions

Understanding Menopause & Symptoms

Perimenopause is the transition phase leading up to menopause, often beginning in the 40s but sometimes earlier. Hormone levels fluctuate, periods may become irregular, and symptoms can start years before the final menstrual period. Menopause is defined as 12 consecutive months without a period.

Common symptoms include hot flashes, night sweats, sleep disruption, mood changes, brain fog, joint pain, vaginal dryness, and changes in body composition. Symptoms vary widely there is no single "normal" menopause experience.

During perimenopause, estrogen levels fluctuate rather than decline steadily. These swings not just low estrogen are responsible for many symptoms.

Hormone Therapy Basics

MHT refers to the use of estrogen, with progesterone when indicated, to relieve menopausal symptoms and support long-term health in appropriate patients.

Compounded hormones are not FDA-regulated and may have variability in dosing and purity. We generally prioritize FDA-approved options because they are standardized, studied, and monitored for safety.

Safety & Risk

For many women, hormone therapy is safe and effective when started at the right time and prescribed thoughtfully. Safety depends on age, time since menopause, medical history, and individual risk factors.

The relationship is complex and depends on the type of hormones used, duration of therapy, and individual risk. Some regimens have little to no increased risk over certain time frames. This is reviewed carefully with each patient.

Risk varies by formulation and route. Transdermal (patch) estrogen is associated with lower clot risk than oral estrogen and is often preferred in women with certain risk factors.

Hormones & Long-Term Health

Yes. Systemic estrogen therapy can help prevent bone loss and reduce fracture risk in appropriate candidates. This benefit is an important consideration in midlife and beyond.

Hormone therapy may improve sleep and vasomotor symptoms, which can secondarily improve mood and cognition. It is not a treatment for depression or dementia.

Weight, Metabolism & Body Composition

Menopause is associated with changes in body composition including increased fat mass and loss of lean muscle even if weight stays the same. Aging, activity, and metabolism all play a role.

No. Hormone therapy does not cause weight gain and may help mitigate unfavorable body composition changes for some women.

Practical Treatment Questions

Options include oral medications, transdermal patches, gels, sprays, and vaginal therapies. The best choice depends on symptoms, risk factors, and patient preference.

Women with a uterus need progesterone alongside estrogen to protect the uterine lining. Women without a uterus generally do not though progesterone may still be recommended for sleep support.

There is no universal time limit. Duration is individualized, with regular reassessment of risks and benefits. We do not simply stop therapy at an arbitrary age.

Hormone therapy is one option among many. Non-hormonal treatments, lifestyle strategies, and targeted therapies may also be appropriate. We'll work with you to find the right path.

Key Takeaways

Schedule a Menopause Consultation

If you're experiencing perimenopause or menopause symptoms and want an evidence-based approach to hormone therapy, we're here to help.

Start Your Vitality Discovery
Renew Vitality. Feel Alive.