Menopause & Perimenopause Treatment: Clinician-Directed HRT and Support

Perimenopause and menopause are normal life stages — and they can still disrupt sleep, mood, cycles, body composition, cognition, and sexual comfort. Treatment is not mandatory. Understanding your options with a licensed clinician is.

This page is educational: what changes are common, how HRT may fit, how Refuvia structures first-month care, and how to start an evaluation without hype. RESTORE · TRANSFORM · THRIVE.

Perimenopause vs menopause (plain language)

• Perimenopause: the transition years when cycles may become irregular and symptoms appear while hormones fluctuate.
• Menopause: typically defined after 12 consecutive months without a period (or after certain medical interventions). Symptoms can continue afterward.

Neither label alone dictates a protocol. Your history, preferences, risk factors, and labs shape the plan.

Symptoms people often bring to a visit

• Hot flashes and night sweats
• Sleep disruption
• Mood changes, anxiety, or irritability
• Brain fog or word-finding frustration
• Vaginal dryness or discomfort
• Libido changes
• Weight redistribution or muscle loss
• Joint aches or reduced recovery
• Cycle irregularity (perimenopause)

Many of these have overlapping causes. Evaluation looks beyond a single hormone number.

Hormone therapy — soft, clinical framing

When appropriate, clinicians may prescribe customized hormone therapy — including options molecularly identical to endogenous hormones. That bioidentical language describes molecular sameness to hormones your body makes; it is not a claim that bioidentical therapy is inherently safer or more effective than all other approaches. Risks, benefits, timing, and route (cream, capsule, etc.) are clinical decisions.

Non-hormonal strategies and local therapies may also be appropriate depending on your goals.

Pricing (as currently marketed)

• $399 first month
• Then $149/mo

Higher doses may cost more. First month includes clinical onboarding plus a more extensive lab panel so the clinician can see the full picture. The clinician orders the markers that matter for the patient’s history and goals, then tailors medication and dosing to the patient — not a one-size protocol.

Labs — examples only

Illustrative categories clinicians may review include:

• Estradiol (E2)
• Progesterone
• Testosterone
• Thyroid-related markers
• Other metabolic or hormone markers as indicated

**These examples are illustrative only, not a guaranteed exact list. The clinician determines which markers are needed for the patient’s history and goals.

We do not promise that any pharmacy "perfectly tunes" a formulation to a marketing ideal — compounding and customization, when used, follow clinician and pharmacy professional standards for your prescription.

Metabolic care overlap

Weight and insulin dynamics often change in midlife. If GLP-1 therapy is discussed:

• Compounded paths have pricing starting at $249/mo (sema) / $329/mo (tirz) when prescribed. Higher doses may cost more.
• Branded path: $100/mo care fee; patient pays pharmacy for brand med
• Compounded medications are not FDA-approved and not brand equivalents — see molecule pages

Longevity-minded care (soft)

Some patients ask about broader optimization. Clinicians may discuss clinically appropriate, physician-directed therapies when appropriate — without anti-aging promises and without research-peptide marketing on this page. See also Women's health.

How care works

1. Start your free consultation.
2. Intake: history, symptoms, preferences, contraindications screen.
3. Labs as indicated; the clinician orders the markers needed for the patient’s history and goals.
4. Clinician plan — HRT, non-hormonal options, metabolic care, or watchful waiting.
5. Follow-up and adjustments.

Availability: clinicians licensed in your state via the HLY network, subject to service and treatment availability.

HSA/FSA: often usable for eligible expenses — confirm with your plan administrator.

Clinical leadership context

Women's hormone and menopause experience is part of Refuvia's care story via HLY Medical Group PA, including clinical leadership context such as Dr. Vanessa Niles on the live About / Our care team page. That is not a guarantee of who you will see at every visit.

Also: Explore treatments · Our care team · Start