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Hormone Replacement Therapy for Women

As women age, they produce less reproductive hormones (estrogen, progesterone, and testosterone) over time, which can lead to a variety of health issues. Many women suffer from symptoms such as hot flashes, incontinence, sexual dysfunction, insomnia, mood disorders and more, due to hormone imbalance.

Thyroid dysfunction is another misunderstood and often misdiagnosed hormone disorder that plagues many women, who may suffer from fatigue, weight gain, depression and hair loss, among other symptoms. Fortunately, there are a variety of treatments to help women regain hormone balance—and the happy, healthy lives they desire.

What is Hormone Replacement Therapy?

Hormone replacement therapy (HRT) is a therapy designed to restore hormones to optimum levels in the body. This treatment is recommended for women who are experiencing symptoms or conditions related to imbalanced sex hormones (estrogen, progesterone and/or testosterone) or thyroid disorders.

To find out if you are a candidate for HRT, schedule a consultation with one of our trained practitioners who specializes in hormone therapy. Your practitioner will assess your current health and medical history, review symptoms and goals, and perform lab tests to develop a comprehensive treatment plan to restore hormone balance. At EVEXIAS, treatment may include pellet therapy, nutraceuticals, diet and exercise plans, and more.

Is hormone therapy right for you?

What is Perimenopause?

Perimenopause refers to a woman’s final reproductive years leading up to the cessation of her period. The perimenopause stage officially ends, and menopause occurs, after 12 consecutive months have passed without a menstrual cycle.

At what age does perimenopause happen?

Women enter the stage of perimenopause around the age of 47 on average, though some women experience symptoms of perimenopause in their mid–thirties. This stage typically lasts between 4 to 8 years, though it can last as long as 14 years.

Causes of Perimenopause

Perimenopause sets in as estrogen and progesterone hormone levels begin to fluctuate unevenly as women age. Many of the symptoms women experience during perimenopause are caused by declining estrogen levels.


Long Term Health Risks of Perimenopause

Low estrogen levels can lead to a variety of health issues, especially after women experience menopause. One of the biggest health risks is osteoporosis, where the bones become less dense and more brittle. Lower estrogen levels can also raise cholesterol levels, which may increase the risk for heart disease and stroke.

Symptoms of Perimenopause

Many menopause symptoms are similar to those experienced during menopause. Common perimenopause symptoms include:

  • Night sweats
  • Hot flashes
  • Sleep disturbances & fatigue
  • Urinary urgency
  • Mood disorders (irritability, anxiety, depression)
  • Bone loss
  • Sexual dysfunction
  • Vaginal dryness
  • Irregular periods
  • PMS may feel more intense
  • Fluctuations in cholesterol levels
  • Difficulty losing weight

What is Menopause?

Natural menopause marks the end of the reproductive period of a woman’s life. It officially occurs when a woman’s menstrual cycles have ended, after having no period for 12 consecutive months (absent the use of birth control, which may cause periods to stop temporarily prior to actual menopause).

At what age does menopause happen?

According to the Office on Women’s Health, the average age a woman experiences menopause in the US is 52.

Causes of Menopause

Natural menopause occurs when your ovaries stop releasing eggs and your periods end, as the production of reproductive hormones (estrogen and progesterone) declines. Menopause also occurs after a woman has had a full hysterectomy. Since the ovaries are removed during a full hysterectomy, women can no longer produce estrogen. Cancer therapies like radiation and chemotherapy can also induce menopause.

Long Term Health Risks of Menopause

Low estrogen levels can lead to a variety of health issues, primarily after women experience menopause. One of the biggest health risks is osteoporosis, where the bones become less dense and brittle. Lower estrogen levels can also raise cholesterol levels, which may increase the risk for heart disease and stroke. Many women also experience urge and/or stress incontinence leading up to and after menopause, as the tissues of the urethra and sexual organs lose elasticity.

Symptoms of Menopause

Many menopause symptoms are similar to those experienced during perimenopause. Common menopause symptoms include:

  • Vaginal dryness
  • Hot flashes
  • Sleep disturbances & fatigue
  • Urinary urgency
  • Mood disorders (irritability, anxiety, depression)
  • Bone loss
  • Sexual dysfunction, pain or discomfort during sex
  • Hair loss or dryness
  • Weight gain, increased belly fat

Find symptom relief at Dream Spa today

Low Testosterone in Women

Testosterone is an androgen, or male sex hormone, produced by both sexes (not just men!). While women produce much less testosterone than men, it is a vital hormone that women need to support reproductive and sexual health. Low libido is the most common symptom of Low T in women.

How Common is Low Testosterone in Women?

While testosterone levels haven’t been studied nearly as closely in women as in men, we do know that testosterone levels naturally decline as women age. Most women can expect to experience lower testosterone levels during perimenopause and after menopause, though the impact of Low T and related symptoms vary among women.

Causes of Low Testosterone in Women

Testosterone is primarily produced in women’s ovaries and adrenal glands. Just as the ovaries produce lower levels of other sex hormones (estrogen and progesterone) leading up to and after menopause, the same is true of testosterone. Testosterone deficiency in women may also be caused by dysfunction of the adrenal glands, oral estrogen therapy, underactive pituitary gland or surgical removal of ovaries, and cancer treatments that inhibit the ability of the ovaries to produce testosterone.

Long Term Health Risks of Low T in Women

Women of child bearing age may experience fertility issues due to low testosterone, as testosterone play a key role in reproductive health. Low testosterone levels may also contribute to osteoporosis and depression in women, which can be debilitating.

Symptoms of Low Testosterone in Women

The symptoms below may be caused by a number of health conditions besides low testosterone, which is one of the reasons Low T often goes undiagnosed in women.

  • Low libido
  • Mood swings
  • Difficulty achieving orgasm
  • Vaginal dryness
  • Fatigue, difficulty concentrating
  • Muscle weakness
  • Hair loss or thinning

Thyroid Dysfunction in Women

Thyroid hormones affect nearly every cell and organ in the body, from the way our hearts beat to how our brains, muscles, and other organs function. Common thyroid conditions include hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid), Grave’s Disease and Hashimoto’s thyroiditis, as well as thyroid cancer, thyroid nodules, and thyroid eye disease.

The biggest challenge practitioners face in treating thyroid dysfunction is widespread misdiagnosis, as many common symptoms of thyroid disease are often attributed to other diseases and aging. These symptoms include fatigue, weight gain, depression and hair loss among others.

How Common is Thyroid Dysfunction?

According to the American Thyroid Association, approximately 20 million people in the US suffer from some form of thyroid dysfunction, and 60% of those people don’t realize it. Women are five to eight times more likely than men to experience thyroid disease, with one in eight women experiencing a thyroid disorder during their lifetimes.

Are you experiencing symptoms of a thyroid disorder?


Also known as overactive thyroid, hyperthyroidism is a condition where the thyroid produces more thyroid hormone than the body needs.

Overactive thyroid can result for a variety of reasons. Some of the most common causes of hyperthyroidism include: Graves’ disease, getting too much iodine or thyroid medicine, inflammation of the thyroid gland, overactive thyroid nodules, and noncancerous tumors of the pituitary gland.

Long Term Health Risks

When the thyroid gland produces too much thyroid hormone, the various systems of the body speed up, which can lead to serious health issues. Left untreated, hyperthyroidism may cause fertility and menstrual problems, osteoporosis, irregular heart beat and heart issues, as well as Graves’ disease.

Symptoms of Hyperthyroidism

  • Appearance of a goiter
  • Accelerated heart rate or irregular rhythm
  • Feeling anxious and irritable
  • Trembling hands
  • Hair loss
  • Smooth skin
  • Fingernails separating from nail bed
  • Prominent stare and/or protrusion of eyes
  • Osteoporosis due to accelerated calcium deficiency
  • Weight loss with no change in eating habits
  • Irregular periods
  • Muscle weakness in arms and thighs
  • Intolerance to heat and tendency to perspire
  • Loose, frequent bowel movements
  • Increased risk of miscarriage


Hypothyroidism, also known as underactive thyroid, is the most common type of thyroid disorder in the U.S. If you have underactive thyroid, your body isn’t producing enough thyroid hormone to support its needs.

According to the NIH, the most common cause of hypothyroidism is the autoimmune disorder, Hashimoto’s disease, where the body’s immune system attacks the thyroid, preventing it from producing enough thyroid hormone. Other causes include radiation treatment, surgical removal of the thyroid, inflammation of the thyroid, congenital hypothyroidism, and certain medications. Health conditions such as diabetes (1 and 2), celiac disease, Sjogren’s syndrome, and other autoimmune diseases may increase the likelihood of underactive thyroid.

Long Term Health Risks

When the thyroid gland doesn’t produce enough thyroid hormone, bodily systems and organs can slow down and cease to function properly. Left untreated, the slowing of bodily systems can become life threatening for some patients. Hypothyroidism can also cause high cholesterol, which may increase the risk for heart disease and stroke.

Symptoms of Hyperthyroidism

  • Fatigue and drowsiness
  • Difficulty learning and forgetfulness
  • Slowed speech and hoarseness
  • Puffiness in the face
  • Dry, itchy skin
  • Dry, brittle nails and hair
  • Hair loss
  • Queen Anne’s sign
  • Heightened sensitivity to cold
  • Weight gain and fluid retention
  • Heavy or irregular periods
  • Constipation
  • Sore, achy muscles
  • Increased risk of miscarriage

Are you experiencing symptoms of a hormone imbalance?

How Are Hormone Imbalances in Women Diagnosed?

At EVEXIAS, we use a variety of methods to diagnose hormone imbalances in women. During a consultation, our health practitioners review the patient’s symptoms, challenges, and health goals. A series of lab tests will also be performed to analyze the patient’s hormone levels, along with other health markers.

Based on lab results and the patient interview, a diagnosis will be made and a treatment plan recommended to help the patient achieve optimum health.

How Is Hormonal Imbalance Treated?

Hormone imbalances may be treated with hormone therapy, nutraceuticals, and a balanced, healthy lifestyle that includes regular exercise, proper nutrition, and maintaining a healthy weight. When hormone levels are optimized, women experience increased energy, improved mood and libido, quality sleep, and other benefits that make it easier to enjoy a higher quality of life.

Hormone Replacement Therapy (HRT)

Hormone replacement therapy can address these problems whether you are a man or a woman. This therapy is designed to supplement the body with the hormones that your body is currently lacking.

That way, the body should function better, and the negative effects of this health problem should become less of an issue.

What are the Different HRT Delivery Methods?
What you might not know about HRT is that there are several types of delivery methods you can consider.

It is important to consider these different methods to ensure that your treatment is seamless: fits your lifestyle and achieves optimal results during each treatment cycle.

Creams and Gels

Creams and gels are a common method of hormone therapy because they both simple to use and discreet.

However, this delivery method comes with some risks. Hormone creams and gels may transfer from one person to another through contact with the area where the cream was applied. This exposes kids, pets, and partners to the therapy and can impact their health.

Creams and gels also require application one to two times daily. If you skip a dose because you run out or forget, you can hinder the effectiveness of the treatment. It can also be difficult measure each dose and ensure that the exact amount is absorbed into the skin further impacting consistent and effective relief.


Pills are also a common method of hormone therapy. Pills allow for precise dosing and travel easily. However, much like creams and gels, they can be inconvenient.

Most pills have to be taken at least once a day, depending on the prescription. If you skip a dose, your treatment may be impacted. Furthermore, pills have to compete with the harsh environment of the gut. While most pills are designed to be effectively absorbed as they travel through your GI tract, this delivery method does not offer the consistency achieved by other delivery methods.


Patches offer the convenience of “set it and forget it,” but a bulky patch is hardly forgettable.

Patches may only be placed on certain areas of the body that are not always discreet in certain clothing.

Not to mention that patches do not adhere well when coming in contact with water or certain fabrics. If a patch falls partially or completely off, your treatment will be impacted.

Steady dosing is difficult with patches as well because the volume of hormone in the patch declines toward the end of the treatment cycle, leading to the return of unwanted symptoms until a new patch is applied.


Injections are a particularly popular method of testosterone therapy. Injections enter the bloodstream directly and therefore absorption is highly effective. However, injections must be administered every 7 to 10 days. If you skip or delay a dose, your treatment may be impacted.

Injections notoriously cause a rollercoaster dosing effect. Most patients that choose injections will experience a surge of hormones in the days after the injection followed by significant declines each day until the next injection. This can make symptom relief short-lived.

Injections are also associated with discomfort, inflammation, bruising, bleeding or pain at the injection site.


Pellets are the preferred method of hormone replacement therapy and have grown in popularity over the last decade.

For most people pellets offer a convenience that is unparalleled. Pellets are placed under the skin during a short medical visit and deliver a steady dose of hormone for 3 to 6 months based on your level cardiac output, gender, and dose.

You don’t have to remember to apply a cream, take a pill or hassle with painful injections.

This method of delivery also most closely mimics the body’s natural secretion of hormones–delivering timely and steady dosing for optimal function.

FDA Disclaimer: This website is for educational purposes only. It is not intended as a substitute for the diagnosis, treatment, and advice of a qualified licensed professional. This site offers people medical information and tells them their alternative medical options, but in no way should anyone consider that this site represents the practice of medicine. This site assumes no responsibility for how this material is used. Also note that this website frequently updates its contents, due to a variety of reasons, therefore, some information may be out of date. The statements regarding alternative treatments for cancer have not been evaluated by the Food and Drug Administration. Dream Spa is an authorized provider of EVEXIPEL® Hormone Pellet Therapy.