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Hormone Replacement Therapy for Women

As women age, they produce less sex hormones. Hormones like testosterone, progesterone, and estrogen decrease over time. These can lead to some clinical symptoms like fatigue, weight gain, depression, hair loss among other symptoms.

Thyroid dysfunction is another clinical concern that plagues many women. There are a variety of treatments that can help women regain hormone balance and live happier, healthier lives. 

What is Hormone Replacement Therapy 

Hormone replacement therapy (HRT) is 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 our provider who specializes in hormone therapy. Our provider 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 Rejuvenate Health and Wellness treatment may include pellet therapy, nutraceuticals, diet and exercise plans, and more.

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.

Are you experiencing symptoms of perimenopause? 

Symptom check list for women

Symptoms of Perimenopause 

Many 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

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.

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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.

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. 

Causes of Low Testosterone in Women

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.

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. 

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 

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. 

Are you experiencing symptoms of a hormone imbalance?

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 are 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 to 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.

Experience Balance at Rejuvenate Health and Wellness

If you believe you are experiencing a hormone imbalance, schedule a consultation with us. Our practitioner is highly trained in hormone health and balance, including the renowned EvexiPEL Method of hormone replacement therapy THE EVEXIPEL METHOD, founded by Dr. Terri DeNeui. 

After years of practicing HRT, Dr. DeNeui sought to eliminate the most common side effects of pellet therapy. She developed the EvexiPEL Method to support reduced inflammation, pain, and scar tissue at the insertion site. The EvexiPEL Method strategically places the pellet to improve and deliver steady dosing throughout the entire treatment cycle. Schedule an appointment today with Rejuvenate Health and Wellness to address your symptoms of hormone imbalance and rediscover your health and self again.

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