Hot flashes. Disrupted sleep. Mood shifts. Brain fog. They aren’t “just aging.” They’re a protocol — built around your specific biology, your cardiovascular risk, and the way your hormones are actually changing.
Female Hormone Optimization is for women in perimenopause, menopause, and beyond who want a physician who takes the symptoms seriously and builds the protocol from evidence — not from a standard dose.
Sleep fragmented. Mood shifts you don’t recognize. Cycle unpredictable. Your PCP said the labs were “normal” and recommended yoga. You know something is changing. You want a physician who investigates the whole picture and builds a protocol around it.
You’ve read the WHI studies, you’ve read the rebuttals, you’ve read the recent cardiovascular and bone-health literature. You want a physician who takes your cardiovascular risk and VTE history into account — not a template protocol.
You’ve tried a telehealth HRT platform. Different clinician at each follow-up. Questions you’ve already answered, asked again. You want one physician who knows your case from first evaluation through every titration adjustment.
Clinical membership: $129/mo. Labs: $40 initial, $40 annual. Medication: billed through the practice with medication management. Three line items, every charge visible, no bundled mystery pricing.
Perimenopause and menopause are clinical diagnoses made from symptom pattern and cardiovascular-risk assessment — not from a single FSH or estradiol measurement. This is where most platforms get it wrong. Hormone values in perimenopause are highly volatile. A normal FSH on the day your blood was drawn doesn’t rule out the transition. An elevated estradiol doesn’t rule it in. Protocols built primarily around those numbers miss the patient entirely.
Dr. Everson builds every HRT protocol from three things: your symptom pattern (what’s changed, how long, how disruptive), your cardiovascular and venous thromboembolism (VTE) history, and the labs that actually inform a safe protocol — metabolic baseline, lipid panel, A1C, and thyroid where clinically indicated. The labs tell him whether HRT is safe for you. Your symptoms tell him what to treat.
Endocrine society guidance and the recent perimenopause literature are clear: FSH and estradiol levels in women age 45 and above are too volatile to reliably rule in or rule out the transition. A normal value on one day can be elevated the next. Protocols that hinge on these single values either under-treat symptomatic women (because their labs “look normal”) or over-treat asymptomatic women (because a lab drifted). Evidence-based HRT treats symptoms and risk — not single hormone snapshots.
“Your labs don’t rule out perimenopause. Your physician does.”
HRT protocols require a 6–8 week titration and evaluation window for effects to stabilize and for adjustments to be clinically meaningful. That’s not a marketing window — it’s how the biology actually responds. Dr. Everson adjusts the protocol across that window and beyond as your symptoms, your labs, and your life evolve.
Every protocol is built from the combination that fits your symptoms, your risk profile, and your preferences. All compounded hormone medications are procured through US-based 503A compounding pharmacy partners.
Transdermal patch, topical gel or cream, or oral. Format selection driven by cardiovascular risk profile — transdermal preferred for patients with elevated VTE risk; oral options for patients without those considerations.
Daily or weekly depending on format.
Bioidentical-type oral micronized progesterone. Prescribed for endometrial protection when estrogen is prescribed in women with an intact uterus; also used for sleep benefit and mood support in appropriate patients.
Daily, typically at bedtime.
Low-dose topical testosterone for libido, energy, and lean-mass maintenance in women where clinically indicated. Custom-compounded concentration. Monitoring included in membership.
Daily topical application.
TSH evaluation at baseline. Compounded thyroid options when clinically appropriate — not automatically, not because every patient gets it, but when the evaluation actually supports it.
Daily.
HRT is safe when the patient is appropriate for it. Cardiovascular risk assessment and venous thromboembolism (VTE) history review are required before treatment initiation — not as a liability exercise, but because the protocol depends on them. Format selection, dose, and route all follow from this assessment.
Labs are ordered through Empower Med and billed at Quest cost + 50% professional-service markup. Same panel initial and annual.
FSH · Estradiol — Not routinely measured in women 45+. Volatile and clinically non-specific. Symptom pattern and cardiovascular-risk assessment drive the diagnosis, not a single hormone value.
Physician fee. Labs. Medication. Three separate line items. You see all of them.
HRT is priced lower than TRT because the required monitoring infrastructure is lighter — but the clinical attention is the same. Here’s the full breakdown:
| Physician clinical membershipInitial physician evaluation and protocol design, titration across the 6–8 week evaluation window, ongoing adjustment as symptoms and labs evolve, async messaging, thyroid co-management as clinically indicated. | $129/ month |
| Initial lab panelBMP, Lipid Panel, HbA1c — with written physician interpretation and cardiovascular-risk framing. | $40one-time |
| Annual monitoring labsSame panel — BMP, Lipid, HbA1c. | $40/ year |
| Hormone medicationsProcured by the practice from a US-based 503A compounding pharmacy, billed through the practice with medication management. Cost varies by regimen — estrogen-only, estrogen + progesterone, and testosterone-addition all price differently. | Variablebilled through practice |
Membership + labs amortized: approximately $132/month. Medications billed separately based on your specific regimen — discussed and itemized at protocol design.
Unlike Metabolic (which has a $100 Lab credit) and TRT (which has a $165 Lab credit), HRT does not offer a conversion credit from the Open-Access Lab Service. The reason is clinical, not commercial: perimenopausal women frequently present with normal routine lab values despite genuine symptoms. A lab panel does not predict whether HRT is clinically appropriate for you — your symptoms and cardiovascular-risk assessment do. Incentivizing a lab-first pathway would point patients to a diagnostic that doesn’t actually answer the question. The right entry point for HRT is a consultation with Dr. Everson, not a lab order.
“Your labs don’t rule out perimenopause. Your physician does.”
Another year of symptoms dismissed as “normal.” Another telehealth platform running a template. Or a physician who takes the full picture seriously.
Request a ConsultationOr reach out directly — info@empowermed.us · (571) 293-6244
