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Bioidentical Hormone Replacement Therapy FAQ

Bioidentical Hormone Replacement Therapy FAQ: 

Hormones play a vital role in our daily functioning. Everything from your metabolism to the health of your skin is impacted by the balance of hormones in your body, so it’s understandable that hormone imbalances can make daily functioning difficult. At Nervana Medical, we help you implement a hormone therapy program designed to help optimize your lifestyle by easing symptoms of aging as well as hormone-related health problems and offering wellness benefits that can help improve a patient’s life for years to come. 


From a physiological perspective, bioidentical hormones derived from natural plant sources are identical to those that the body produces for itself, in the right proportions. When we are “replacing” the body’s hormones, we feel it makes more sense to use entities which the body recognizes as its own, rather than hormones from horses, imbalanced versions, or overly potent synthetic versions. The hormones we use are mainly estradiol (E2), estriol (E3), progesterone (Pg), testosterone (T) and DHEA. 


Compounded dosage forms are numerous and variable in nature. Each method has its advantages for use. Usage of specific dosage forms depends on patient compliance, type of response desired and medications involved. Oral capsules, vaginal suppositories, transdermal creams, gels and troches (a lozenge that dissolves between the gum and tongue) are among the variety of dosage forms available to be compounded. Ideally hormone supplementation should be tailored to individual treatment needs. 


Although compounds such as these cannot be processed at the pharmacy like mass produced medications, most insurance companies will reimburse a percentage of the cost to the patient. Look closely at your benefit package. If you have a flexible spending account or HSA (Health Savings Account), you may use your account to pay for your consult and/or hormone prescription(s).


Every patient is different! Your physician will take many issues into account: age, weight, symptoms, gynecological history and prior or present use of hormones will all affect the choice of dose and dosage form. Saliva and/or blood spot testing to identify specific imbalances of one or more hormones eliminates physician guesswork when prescribing. Follow up testing and regular monitoring when using hormones allows your doctor to adjust your dose as needed. Testing can be done from the convenience of your own home and mailed to the lab. 


The Cost of Bioidentical Hormone Replacement Therapy depends on the treatment option you choose. For optimal effectiveness, BHRT must be approached on a case-by-case basis. Each case involves several steps:

● Consultation 

● Hormone testing 

● Evaluation of deficiencies 

● Discussion of wellness goals and treatment options 

● Individualized treatment plan development 

● Tailored prescriptions from a (compounding) pharmacy 

● Treatment 

● Monitoring and repeat testing 

● Supplementary services related to wellness and lifestyle 

● Follow-up and additional services as needed (per shifting hormone levels and health changes) 

Consultation: $200

This is collected at the time of any labs that Nervana Medical sends a lab requisition form for, or if the patient brings their own labs for us to review, then it will be billed at the time the provider receives the labs 


● Hormone testing prescribing (*client responsible for lab costs, see info below) 

● Evaluation of deficiencies 

● Individualized treatment plan development 

● Discussion of wellness goals and treatment options 

● Tailored prescriptions from a compounding pharmacy 

Pellet Prices: Female $450, Male $650

Pellets typically last 3-6 months, with females usually averaging replacement 3-4 times a year and males 2-3 times a year. Duration of therapy depends on absorption, which will differ for every client. 

Even if you end up on pellets, not all the hormone deficiencies can be treated with pellets, so you may also have the cost of the prescription medication if you also need replacement of a hormone that is unable to be combined with your pellet 

IM / Oral / Creams / Troches / Patches / etc Prices: $200 / quarter

If the patient ends up on any other method other than pellets; (IM, PO, creams, troches, patches, etc.) then they will receive their prescriptions for a duration of 3 months at a time before they will be required to see the provider for another check-up / consultation.

* Lab Work

Specific lab work will be checked 6-8 weeks after pellet placement and 3 months after initiation of any other treatment (i.e. oral, cream, etc). If follow up lab results are stable and the patient feels good, then labs will be drawn every 6 months to a year. If the patient has any symptoms that would be concerning regarding current therapy, then labs may be checked as needed. Cash Price Cost for Initial Labs are around $300-$400 should the patient decide to have us send them a “cash client pay” lab requisition form. If the patient would like an “insurance bill pay” lab requisition form, then the patient will be responsible for whatever their insurance charges. We also offer lab draws at several of our locations.

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