This is your full BHRT Hormone Consultation Packet — your complete guide to hormone optimization at Nervana Medical. Read it before your consultation and keep it as a reference afterward. You can also download the printable PDF version to take home.
This guide is for patient education only. It is not a prescription or medical advice. Your provider will review your symptoms, history, and labs, then build a plan that is personalized to you.
Hormones Are About More Than Symptoms
Most people come to us because something feels off. Fatigue that coffee no longer fixes, brain fog, weight that will not budge, low drive, poor sleep, hot flashes, or mood changes. We can absolutely help with those.
But hormones do far more than control symptoms. They are your body’s master regulators, influencing your heart and blood vessels, bone density, brain and memory, and metabolism. When hormones decline with age and we replace them thoughtfully, the goal is not just feeling better today. It is protecting your long-term health. We think of hormone optimization as preventive, restorative medicine, not a cosmetic add-on.
“Normal” Is Not the Same as “Optimal”
Standard lab ranges are built from a broad population that includes people who are sick, sedentary, stressed, or aging poorly. Falling inside that range only means you are not an outlier. It does not mean you feel or function at your best.
We are not trying to get you to “normal.” We are looking for your optimal, the level at which you feel, perform, and recover the way you want to. And because a single blood draw is just one snapshot in time, we weigh your symptoms alongside your numbers and trend them over time. Your symptoms matter as much as the lab value.
Symptoms guide the plan as much as the labs do. If your numbers look “fine” but you feel awful, we keep looking. If they look low but you feel great, we do not overtreat.
Setting the Record Straight on Safety
Many people were told years ago that hormone therapy is dangerous. Much of that fear traces back to early-2000s headlines about one large study (the Women’s Health Initiative) that were widely misinterpreted. In the years since, a deeper look at the evidence has reshaped how the medical community understands hormone therapy. In particular, bioidentical hormones, started at the right time and properly monitored, can be both safe and protective for many adults.
For women, there is growing recognition that starting hormone therapy earlier in the menopausal transition supports heart, bone, and brain health. Estrogen, for example, is one of the most effective tools we have for preventing bone loss. None of this means hormones are right for everyone. It means the decision deserves an honest, individualized conversation rather than blanket fear.
Bioidentical is not the same as synthetic. Bioidentical hormones are plant-derived and chemically identical to the hormones your body already makes. Older synthetic hormones are chemically different and carry a different risk profile.
Signs Your Hormones May Be Out of Balance
Women (perimenopause and menopause)
- Hot flashes and night sweats
- Mood swings, anxiety, irritability
- Sleep disturbances
- Low libido and vaginal dryness
- Recurrent UTIs or urinary changes
- Weight gain and metabolic changes
- Brain fog and low energy
Men (low testosterone)
- Low energy and persistent fatigue
- Reduced libido or erectile concerns
- Loss of muscle mass and strength
- Increased abdominal weight gain
- Brain fog or poor concentration
- Mood changes or irritability
- Poor recovery from exercise
Perimenopause and low testosterone are both commonly dismissed as “just aging.” They are not. They are treatable, and addressing them can change how you feel and how you age.
What We May Optimize
Your plan is built around you. Depending on your labs and symptoms, it may include one or more of the following, each prescribed and monitored by your provider.
Estradiol, for women in menopause
Eases hot flashes, night sweats, and vaginal dryness, and supports mood, sleep, libido, and long-term bone, heart, and brain health. If you have a uterus, it is always paired with progesterone for protection.
Progesterone, for women
Balances estrogen and protects the uterus, and often improves sleep, anxiety, and cycle-related symptoms. If you’re a woman who has had a hysterectomy, this may still benefit you even though you no longer have a uterus.
Testosterone, for women and men
In women, it supports libido, energy, mood, muscle, and clarity, and is often helpful even when baseline levels are not “low.” In men, it restores energy, drive, strength, and focus. It is delivered as a cream, injection, oral (for men), or pellet.
Thyroid
Regulates energy, weight, mood, and metabolism. Even mild imbalances can cause fatigue, weight gain, or hair loss, so we evaluate and optimize it as part of the whole picture.
DHEA
An adrenal hormone and building block for other hormones that can support energy, mood, and overall balance.
How Hormones Are Delivered
Your provider will recommend the route that best fits your hormones, history, and lifestyle.
Creams and gels
Absorbed through the skin, with steady delivery that is easy to adjust. Apply consistently and wash your hands to avoid transfer to others, especially children.
Troches and sublingual
Dissolve under the tongue for quick absorption.
Injections
Reliable, consistent dosing given on a regular schedule.
Pellet implants
A tiny pellet placed under the skin gives steady hormone release over several months, with no daily dosing.
Oral
Convenient for certain hormones, such as progesterone at bedtime.
Patches
Delivers hormones steadily through the skin and is typically changed once or twice weekly.
Your Hormone Journey
- Intake and symptoms. You complete a health history and a hormone symptom questionnaire.
- Consultation and labs. You meet with your provider to review the benefits, risks, and options, then have comprehensive labs drawn (please come fasting).
- Personalized plan. Your provider reviews your results with you and builds a plan matched to your symptoms and your optimal targets, not just the population average.
- Start treatment. You begin your therapy. If you are a pellet candidate, your pellets are placed in office.
- 6 to 8 week follow-up. We recheck symptoms (and often labs) when hormone levels are settling in, and fine-tune your dose.
- Ongoing optimization. We recheck periodically and adjust over time, with doses increased slowly and guided by how you feel. Pellets are typically reinserted about every 3 to 4 months for women and every 4 to 6 months for men. Injections are usually given on a weekly schedule (sometimes split into twice-weekly doses), and cream or troche plans involve a follow-up roughly every 6 months for renewals.
What to Expect and Staying Safe
As your body adjusts, especially in the first weeks, you may notice temporary changes like mild fluid retention, breast tenderness, mood shifts, or minor skin breakouts. Most settle as your levels balance, and your provider will guide you. Because some hormones can stimulate hormone-sensitive cancers, staying current on age-appropriate screenings such as mammograms and PSA is an important part of safe therapy. Men who wish to preserve fertility should tell us up front, as testosterone reduces sperm production. Premenopausal women must use reliable birth control while on testosterone.
Supplements and Lab Testing
Professional-grade supplements through Fullscript
Hormone balance is supported by what happens outside the prescription, too. We offer professional-grade nutraceuticals (higher quality, purity, and potency than most over-the-counter options) to complement your plan, from targeted hormone support to sleep, mood, and metabolic health. You can order your recommended protocol through our Fullscript dispensary and have it shipped straight to your door, so refills are simple and you always know you are getting quality-tested products. We also stock supplements in our clinic in Sandy, Utah.
Lab testing made convenient
Comprehensive lab testing is the foundation of a personalized plan. We order labs through trusted reference laboratories, including Quest Diagnostics, Cleveland HeartLab, and Intermountain Health, and most patients are drawn at a Quest or Intermountain location near them. In-clinic draws are also available.
You have options on how to pay. Cash-pay lab panels include provider review and basic recommendations and do not require a separate consult. If you would like customized lab ordering, or want to try running labs through insurance, a brief lab consult is needed so we can order the right tests and provide the codes your insurer may require. Running labs through insurance does not guarantee coverage, so we recommend confirming with your plan first, and we will always share transparent cash-pay pricing so you can compare.
A few lab prep reminders
- Come fasting for 12 hours (water is fine) when fasting labs are ordered.
- Stay on your prescribed dose consistently for at least 6 to 8 weeks before hormone levels are tested.
- For injections, labs are drawn the day before your next dose; for pellets, about 6 to 8 weeks after placement.
- Hold biotin for 48 hours (if taking more than 5,000 mcg per day) and high-dose vitamin C (over 15 g) for a week.
- After your labs are drawn, let us know so we can book your results review about 2 weeks later.
Ready to Start?
Book a consultation
Hormone Consultation · Thyroid Consultation · Peptide Consultation
Call: (801) 335-5243
Online: nervanamedical.com (click “Book Now”)
In person: 8899 South 700 East #125, Sandy, UT 84070
In-person hormone services are provided at our Sandy, UT clinic, with telehealth follow-up available across multiple states. If you have been told your labs are “fine” but something is still off, come in, bring your labs, and we will look at the whole picture together.
Want a printable copy?
Download the full BHRT Hormone Consultation Packet (PDF)
