Hormone Replacement Therapy:

The Truth Every Woman Deserves to Know

Understanding Hormonal Balance in Women

Hormones are the silent conductors of our bodies, orchestrating everything from mood and energy levels to metabolism, sleep, and sexual health.

When they’re in harmony, we feel vibrant, confident, and strong. But as we age—or face stress, environmental toxins, or underlying health conditions—our hormone levels can shift, leading to symptoms that impact every area of life.

At Proactive Wellness, we specialize in restoring balance through advanced Hormone Replacement Therapy (HRT), personalized for each woman. Our goal is to help you feel empowered, educated, and energized—not confused or fearful.

Estrogen Deficiency

Estrogen is essential for mood, bone health, skin elasticity, metabolism, and sexual function. When levels drop, symptoms can include:

• Hot flashes and night sweats

• Vaginal dryness and painful intercourse

• Wrinkling, thinning skin and hair loss

• Mood swings, anxiety, or depression

• Insomnia and poor sleep

• Decreased libido

• Bone loss and increased fracture risk

Estrogen Therapy Benefits: Restores emotional stability, boosts collagen, reduces menopausal symptoms, and protects bones.

Progesterone Deficiency

Progesterone calms the nervous system and balances estrogen. Deficiency may cause:

• Irregular or heavy periods

• Sleep disturbances

• Anxiety and irritability

• Bloating and water retention

• Migraines

Progesterone Therapy Benefits: Improves sleep, reduces PMS and anxiety, and supports emotional balance.

Testosterone Deficiency

Yes, women need testosterone too! It affects:

• Energy and stamina

• Mental clarity

• Libido and sexual satisfaction

• Muscle tone and fat distribution

• Motivation and mood

Testosterone Therapy Benefits: Increased vitality, sharper focus, and restored libido.

Different Types of Hormone Replacement

Conventional HRT uses synthetic or animal-derived hormones that don’t exactly match your body’s natural hormones, which may cause more side effects.

Bioidentical Hormone Replacement Therapy (BHRT) uses plant-derived hormones that are molecularly identical to your own. Many women report BHRT feels more natural, effective, and gentle.

🧪 Compounded HRT Delivery Options 🧪

At Proactive Wellness, we don’t believe in cookie-cutter medicine. Every hormone therapy we prescribe is custom-compounded from high-quality ingredients at trusted, accredited pharmacies. That means your treatment is tailored precisely to your body—in both formulation and delivery method.

Below is a breakdown of the personalized delivery options of HRT and how each one fits into your hormone health journey.

Methods of HRT Delivery

1. Troches (Sublingual Lozenges)

How it works: Small, flavored lozenges dissolve slowly under your tongue or between cheek and gum. The hormones are absorbed through your mucous membranes—bypassing digestion for more efficient entry into your bloodstream.

Compounded for: Estrogen, progesterone, testosterone

✅ Benefits:

• Gentle on the liver; avoids first-pass metabolism

• Steady absorption = stable hormone levels

• Custom flavors and doses available

• Easy to use for patients who don’t like creams or injections

⚠️ Considerations:

• Requires slow, uninterrupted absorption (no chewing or swallowing)

• Eating or drinking too soon after use can reduce effectiveness

• May cause mild mouth irritation in some users

2. Topical Creams & Gels

How it works: Hormones are applied directly to the skin (typically inner arms, thighs, or abdomen) and absorbed transdermally.

Compounded for: Estrogen, progesterone, testosterone

✅ Benefits:

• Easy to adjust dosing based on your lab results

• Customized to your absorption rate and sensitivity

• Avoids the liver, reducing risk of clotting or side effects

• Smooth application with custom base formulas

⚠️ Considerations:

• Transfer risk: Hormones can rub off on others—partners, children, or pets—if not fully absorbed. Apply in low-contact areas and wait at least 10–15 minutes before skin contact with others.

• Must be applied daily and consistently

• Skin irritation is rare, but possible

3. Transdermal Patches (Compounded)

How it works: Though not as common in compounded form, some compounding pharmacies can create customized adhesive patches that release hormones steadily into the skin over time.

Compounded for: Estrogen

✅ Benefits:

• Convenient and steady hormone delivery

• Good for women who prefer not to take daily doses

• Bypasses liver for safer metabolism

⚠️ Considerations:

• Less commonly compounded than other forms

• Potential for skin irritation or adhesive allergies

• Visibility on skin may be a consideration for some patients

4. Vaginal Applications (Creams, Suppositories, Rings)

How it works: Hormones are applied directly to the vaginal tissues for localized relief from dryness, thinning, itching, or urinary issues.

Compounded for: Estriol, estradiol, DHEA, and combinations

✅ Benefits:

• Excellent for targeted relief without systemic absorption

• Extremely low-risk option for many women

• Multiple formats available (creams, suppositories, vaginal tablets or mini-rings)

⚠️ Considerations:

• Needs to be used consistently for best results

• May not treat systemic symptoms like hot flashes or brain fog

• Internal application may not be preferred by all patients

5. Pellet Therapy (not currently available at Proactive Wellness)

How it works: Tiny pellets—custom-compounded and tailored to your hormone needs—are inserted just under the skin (usually in the upper hip area). They dissolve slowly over 3–6 months, delivering consistent hormone levels.

Compounded for: Estradiol, testosterone

✅ Benefits:

• Long-lasting with no daily dosing

• Provides a very steady release of hormones with minimal fluctuations

• Great for busy lifestyles or those wanting a “set-it-and-forget-it” option

⚠️ Considerations:

• Requires a quick in-office procedure

• Dose cannot be adjusted once placed

• Must be repeated every few months

6. Injections

How it works: Hormones are injected into the muscle or fatty tissue (typically once weekly). Compounded injectables can be customized in both dosage and carrier oils to suit your tolerance and needs.

Compounded for: Testosterone, occasionally estrogen

✅ Benefits:

• Rapid symptom improvement

• Effective for women who metabolize other delivery forms quickly

• Weekly or biweekly schedule is manageable for many patients

⚠️ Considerations:

• Can cause hormone level “peaks and valleys” in some women

• Some patients are sensitive to oils used in standard injectables—compounding allows us to adjust

• Injection site tenderness is possible

7. Oral Capsules (Bioidentical, Compounded)

How it works: Compounded oral capsules are swallowed like a traditional pill, but customized to avoid fillers, allergens, and unnecessary additives.

Compounded for: Micronized progesterone, estrogen blends

✅ Benefits:

• Especially effective for calming the nervous system and promoting sleep (oral progesterone)

• Easy to take for women who prefer pills

• Customizable blends for multi-hormone support in a single capsule

⚠️ Considerations:

• Processed through the liver (first-pass metabolism), which can increase clotting risk for some women

• Not ideal for women with liver issues or higher cardiovascular risk

• Must be taken consistently every day

Why Compounded Hormones?

Unlike mass-produced pharmaceuticals, compounded HRT gives us the flexibility to:

• Adjust doses to your unique lab values and symptoms

• Eliminate unnecessary additives, allergens, and synthetic fillers

• Customize the form, strength, and delivery for optimal absorption

• Improve comfort, safety, and long-term outcomes

At Proactive Wellness, we work only with reputable, PCAB-accredited compounding pharmacies to ensure the highest standards of quality, sterility, and consistency.

Clearing the Confusion: What the Science Actually Says About HRT

You may have heard hormone therapy is risky—but that fear was born from

flawed, outdated research.

The Truth Behind the Studies: What You Weren’t Told About HRT

The Women’s Health Initiative (WHI): Misinterpreted & Misrepresented

Launched in the 1990s and making headlines in 2002, the Women’s Health Initiative (WHI) was one of the largest clinical trials ever conducted on postmenopausal women. It aimed to study the effects of hormone therapy on chronic disease prevention, including heart disease, cancer, and fractures. However, how the data was interpreted—and presented to the public—caused widespread fear and confusion.

Here’s what went wrong:

• Age of Participants: The average participant was 63 years old, and many were more than a decade past menopause. Starting HRT this late is now known to be less beneficial and potentially riskier than initiating it near the onset of menopause (typically around age 50–55).

• Type of Hormones Used: The WHI didn’t study bioidentical hormones. It used a synthetic combination of conjugated equine estrogen (Premarin) and medroxyprogesterone acetate (Provera)—substances that do not match the molecular structure of human hormones. This is critical, as different hormone types have different biological effects.

• Statistical Misrepresentation: The initial press release emphasized a 26% increased relative risk of breast cancer, which sounds alarming—but the absolute risk increased from only 3 cases per 1,000 women per year to 4. That’s a difference of one additional case per 1,000 women per year—hardly cause for the fear it generated.

• Early Termination of the Study: The trial was stopped prematurely, a move often reserved for ethically urgent cases. However, the decision was largely based on relative risk numbers and assumptions about long-term harms—not conclusive evidence.

• Reanalysis Revealed the Truth: When broken down by age and timing of therapy initiation, women aged 50–59 who began HRT closer to menopause had lower risks of heart disease, diabetes, and all-cause mortality compared to those who did not take hormones.

“When we reanalyzed the data based on age and timing, we found that younger women on HRT actually had better outcomes.”
— Dr. JoAnn Manson, WHI Investigator, Chief of Preventive Medicine at Brigham and Women’s Hospital

The Million Women Study: A Flawed Foundation for Fear

Published in 2003 in the UK, the Million Women Study sought to assess breast cancer risk among hormone users. But the methodology was riddled with flaws:

• Self-Reported Data: Information about hormone use and health conditions came from surveys, not verified medical records, leaving room for recall bias and reporting errors.

• No Control for Confounding Variables: The study did not adequately adjust for pre-existing health conditions, lifestyle factors, or family history, all of which can affect breast cancer risk.

• Included Women Already Diagnosed with Breast Cancer: Including these participants skewed the data, inflating perceived risks for women without the disease.

• Misleading Risk Reporting: As with WHI, the results were shared in relative risk, not absolute risk. The media focused on a “doubling” of risk—which actually translated to a small absolute increase that remained within a manageable range.

Despite these flaws, the study became a cornerstone in anti-HRT rhetoric. It should never have been used as the basis for sweeping public health policies.

The Nurses’ Health Study: Supporting HRT When Timed Right

In contrast, the Nurses’ Health Study—an ongoing, long-term cohort study involving over 120,000 nurses since 1976—has provided valuable data with a more nuanced understanding of HRT's effects.

• This study supported the “Timing Hypothesis”: Women who began HRT within 10 years of menopause onset had a significantly reduced risk of coronary heart disease and lower all-cause mortality.

• Long-Term Observation: Unlike the WHI, which followed women for just 5 years on average, the Nurses’ Health Study has tracked participants for decades, providing deeper insight into long-term outcomes.

“Hormones are not just about symptom relief—they’re about long-term health. For many women, bioidentical HRT is a cornerstone of aging well.”
— Kara Mitchell, NP, Integrative Women’s Health Specialist

What This Means for You

The fears generated by early studies were based on:

• Synthetic hormone combinations

• Poor timing of therapy

• Misrepresentation of relative vs. absolute risk

• Flawed data collection methods

Today, more refined research and clinical experience show that when prescribed appropriately and timed correctly, HRT—especially bioidentical HRT—offers powerful protective benefits for many women.

At Proactive Wellness, We Practice Evidence-Based, Personalized Hormone Care

We don’t rely on one-size-fits-all protocols or outdated research.

Instead, we use:

• Comprehensive hormone testing

• Individualized treatment plans

• Ongoing monitoring

• A deep commitment to safety, efficacy, and your overall wellness

✨ You deserve to feel amazing, informed, and empowered—not scared.
Let us help you make decisions based on fact, not fear. ✨

Real Women. Real Stories. Real Results.

"I spent years thinking I was just 'getting older'—waking up drenched in sweat, snapping at my kids, crying for no reason. I didn’t even recognize myself anymore. Within weeks of starting bioidentical HRT, it felt like the fog lifted. I got my energy, my libido, and my joy back. This therapy gave me my life back—no exaggeration."
— Lena R., 52, Patient of Jessica Veloza, APRN

"I was terrified of hormone therapy because of what I heard in the news years ago. But Jessica Veloza, APRN walked me through the science and made me feel safe, heard, and empowered. I’ve been on BHRT for over a year, and not only are my hot flashes gone, but I feel sharper, stronger, and more confident in my skin than I did in my 30s."
— Melissa H., 58, Breast cancer survivor & wellness advocate

"After menopause, I felt like my light had dimmed. I was exhausted, my skin was aging overnight, and I had zero sex drive. I didn’t want to just ‘accept’ that. With bioidentical hormone therapy, my vitality returned. My husband noticed, my friends noticed—I noticed. I feel like myself again. Every woman deserves to feel this good."
— Danielle S., 61, Retired Teacher & Grandmother of Four

"What frustrates me most is that no one told me this was an option sooner. I suffered through years of mood swings, insomnia, and bone loss before someone finally suggested HRT. I was hesitant at first—but I’m so glad I trusted my gut and sought help. The care I received was thorough, compassionate, and science-backed. It changed everything."
— Maria G., 55, HRT Patient & Former Skeptic

Protective Benefits of Hormone Therapy

HRT is more than symptom relief—it can help prevent serious disease:

• ✅ Bone Health: Reduces risk of osteoporosis and hip fractures

• ✅ Heart Health: Lowers risk of cardiovascular disease when started early

• ✅ Brain Health: May reduce the risk of Alzheimer’s and cognitive decline

• ✅ Colon Cancer: Estrogen has been shown to lower incidence

Is HRT Right for You?

Every woman’s hormonal journey is unique. At Proactive Wellness, we don’t use one-size-fits-all protocols. We test thoroughly, listen deeply, and customize your plan to help you feel your absolute best—safely and naturally.

✨You don’t have to accept

feeling “off”

as just part of aging. ✨

References:

1. Manson JE et al. “Menopausal Hormone Therapy and Long-term Mortality,” JAMA, 2017.

2. Bluming A, Tavris C. Estrogen Matters, 2018.

3. Fournier A et al. “Unequal risks for breast cancer with HRT,” Breast Cancer Res Treat, 2008.

4. Rossouw JE et al., WHI Study Reanalysis, 2007.

5. North American Menopause Society Position Statement, 2022.

6. Grodstein F et al., Nurses’ Health Study, Ann Intern Med, 1997.