Your Health and Hormone Optimization Journey

Assessing the complete picture of your current health and designing opportunities to create the optimal version of you at any age is our passion. As we have all experienced in traditional medicine, this cannot be achieved in 15 minutes! 

To establish an initial picture of where you are now and co-create a plan to build the optimal future version of you, we will devote over three hours of dedicated time over three visits to focus only on you and your needs. (Including 2 ½ hours of in person time and an hour of dedicated preparation and documentation time.)

Your first 30-minute visit can be completed at either of our Houston locations, and is gathering important information about you! We draw an extensive blood panel (our lab accepts all major insurance and specializes in women’s health. We order specific tests related to your hormone status, general wellness, nutrient and inflammatory status and risks for common diseases including cardiovascular disease, insulin resistance, diabetes and others, so we do not accept outside labs). Please come in fasting (zero-added tea, coffee or water only) so we can get an accurate result. One of our nurses will review your history, collect vital signs and InBody body composition, and review your goals and how you envision your optimal second half of life. Based on your specific needs we will provide you with resources to help empower you with education before meeting with your provider to create your personalized plan. If you need routine screening (mammogram, bone density, colonoscopy etc.) we will get those ordered right away. 

Your second visit will last 90 minutes (including a full 60 minutes of face-to-face provider time), and you can choose one of our highly trained Physicians or Menopause Certified Nurse Practitioners for this visit. Some patients choose to have this visit remotely, although we still believe in the power of in-person connection when possible. 

At this visit we will review every aspect of your health, including hormone optimization, as well as focusing on exercise, nutrition, sleep/rest, sexual and relational wellness and stress management. We will recommend all appropriate screening tests for assessment of cancer risk, heart disease risk, diabetes risk, strategies to reduce cognitive decline, and discuss options for higher level micronutrient and gut testing, and cardiorespiratory fitness testing (VO2Max). 

We believe that food is the best source of nutrients, but we will recommend any supplements that have scientific evidence to support their use in individual patients. Together we will create your vision, and design scientifically backed steps to get you there, so you can maximize your Holistic Healthspan (living a long time in great emotional and physical health). What do you want to be able to do when you are 70, 80, 90 or older? Let’s create a plan to make that possible, because you are worth it, and our loved ones need us!

Your third visit will last 30 minutes and will follow-up to see how you are doing, go over repeat lab work and any testing that we ordered, and make any necessary adjustments to your plan. 

After your initial three visits we will plan to see you every three-six months based on your individual needs. 

Menopausal Hormone Therapy (MHT)

MHT has been expensively studied and shown to have numerous health benefits, as well as reducing the symptoms that accompany menopause and perimenopause (the years leading up to menopause).  It is easy to be confused with so much conflicting information available online and in product advertising. We look forward to discussing this with you at length during your consultation, but here are our top 10 MHT facts:

1. Replacing the hormones that we lose during menopause (estradiol, progesterone and testosterone) can dramatically improve quality of life, as well as significantly reducing the risk of heart attack, diabetes, osteoporosis, colon cancer and neurologic decline – and the sooner we start it after menopause the better.

2. The term “bio-identical” is often used in marketing but applies to any hormone that looks chemically identical to human hormone. Any product called estradiol, progesterone or testosterone is by definition bio-identical. Some bio-identical products are FDA approved and come from a commercial pharmacy and some come from a compounding pharmacy. These are both good options for different patients.   

3. Estradiol (i.e. bio-identical estrogen) and testosterone ideally should not be given by mouth, since the effect on the liver seems to be responsible for the risks that have been shown in some studies related to blood clotting.

4. Estradiol does not cause breast cancer, and when given non-orally does not increase this risk of a blood clot, heart disease, and stroke. The risk of dying from breast cancer, heart disease, diabetes and all causes is significantly reduced in patients who take estradiol after menopause, if we start it within the first 10 years. Timing is important to prevent disease processes from starting. Once started, there is no reason to stop at any particular age, and long-term (lifelong) use can be considered. 

5. Testosterone is important for women as well as men. We make more testosterone than estrogen throughout our lives as women, although 10 times less than men. Replacing low testosterone improves sex drive, muscle mass and bone density, and may reduce the risk of breast cancer. 

6. Hormone pellets are one option for replacing estradiol and testosterone. They are tiny slow-release rods that last several months and can be dosed differently for each patient, based on age, where she is in the menopause spectrum, her symptoms, and her personal history. 

7. Other great options include an estradiol patch or gel, or testosterone cream. The FDA has not approved any testosterone products for women in the US (yet), so all testosterone for women comes from a compounding pharmacy, or we can use male FDA approved products at 1/10 of the male dose. 

8. Every patient with a uterus should take progesterone to prevent uterine cancer, as well as improving sleep and moods. Progesterone is safe for the liver and is taken by mouth at night, since it helps with sleep and is not included in a pellet (since it makes you sleepy and is not absorbed well through the skin). Some patients chose a progestin IUD for uterine cancer protection. Many patients without a uterus choose to take progesterone for its other benefits. Progesterone cream has not been shown to prevent uterine cancer. 

9. MHT is not contraindicated due to any family history, for example a family history of breast cancer or heart disease. It is also not contraindicated if you have an increased risk of breast cancer due to genetics. 

10. For the vast majority of women, MHT has significantly more benefit that risk, and is much more likely to extend our lifespan and healthspan than to reduce it. 

We look forward to discussing all of these options with you!

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Special Articles

I Think I Need Hormones, But Aren’t They Dangerous?

There is so much information available about hormone replacement these days that it is difficult even for doctors to keep it straight. About 18 years ago the largest study…

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All About Bio-Identical Hormones

Many of our patients ask about bio-identical hormones for treatment of menopausal symptoms, and it is easy to be confused with so much conflicting information available online and in…

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MHT Including Hormone Pellets

Hormone pellets are tiny slow-release bio-identical rods made of estradiol, or bio-identical testosterone. They can be dosed differently for each patient, based on her age, where she is in…

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Interested In Hormone Pellets?

We welcome you to schedule a consult with us to ensure that hormone pellets are the right option for you. Even if you’re just looking for more information on hormone pellets, we welcome you to reach out, and we can discuss the best option for you!

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FAQ’s

Pellets contain plant-based hormones that are biologically identical to the human hormones estradiol and testosterone. The hormones are time released over several months and the dose is variable based on the individual patient’s starting symptoms, age and lab work.

Pellets are injected into the fat of the buttock through a small trochar (like a large hollow needle) through a tiny incision which does not even require a suture and heals invisibly. Local anesthetic is used to make it minimally uncomfortable and the insertion takes less than 5 minutes.

Most women require a new pellet about every 4 months, and most men about every 6 months. More physically active people will metabolize the hormones more quickly, perhaps as early as every 3 months for women or 5 months for men.

For women in menopause, essentially all of the common menopause symptoms (hot flashes, night sweats, vaginal dryness, mood swings, lack of energy, insomnia, brain fog, and others) will disappear or be very minimal. Testosterone will also improve muscle:fat ratio, energy and libido for most women. For men, testosterone will improve libido, many cases of ED, muscle loss, sleep and energy.

For women, estrogen is not given until menopause, but testosterone replacement can be helpful for many women as young as 30. Men can also benefit from testosterone replacement, although we only offer them to men who are finished childbearing.

Symptoms will return and benefits will disappear as soon as replacement is stopped. So unless a health condition develops that makes hormone replacement unwise, you will benefit from staying on replacement as long as you want to feel good! (Your whole life.)

Many of our female patients have a huge improvement in libido and energy with their pellet, and still struggle if their male partner has low testosterone or ED. We will offer pellets to male partners of our patients.

Yes, pellets do need to be placed in the office. We no longer offer mobile pellet placement.

Before the pellet, when I clocked out for work at 5pm I pretty much clocked out for the rest of the day. I never had energy to run errands, work-out and my libido was pretty much non-existent. After a few weeks of pellet therapy, I feel like a better version of myself! The brain fog has lifted, my mood and energy have improved and of course my sex life is better than ever. The actual procedure was quick and painless absolutely worth it!

As a wife and mother of two young children in her forties, I found myself short-tempered, non-motivated, complacent, and just tired all of the time especially when it came to “OUR TIME” with my hubby. I always felt there was never enough time in the day to do all that needed to be done and the world was always caving in on me. It was exhausting. Since my pellet insertion with Dr. Susan, which was about 5 weeks ago, I am more energetic, patient with my children, clear-minded, and sexual with my husband. Did I mention energetic and sexual!!

I can’t begin to tell you the difference in how I feel today compared to how I felt 6 weeks ago. I went into this knowing that everyone is made different. I am diabetic, insulin-dependent, and suffer from gout. After the painless procedure, I immediately noticed a change in me. Today I am 12 units down with my insulin and my endocrinologist completely removed one of my prescriptions and I haven’t had a gout flare-up in weeks. Not to mention the energy level took me back to how I felt in my twenties. This therapy works. Would I do it again…… oh yes! Thank you Dr. Susan!

It’s been 15 days since I received the hormone pellet therapy, I am amazed! Within the first week I noticed “something was different.” I had more energy and less pain. For the past 4 years I was struggling silently. Serve lower back pain, bloating, mood swings, fatigue, irritability, and depression on and off. Not to mention my weight kept creeping up no matter how hard I trained. I wish I had found Dr Susan sooner, like in my THIRTIES! Thank you Dr Susan for making my midlife journey “happier”. I know it will only get better from here on… I am so excited for the next few months!

About 10 days for sure, I had an increase in energy. That was one of the symptoms I was feeling before I contacted Dr. Susan; low energy, I was feeling tired all the time. So the last 4-5 days, I’m bouncing out of bed, I’m sleeping better, and I’ve got a great energy level, pretty steady throughout the day. The procedure was very painless, just a tiny little prick. The pellet got placed in, but we were chit-chatting, but I suprised how fast it was. I had a little soreness the next day in the area, but I couldn’t tell you right now where the pellet is in my body.

Learning about you and HRT has been a blessing in my life it was literally an answer to a prayer. I was desperate. I feel transformed! My intimate relationship with my husband has been refueled. I can sleep at night, I have a better moods, and look at the world with a completely different lens. Everything looks better! I talk to all the women I know about your podcasts, book, and office in Houston. I wish everyone in our stage of life knew what you have discovered, studied, and are teaching! You are a treasure Dr. Susan. I’m already telling my daughter and daughters in-laws to come talk to me when they think they are post menopausal.