Hormone Therapy

Hormone therapy is a treatment that gently replaces some of the hormones your body makes less of during perimenopause and menopause, mainly estrogen and often progesterone. By bringing these hormone levels back into a healthier range for you, it can ease symptoms like hot flashes, night sweats, vaginal dryness, sleep problems, mood changes, and brain fog, and can also help protect bone health in many women. The exact type, dose, and form (such as pills, patches, or creams) are personalized after a careful review of your health history so that benefits and risks are balanced for your specific situation.

Hormone replacement therapy (HRT) is mainly for women in perimenopause or menopause who are bothered by symptoms like hot flashes, night sweats, sleep problems, mood changes, vaginal dryness, or brain fog. It is especially considered for women with moderate to severe symptoms, or those at higher risk of bone loss and fractures, after a careful review of their age, health history, family history, and personal risk factors. In general, HRT is most often recommended for women who are under 60 or within about 10 years of their final period, and who do not have contraindications such as a history of certain cancers, blood clots, stroke, or significant liver disease.

Empower Pharmacy is a specialized compounding pharmacy that prepares customized hormone replacement medications—such as estrogen, progesterone, testosterone, thyroid, and other hormones—tailored to each patient’s prescription and needs. They work in both 503A and 503B settings, meaning they can create patient‑specific formulations (like creams, capsules, troches, pellets, and gels) as well as larger‑batch office‑use products, all under strict quality and sterility standards. For women in perimenopause and menopause, this allows highly individualized dosing, combinations, and delivery routes that can better match symptom patterns and tolerability, supporting a more precise and flexible approach to hormone therapy than standard, one‑size‑fits‑all prescriptions.

For menopause, the most commonly used HRT medications are forms of estrogen (such as estradiol tablets, skin patches, gels, or sprays, and conjugated estrogens) often paired with a progestin or micronized progesterone for women who still have a uterus. Many clinicians use a combination of estradiol plus progesterone in various doses and delivery methods to match a woman’s symptoms and risk profile, and local vaginal estrogen (as creams, tablets, or rings) is also widely used when the main issues are vaginal dryness or pain with intercourse.

In this practice, hormone therapy is offered entirely outside of insurance so care can stay truly personalized, transparent, and under your control. The compounding pharmacy used for HRT also does not bill insurance, which allows them to create customized formulations and doses based on your specific needs rather than on what a plan will cover.​

Working outside of insurance means there are no surprise bills, prior authorizations, or coverage denials shaping your treatment; you know the cost up front, and that fee includes both your medication and all direct interactions with Dr. Parrish related to your hormone care. This model supports a higher‑touch, longer‑visit approach, where decisions are driven by your symptoms, goals, and safety—not by time limits or insurance rules.