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Treatment Options
Treatment Options for Perimenopause & Menopause Personalized Care Designed Around Your Body — and Your Life
There is no single “right” way to treat hormonal symptoms.
Some women need full systemic support.
Some need targeted vaginal therapy.
Some need sleep support.
Some need mood stabilization.
Some don’t need hormones at all.
The goal is not to put everyone on the same protocol.
The goal is to restore balance — safely and thoughtfully.
That is what makes Happy Hearts Women's Health different. We don't oversimplify for the fastest, most convenient treatments for the providers. We truly tailor your care plan and treatments to your needs, budget, lifestyle, and preferences.
Designed for Real Life
- Personalized care
- Direct provider communication
- No rushed visits
- Follow-up and monitoring
The goal is not just symptom relief.
The goal is helping you feel stable, clear, and functional again.
Below are the most common treatment options we may consider together.
Systemic Hormone Therapy
(For whole-body symptoms)
Used when symptoms such as hot flashes, mood changes, sleep disruption, joint pain, or brain fog are impacting quality of life.
Available Forms
Transdermal Creams (Compounded)
Plant-derived bioidentical hormones applied directly to the skin.
Hormones may include:
- Estradiol
- Progesterone
- Testosterone
- Combination therapy
- DHEA (when appropriate)
Why some women prefer this option:
- Flexible dosing
- Customizable combinations
- Bypasses the digestive system
Best for women who prefer a tailored approach.
Transdermal Patch (FDA-approved options)
A small adhesive patch worn on the skin and changed once or twice weekly.
Why some women prefer this option:
- Steady hormone delivery
- Low-dose systemic estrogen
- Avoids first-pass liver metabolism
Often used when we want consistent, controlled estrogen support.
Oral Capsules or Tablets
Taken daily.
Options may include:
- Micronized progesterone
- Estradiol
- DHEA
Why some women prefer this option:
- Simple routine
- Helpful for sleep support (progesterone)
- Easy titration
For some patients, oral therapy is very effective. For others, transdermal options are preferred. We individualize this decision.
Localized Vaginal Hormone Therapy
(Targeted Tissue & Arousal Support)
When symptoms are primarily related to vaginal or sexual health, localized therapy can be highly effective with minimal systemic absorption.
These therapies focus on restoring tissue health, comfort, and function.
Vaginal Hormone Support
Low-dose vaginal estrogen or DHEA may help with:
- Vaginal dryness
- Pain with intercourse
- Recurrent UTIs
- Bladder urgency or irritation
- Thinning or fragile tissue
Available as:
- Vaginal cream
- Vaginal insert
- Vaginal tablet
These treatments work directly on the tissue and typically do not significantly raise systemic hormone levels.
Topical Arousal & Orgasm Support Creams
For women experiencing:
- Decreased clitoral sensitivity
- Difficulty achieving orgasm
- Reduced arousal response
- Postmenopausal sexual changes
Compounded topical formulations may include low-dose testosterone, DHEA, or vasodilating agents applied externally to the clitoral tissue.
These are designed to:
- Improve blood flow
- Enhance sensitivity
- Support sexual response
Dosing is individualized and monitored carefully.
Bioidentical Hormone Pellets
(Extended-Release Hormone Support)
Pellet therapy involves placing a small, bioidentical hormone pellet just under the skin during a brief in-office procedure. The pellet gradually releases a steady dose of hormone over several months.
Most commonly used for:
- Testosterone support
- Estrogen support (in appropriate candidates)
Why Some Women Choose Pellets
- Long-lasting delivery (typically 3–4 months)
- No daily dosing
- Consistent hormone levels
- Helpful for energy, libido, and cognitive support in selected patients
Pellets are not ideal for everyone. Because dosing cannot be adjusted once inserted, careful evaluation and lab review are important before proceeding.
For some women, pellets provide excellent stability. For others, creams, patches, or oral therapy allow more flexibility.
We determine this together based on your goals, labs, and comfort level.
Non-Hormonal Support Options
Hormones are not the only solution.
Depending on your symptoms, we may also consider:
- Nutritional optimization
- Sleep regulation strategies
- Stress physiology support
- Targeted supplementation
- Non-hormonal prescription options
- Pelvic floor therapy referral
- Strength and resistance training support
For some women, stabilizing sleep and stress significantly reduces symptoms.
How We Choose the Right Option
We consider:
- Your symptom
- Your medical history
- Uterus status
- Cardiovascular risk factors
- Personal preferences
- Lab findings (when helpful)
- Family history
There is no algorithm that replaces clinical judgment.
We decide together.
Common Treatment Options
Testosterone Cream
Ellage Estradiol Vaginal Cream
Ellage Estradiol Vaginal Cream
We offer custom compounded testosterone creams based on your personal needs from excellent compounding pharmacies.
$69 per month
Ellage Estradiol Vaginal Cream
Ellage Estradiol Vaginal Cream
Ellage Estradiol Vaginal Cream
Ellage is a gentle, water-free base that delivers estradiol directly to vaginal tissue to relieve dryness, irritation, and discomfort with intimacy. It is designed for sensitive tissue, improving absorption while minimizing leakage and avoiding common irritants, making it a comfortable alternative to traditional creams.
$63 per month
Customized Combinations
Ellage Estradiol Vaginal Cream
Bioidentical Progesterone
For patients needing combination treatments, our custom compounded creams offer quality and convenience with just a click of a Unodose dispenser
$69 per month
Bioidentical Progesterone
Bioidentical Estrogen Patches
Bioidentical Progesterone
Micronized Progesterone may be ordered through your local pharmacy, using your health insurance or as little as $35 for 3 months supply
Bioidentical Estrogen Patches
Bioidentical Estrogen Patches
Bioidentical Estrogen Patches
Bioidentical Estradiol patches may be ordered through your local pharmacy, using your health insurance or as little as $35 per month
Testosterone Pellets
Bioidentical Estrogen Patches
Bioidentical Estrogen Patches
Bioidentical Hormone pellets provide steady, long-acting bioidentical hormone support through a small implant placed beneath the skin. Pellets release consistent levels of hormone over time, helping avoid the daily fluctuations that can occur with creams or oral medications. Price, including insertion procedure as little as $57 per month
Intimacy Cream
Targeted Nutrition and Supplements
Targeted Nutrition and Supplements
A custom compounded cream designed to support arousal and sensitivity by enhancing blood flow and tissue response. Applied as needed to the female genital area, it offers a targeted, non-invasive option to improve comfort, responsiveness, and overall intimacy.
$140
Targeted Nutrition and Supplements
Targeted Nutrition and Supplements
Targeted Nutrition and Supplements
Healthy, balanced hormones starts from within. This personalized approach uses targeted nutrition and high-quality supplements essential for hormone production, improving metabolism and detox pathways, and stabilizing blood sugar and inflammation.
All of our patients receive customized nutrition guidance based on symptoms, laboratory results, and patient preferences to suit their lifestyle and needs.
Radiance Renewal Cream
Targeted Nutrition and Supplements
Radiance Renewal Cream
A highly effective, prescription-strength skin treatment with Estriol + Tretenoin designed to restore firmness, improve texture, and enhance radiance. This customized topical combines bioidentical estradiol with tretinoin to support collagen production, increase skin turnover, and improve overall tone and elasticity.
Ideal for aging or hormonally changing skin, this advanced therapy helps soften fine lines, refine texture, and promote a smoother, more luminous complexion.
$65 per month
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