Perimenopause
Hormone levels can fluctuate for years before menopause, sometimes causing changes in sleep, mood, energy, temperature regulation, and menstrual cycles. You may be experiencing hormonal changes even if your periods have not stopped.
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BIOIDENTICAL HORMONE CARE IN GILBERT, AZ
Bioidentical Hormone Replacement Therapy (BHRT) in Gilbert, AZ
Bioidentical hormone replacement therapy, or BHRT, uses hormones with the same molecular structure as your own to treat the symptoms of perimenopause, menopause, and low testosterone. At Onyx Integrative Medicine in Gilbert, AZ, licensed naturopathic doctors run a comprehensive assessment first, including appropriate testing, then review how you respond and adjust as needed. In office across the East Valley, or by telemedicine anywhere in Arizona.
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Medically reviewed by
Dr. Stephanie Nichols, NMD
Serving
Gilbert & the East Valley
Molecule for molecule
What Is Bioidentical Hormone Replacement Therapy?
Bioidentical hormone replacement therapy (BHRT) uses hormones that have the same molecular structure as hormones naturally produced by your body. It may be used when changing hormone levels contribute to symptoms associated with perimenopause, menopause, or low testosterone.
At Onyx Integrative Medicine, BHRT starts with a comprehensive evaluation rather than a prescription based on symptoms alone. Your provider reviews your health history, symptoms, and appropriate laboratory testing to determine whether hormone therapy is appropriate and which treatment approach may fit your needs.
BHRT and HRT
BHRT vs Traditional HRT
The terms BHRT and HRT are often used interchangeably, but they do not mean exactly the same thing. HRT is the broader term for hormone replacement therapy, while “bioidentical” describes the molecular structure of the hormone being used.
| Attribute | Bioidentical HRT (BHRT) | HRT |
|---|---|---|
| What does it mean? | Uses hormones with the same molecular structure as hormones naturally produced by the body. | A broad term for treatment that replaces hormones your body is no longer producing enough of. |
| What hormones can be used? | May include bioidentical estradiol, progesterone, or testosterone. | May include bioidentical or non-bioidentical hormones, depending on the treatment. |
| Where does it come from? | Can be available as an FDA-approved medication or a compounded preparation. Compounded preparations are not FDA-approved as finished products. | Can also be available in FDA-approved or compounded preparations, depending on the medication. |
| How is treatment chosen? | Based on your symptoms, medical history, and clinical evaluation. | Also based on your symptoms, medical history, and clinical evaluation. |
Is This You?
Who May Benefit From BHRT?
Bioidentical hormone replacement therapy may be appropriate when changing hormone levels are contributing to persistent symptoms. BHRT is not right for everyone, so your provider considers your symptoms, medical history, examination, and appropriate testing before recommending treatment.
Menopause & Beyond
After menopause, changing estrogen and progesterone levels can affect sleep, temperature regulation, sexual health, and other aspects of well-being. Your age, health history, and time since menopause help determine whether hormone therapy is appropriate.
Low Testosterone
Testosterone levels can decline gradually, making changes in energy, libido, strength, or recovery easy to overlook. A comprehensive evaluation can help determine whether low testosterone is contributing to your symptoms.
Your Treatment Isn’t Working as Expected
If you are already taking hormone therapy but still don’t feel like yourself, your treatment may need to be reassessed. Bring your current prescription and recent test results so your provider can review what you are taking and how you are responding.
Your Symptoms Don’t Match Your “Normal” Labs
Being told your results are normal does not always explain how you feel. If symptoms persist, your provider can look at your broader health picture and determine whether hormones are actually contributing or whether something else may be responsible.
Whether BHRT is appropriate for you is a clinical decision based on your medical history, symptoms, examination, and appropriate testing.
Sound familiar?
Symptoms BHRT May Address
Hormone symptoms are easy to explain away one at a time. It is the pattern that matters, and the fact that it has not lifted on its own.
- Exhausted no matter how long you sleep
- Hot flashes or night sweats breaking up your nights
- Your sex drive has quietly disappeared
- Weight settling around your middle despite no change in diet
- Anxious, irritable, or just not like yourself
- Strength or recovery from workouts has dropped off
- Forgetting words, names, or why you walked into the room
- Cycles becoming shorter, longer or unpredictable
- Symptoms come back before your next dose is due
- Nobody has retested your levels since you started therapy
Any of these can have more than one cause, so this is a starting point for a conversation and nothing here is a diagnosis or a result.
One system, not five separate ones
Hormones We May Evaluate
Hormones work as a system, so a plan is rarely built on one of them. These are the ones most often looked at. Which of them apply to you is decided at your visit.
Estradiol
Commonly evaluated in relation to perimenopause and menopause.
Progesterone
May be evaluated alongside estrogen, particularly when considering hormone therapy for women.
Testosterone
Evaluated in both men and women when symptoms warrant it.
Thyroid hormones
Thyroid function can overlap with symptoms commonly attributed to hormonal changes.
DHEA
May be evaluated as part of a broader assessment where appropriate.
Educational only. No reference ranges, target numbers or strengths are published here, because a result only means something next to your history and your symptoms.
For women
BHRT for Women
For women this usually means estradiol and progesterone, and often testosterone as well. Progesterone is part of the conversation whenever estrogen is prescribed and you still have a uterus, and your doctor will explain why.
Vaginal and urinary symptoms have their own treatment route and are treated as a separate question from systemic therapy. Testosterone is sometimes part of a woman’s plan as well, at a fraction of the strength used for men.
For men
BHRT for Men
For men this is usually testosterone, prescribed as a cream, an injection or a pellet.
Total and free testosterone are read together, because a total on its own says little about how much is actually available to your tissue, and SHBG is what explains the gap between the two. How your body handles testosterone matters as much as the strength prescribed, which is why follow-up looks at more than testosterone alone. Several of the things that lower testosterone respond to being treated directly, and those are addressed alongside.
From first visit to follow-up
How BHRT Is Personalized
BHRT should not be a one-size-fits-all prescription. At Onyx Integrative Medicine, your treatment plan is built around your symptoms, health history, appropriate testing, and how you respond to treatment over time.
Comprehensive Evaluation
Your provider reviews your symptoms, medical history, current medications, previous hormone therapy, and health goals to understand the full picture before recommending treatment.
Appropriate Testing
When indicated, laboratory testing helps evaluate your hormone levels and other markers that may contribute to your symptoms. Results are considered alongside your symptoms and medical history rather than interpreted on their own.
Individualized Treatment
If BHRT is appropriate, your provider selects the hormone, dose, and delivery method based on your individual needs. Your treatment may be adjusted as your needs change.
Follow-Up & Monitoring
Your response to treatment is monitored over time. Follow-up visits and testing, when appropriate, help your provider determine whether your treatment should be continued, adjusted, or changed.
Your Treatment Is Built Around You
The goal is not simply to change a lab result. It is to determine whether hormone therapy is appropriate, establish a treatment plan that fits your needs, and make adjustments based on how you respond.
How it is taken
BHRT Treatment Options
The same hormone behaves differently depending on how it reaches your bloodstream, so the route is part of the prescription rather than a matter of preference.
Pellets
Inserted under the skin in a short visit, then released steadily for months. The lowest-maintenance route.
Trade-off: the strength cannot be changed until the next insertion.
Creams and gels
Applied at home on a daily rhythm. The easiest route to adjust, which often suits the months while a strength is still being settled.
Trade-off: easy to miss a day, and care is needed around skin contact.
Capsules
Most often used for progesterone, and usually taken at night. How a hormone is metabolised depends partly on whether it is swallowed or absorbed another way.
Trade-off: the route itself changes how the hormone is processed.
Injections and patches
Injections are most often used for testosterone. Patches are worn on the skin and changed on a set schedule, without a daily step.
Trade-off: a routine to keep, and levels move between doses.
Your doctor recommends a route based on the hormone you need, your results and how quickly the strength may need to change. You are not locked into the first one.
Your first appointment
What to Expect During a BHRT Consultation
A first visit is an evaluation, not a commitment to a prescription. This is what the appointment covers and what to bring with you.
- What the visit coversYour symptoms, your medical history, your current medications, any previous hormone therapy and your health goals. Your provider is building the full picture before recommending anything.
- What to bringYour current prescription if you are already taking hormone therapy, any recent test results, and a list of everything else you take, including supplements.
- Whether testing is orderedWhen indicated, laboratory testing is ordered to evaluate your hormone levels and other markers that may be contributing to your symptoms.
- What you leave withAn understanding of whether hormone therapy is appropriate for you and what your provider recommends. If BHRT is not appropriate, your provider will say so and explain what may be worth pursuing instead.
Not sure if bioidentical hormone therapy is right for you?
What patients are hoping for
Benefits of BHRT
What hormone therapy can do depends on which hormone is low, how long it has been low, and what else is going on underneath. These are the changes patients most often come in hoping for.
Fewer hot flashes and night sweats
The symptom hormone therapy has the longest track record for, and often the one that shifts earliest.
Sleep that holds through the night
Waking at a consistent hour is a different problem from struggling to fall asleep.
Steadier mood
Irritability or anxiety that arrived without a reason, or that tracks your cycle.
Energy through the afternoon
Daytime energy that dropped away without a change in your sleep or your workload.
Libido and drive
Total and free testosterone matter here for women as well as men.
Support for bone density
Estrogen therapy is recognised for reducing the bone loss that follows menopause.
These are potential benefits, not promises, and none of them is a treatment guarantee. Responses vary from person to person. Being bioidentical does not by itself make a hormone safer or more effective. Hormone therapy carries risks that vary with your age, your personal and family history, which hormone is used and how it is delivered, and your doctor reviews those with you before you start.
After you start
BHRT Monitoring and Follow-Up
Hormone therapy is not a set-and-forget prescription. Your response is reviewed over time, and your plan is adjusted as your needs change.
Follow-up visits
Your provider reviews how you are responding, what has changed and what has not. Follow-up is part of the plan rather than something you have to ask for.
Retesting, when appropriate
When indicated, repeat testing helps your provider see how your levels have responded alongside how you are actually feeling.
Adjusting your treatment
The hormone, the dose or the delivery method may be adjusted. Needing an adjustment is common and is not a sign that something has gone wrong.
Continuing, changing or stopping
Your provider determines whether treatment should be continued, adjusted or changed. Hormone therapy is not necessarily permanent.
Why Onyx
Why Choose Onyx for BHRT?
Onyx is a naturopathic clinic before it is a hormone clinic. Your prescription comes from your own evaluation rather than a starting chart, and someone reads your results again a few months later. If your symptoms turn out to be driven by something other than your hormones, we will tell you that too.
- Three licensed naturopathic doctorsIn person in Gilbert, or by telemedicine anywhere in Arizona.
- A comprehensive assessment before anything is prescribedYour evaluation covers more than your sex hormones, and it happens before anything is prescribed.
- An FDA-approved product considered firstWith compounding used when your doctor specifies a strength that is not made off the shelf.
- Someone reads your numbers againRetesting and adjustment are built into the plan, not extras you have to ask for.
Meet your naturopathic doctors
Dr. Stephanie Nichols, NMD
Onyx's founder, working mainly in women's hormones, thyroid health, PCOS (also called PMOS), perimenopause, and menopause. Dr. Stephanie prescribes from a full clinical assessment rather than from a standard starting strength.
Founder · Naturopathic Physician
Dr. Kasey Nichols, NMD
Connects hormones with digestion, metabolism, and mindset. Dr. Kasey works on low testosterone and thyroid concerns at the root, pairing hormone therapy with the lifestyle pieces that hold the result in place.
Co-Founder · Naturopathic Physician
Dr. Chelsea Deveson, NMD
Focused on the root causes of chronic disease. Dr. Chelsea treats thyroid conditions, adrenal fatigue, PCOS (also called PMOS), perimenopause, and digestive issues with individualized, lab-guided care.
Naturopathic Physician · Root-Cause Care
From our patients
What hormone patients say about Onyx
These are Onyx patients talking about their own care, recorded in the clinic and unscripted. Most of them arrived after being told their labs looked normal, or after a prescription that never quite landed. Hormone stories are personal, so treat what you hear as one person's experience rather than a forecast of yours. Your labs, your plan, and how you respond to it will be your own.
Frequently Asked Questions
Bioidentical Hormone Therapy (BHRT)
Is bioidentical actually different, or is it a marketing term?
It is a real distinction, and a narrow one. Bioidentical means the hormone has the same molecular structure as the one your body produces. It does not tell you anything about the strength you were prescribed or whether anyone is checking it. That part is the plan, and it is the part worth asking about.
What are the side effects of bioidentical hormone therapy?
Bioidentical hormones are the same molecules your body makes, but they are still medication, and being bioidentical does not make them free of side effects. The ones patients report most often are tenderness at the application or insertion site, fluid retention, breast tenderness, changes in mood or sleep, and skin changes such as acne. These may settle as the strength is adjusted. Less common risks depend on your age, your personal and family health history, which hormone is used, and how it is delivered, and your doctor reviews those with you before you start and monitors you with follow-up labs. Tell your clinician about anything new so the plan can be adjusted.
Are compounded bioidentical hormones FDA-approved?
Some bioidentical hormones are available as FDA-approved products, and those are used where they fit. Preparations mixed by a compounding pharmacy are not FDA-approved as finished products, which is standard for compounded medication generally. Your doctor will tell you which one you are being prescribed and why.
My doctor said bioidentical hormones are unproven. Who is right?
Both positions are usually about compounding rather than about the molecule. The hormones themselves are well studied. The disagreement is about compounded preparations, where the strength is set per patient rather than manufactured to a fixed dose. Your doctor will go through the evidence and the cautions for your situation before you start.
I am already on hormone therapy. Do I have to stop before my first visit?
No, and please do not stop a prescription on your own. Bring what you are taking and any labs you have, and your doctor will work from where you are rather than starting you over.
What does bioidentical hormone therapy cost at Onyx, and do you take insurance?
Onyx is primarily cash-pay. Some naturopathic visits may be eligible for out-of-network reimbursement. What you spend depends on your labs, which hormones you need, and the delivery method, so the clinic goes through costs with you before anything is ordered. Call (480) 531-2557 to ask about your situation. A deposit secures your first appointment.
Do I have to use pellets?
No. Pellets suit patients who would rather not think about a daily step, but they are one option of several, and the strength cannot be changed until the next insertion. Creams, gels, capsules and injections all allow faster adjustment, which is often the better choice while your dose is still being settled. Your doctor will go through the trade-offs for the hormone you need.
Is bioidentical hormone therapy for men as well?
Yes. Low testosterone is one of the most common reasons men come in, and the approach is the same: a full panel first, a prescription set by your doctor, then follow-up testing. Men’s hormone care is covered in more detail on our TRT page.
Bioidentical hormone therapy near you
Bioidentical hormone care across the East Valley
Onyx Integrative Medicine is on W Elliot Rd in Gilbert and sees hormone patients in office from across the East Valley. Naturopathic care is also available by telemedicine anywhere in Arizona, so the drive does not have to decide whether you get evaluated.
GilbertChandlerMesaQueen CreekTempeSan Tan ValleyApache Junction
Onyx Integrative Medicine1425 W Elliot Rd, Ste 104, Gilbert, AZ 85233(480) 531-2557
Explore more
Related hormone care at Onyx
Parent hubHormone Care at OnyxHow we approach hormones overall.What's included
- Testing and treatment for women and men
- Perimenopause, menopause and low testosterone
- In person in Gilbert or by telemedicine in Arizona
- Hot flashes, night sweats and sleep changes
- Cycle changes through the transition years
- Hormone therapy where it is appropriate
- Total and free testosterone, read together
- Creams, injections and pellets
- Follow-up testing and adjustment
- A full panel, not TSH alone
- Symptoms that overlap with low sex hormones
- Treated alongside your hormone plan
- Semaglutide and tirzepatide
- Nutrition coaching alongside the medication
- Doctor-supervised, in clinic or by telemedicine
Next step
Ready to get your hormone plan right?
One visit and one comprehensive panel can give you a clearer picture than another year of adjusting on your own. Book with a licensed naturopathic doctor at Onyx in Gilbert.