Support for energy, mood, focus, libido, and hormonal transitions across adulthood, including perimenopause, menopause, and low testosterone. Every plan starts with a comprehensive evaluation, not a standard protocol.
Not sure which fits? Start with a new patient evaluation.
Hormone signaling is different in women and men, so the care is too. The method is the same: evaluate the full picture, stabilize, then optimize.
Medically guided hormone care for women navigating perimenopause, menopause, and complex hormonal changes, including those who feel “off” despite being told their labs are normal.
For men who don’t feel like themselves anymore while routine labs say everything is fine. We evaluate free and total testosterone, estrogen balance, thyroid, and metabolic function before recommending anything.
Many people are told their levels are normal while living with fatigue, brain fog, poor sleep, low libido, mood changes, or weight that won’t move. A reference range tells you whether a number is unusual. It doesn’t tell you whether it’s right for how you function.
Hormones also don’t act alone. Estrogen, progesterone, testosterone, thyroid signaling, cortisol, insulin, and inflammation influence one another. That’s why we look at them together, and why introducing support too quickly, or focusing on a single hormone without context, can lead to incomplete results or unwanted side effects.
A staged approach, so your body has time to stabilize before we optimize.
Comprehensive labs, intake, and symptom mapping.
A personalized protocol guided by your data.
Quarterly monitoring to protect your progress.
A long-term strategy that adapts as your body changes.
You don’t need to decide what type of care you need ahead of time. That’s part of our role. Your evaluation includes an unrushed visit, a review of a comprehensive lab panel, and a personalized plan recommendation. You leave with clarity, not a follow-up to schedule a follow-up.
The evaluation is the first step for our hormone, weight, and longevity programs. Looking for everyday primary care? Direct Primary Care members enroll online, no evaluation needed.
All care is individualized and provided by a licensed medical provider. Results vary based on individual factors.
No. Many women we see are in perimenopause: still cycling, but dealing with sleep disruption, mood changes, or cycle irregularity. Hormone shifts often begin years before periods stop, and evaluating early gives a clearer baseline to work from.
You may not, and that’s the point. Fatigue, brain fog, low drive, and body composition changes can come from testosterone, thyroid dysfunction, metabolic imbalance, or a combination. We evaluate the full picture before drawing conclusions.
Bioidentical hormones are structurally identical to what your body produces: estradiol, progesterone, and in some cases testosterone. They are prescribed thoughtfully, monitored closely, and adjusted based on symptoms, not just lab numbers. Read more about bioidentical hormone therapy.
Safety depends on your individual history, which is why we start with a full medical review and comprehensive labs rather than a standard protocol. We go through your personal and family history together, discuss what the current evidence supports, and monitor on an ongoing basis.
Sleep, mood, and energy often shift within the first few weeks. Libido, cognitive clarity, body composition, and strength typically take longer, commonly several weeks to a few months, as your protocol is adjusted. Results vary from person to person.
Women under 50: perimenopause rarely starts with hot flashes. Take the two-minute early symptom check and get the free BHRT Guide.
We care for patients from Midlothian, Richmond, Chesterfield County, Bon Air, Powhatan, and Chester, and across the greater Richmond area. Visits are in person at our Midlothian office, and by telehealth when it’s clinically appropriate.
Updated September 2026
