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Clinician-led hormone therapy across Austin · Insurance accepted · Virtual appointments
(613) 324-9141

Hormones

How It Is Given

Getting Started

Most Common

Body Changes

Which Stage

Testing

Cost

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Safety

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Common questions

Hormone therapy FAQs for Austin patients

Twenty-five questions grouped into getting started, treatment, safety, cost and practicalities. These are the ones we are actually asked, answered the way we would answer them in the room rather than the way a brochure would.

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  • 25 questions
  • Answered by clinicians
  • Updated annually
Not here? (613) 324-9141 If your question is not on this page, ask it. Anything asked more than a couple of times ends up here, which is how this page got to twenty-five.

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Getting started

Starting treatment in Austin

Eligibility, what the first appointment covers and how quickly things move.

No. You can book directly. If your history means input from a gynecologist, oncologist or cardiologist would help, we will say so and arrange it rather than leaving it with you.
Perimenopause commonly begins in the early forties and sometimes in the late thirties. Symptoms before 45 are worth investigating properly rather than dismissing, because early menopause changes long-term management.
Under 60, or within ten years of your last period, is the window where benefits most often outweigh risks. Beyond it treatment is not ruled out; the conversation becomes more individual.
Usually within a week or two. If symptoms are severe or you have had unexplained bleeding, mention it when you book, because that changes the priority.
Yes, and it is common. Bring what you are on and how it has suited you. Nothing needs stopping in the meantime.

Treatment

Treatment questions

What is prescribed, in which form and how the dose is settled.

Most often estradiol, usually as a patch, with micronized progesterone if you still have a uterus. Vaginal estrogen is added or used alone where dryness and urinary symptoms are the main issue.
A patch bypasses the liver and has not shown the increase in clot risk that oral estrogen carries. That matters most if you have any cardiovascular risk factor, and it is why patches are the usual starting point.
Start on the lowest dose likely to control your symptoms, review at three months, change one thing at a time. Symptoms decide the dose rather than a target blood level.
Most of the change lands between weeks four and twelve. Sleep often shifts first. Vaginal symptoms take eight to twelve weeks because the tissue has to rebuild.
For low sexual desire after menopause, where estrogen, dryness, sleep and mood have already been addressed. It is off-label in the United States, uncovered, and requires blood monitoring.

Safety

HRT safety questions

Risk, contraindications and what the 2002 study actually found.

For most healthy women starting before 60 or within ten years of menopause, the benefits usually outweigh the risks. Safety depends on your age, your history, which hormones, which form and for how long.
Combined therapy carries a small increase in risk that grows with duration. Estrogen alone has not shown the same signal. The absolute increase is comparable in scale to a couple of daily units of alcohol.
Oral estrogen raises clot risk through its effect on the liver. Estrogen absorbed through the skin has not shown that increase, which is why patches are preferred for anyone with additional risk factors.
Women with current or past hormone-sensitive cancer, unexplained vaginal bleeding, active liver disease, previous clot or stroke, or known thrombophilia. Several of those need specialist input rather than an automatic refusal.
No. Current guidance sets no arbitrary duration, and the five-year rule that still circulates is not supported by any current position statement. The decision is reviewed annually.

Cost

Cost and coverage in Austin

What it costs, what insurance covers and what is billed separately.

Between roughly $10 and five hundred, and the gap is almost entirely generic against brand. Generic patches run under $40 a month with coverage.
FDA-approved forms prescribed for menopause symptoms are covered under most plans, and patches under almost all of them. Compounded pellets are not covered by anyone.
Bloodwork by the laboratory and the prescription by your pharmacy. Only the consultation comes from us. Three bills, from three places, and we tell you that up front.
Part D can, and some Part C plans include drug coverage. Original Medicare Parts A and B do not cover outpatient prescriptions. Which products are covered depends on your plan formulary.
Ask for the generic by name, check the pharmacy cash price, and use a discount card for anything uncovered. The generic-versus-brand difference is the biggest single lever.

Practical

Practical questions

Appointments, tests, pharmacies and what happens between reviews.

Not always. The first consultation works either way and most reviews are remote. Blood pressure needs measuring somewhere, though a validated home monitor is acceptable.
At a collection site near you. The request goes through from us and results come back to us, so you are not chasing a laboratory.
Whichever one you already use. Nothing is dispensed here, so you can compare prices and keep your usual pharmacist.
Call. Questions about side effects, application or whether something is normal are part of the treatment rather than a separate transaction.
Come and talk it through. A planned taper with a review afterwards tells you far more than stopping and hoping does, and restarting later is a reasonable decision rather than a failure.

Patient reviews

Austin patients on their hormone therapy

★★★★★

I had been waking three or four times a night for two years and had been told it was just stress. The consultation actually went through my cycle history. Six weeks on a patch and I am sleeping through.

Rebecca H.
Austin
★★★★★

What I wanted was someone who would talk about the risks honestly rather than sell me something. They walked through the clot data and why a patch suited me better than tablets.

Marguerite O.
Round Rock
★★★★★

The brain fog was the part nobody warned me about. Having a clinician tell me it was a recognized symptom and not early dementia was worth the appointment on its own.

Denise W.
Pflugerville
★★★★

It took two dose changes before things settled, which they had told me upfront might happen. The three-month review was booked before I left the first appointment.

Priya N.
Austin

From the blog

Austin menopause guides from our clinicians

All menopause articles
A woman weighing up whether to start treatment Hormone Therapy Basics

September 14, 2026 9 min read

Is hormone therapy worth it?

What you are actually weighing up, and why the honest answer depends on three things rather than one.

Read article

Next step

Ask the question that is not here in Austin

If it is not on this page, it is worth asking. Anything we are asked more than a couple of times gets added.

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Consultations are by appointment. Prescriptions are issued only where clinically appropriate.