The Thrive Program

Hormone Replacement Therapy (HRT) and Nutrition Optimization

The Thrive Program consists of Hormone Replacement and Nutritional Optimization for both men and women - managed by our experienced medical providers. Hormone Replacement can be life changing for people struggling with the Menopause/Andropause transition – or for anyone seeking increased energy, improved mood, enhanced physical and mental performance, improved libido and overall vitality.

See if you're eligible!

About The Thrive Program

FDA Approved

Hormone Replacement Therapy (HRT) has been FDA approved since 1942 – with millions of people treated worldwide.

Professional Support

Our experienced medical professionals are with you every step of the way - monitoring your labs and dosing - with 24/7 support throughout the program.

Convenience

Medications are shipped directly to your home, with check-in appointments available in person and virtually.

Nutritional Support

As a part of your Thrive Program, we will assess your nutritional needs and build a comprehensive plan to optimize your supplements and vitamins

Enjoy Increased Vitality

Hormone Replacement Therapy (HRT) can improve energy, sleep, strength and endurance, well-being and libido.

Improved Health

Hormone Replacement Therapy will help you lose fat and gain muscle. This leads to significant long term health benefits - including reductions in heart disease, diabetes, osteoporosis and dementia.

What is Hormone Optimization?

From the day we are born, our hormones act as our body’s natural “instruction manual” – and optimal hormone levels allow us to feel and function our best. Hormones are the messengers of our Endocrine system – but aging and disease can cause them to decline. When this happens, we begin an accelerated aging process. As we lose that “instruction manual” we experience fatigue, weight gain, decrease in mental sharpness, and decreased sexual desire and enjoyment.

The quality of our sleep declines and our strength and endurance are not what they were. We may feel anxious, depressed, or irritable and “grouchy” all the time. When we are injured or sick it takes us longer to heal - and we begin to lose the ability to do the activities that we used to enjoy. Then - in our mid 40s or 50s - Estrogen and Progesterone - the two main female sex hormones drop off very suddenly - leading to the additional symptoms of perimenopause and menopause such as hot flashes, painful intercourse, irregular bleeding, and declining short term memory (or “brain fog”).

Hormone replacement therapy allows you to feel and function your best by recreating the hormone levels your body produced when you were younger - which has been shown to not only prolong life but prolong the quality of one's life. Hormonal support is beneficial at any age, but the best long term protective benefits are achieved if hormones are replaced when you begin to lose them, usually in our 40's.

What Hormones do for Women?

Estradiol and Progesterone are the two hormones that most people are referring to when they discuss “taking hormones” or hormone replacement therapy (also called HRT or ERT).

ESTRADIOL. Estradiol is normally made by our...

ovaries. Loss of estradiol causes many of the unpleasant symptoms of menopause – including hot flashes, vaginal dryness, urinary incontinence and infections, “brain fog” and depression/anxiety/loss of well-being. Treatment with Estradiol can alleviate these symptoms of menopause – and has also been shown to protect against heart disease, stroke, osteoporosis, and some forms of dementia. Learn More

PROGESTERONE. Progesterone is made by our ovaries and acts as a...

necessary and natural balance to Estrogen. It is the 1st hormone that we start to lose in perimenopause – and loss of progesterone leads to the insomnia and anxiety that many women experience as their first peri-menopausal symptoms. Progesterone (not to be confused with synthetic Progestins which have been shown to increase the risk of breast cancer) is protective against both breast and uterine cancer and acts as your brain’s natural anti-anxiety medication. Treatment with Progesterone will help rebuild your normal sleep patterns, prevent irregular vaginal bleeding and spotting, reduce hot flashes, and in the longer term, protect you from oesteoperosis. Learn More

TESTOSTERONE FOR WOMEN. While most people think of testosterone as...

a male hormone – and men do typically have levels 10 times higher than females do - but the truth is that testosterone is as vital to our health and well-being as it is for men. In fact – the average female makes more testosterone than she does estrogen! In females Testosterone supports strength and endurance, mental well-being and is the most important hormonal driver for sexual desire. Women typically begin to lose their testosterone in their late 30s and 40s – corresponding with the onset of middle-aged weight gain, fatigue and a decreased libido. Replacing your lost Testosterone can improve your energy levels, increase your energy and endurance, and restore your desire for intimacy with your partner. Learn More

THYROID HORMONES. Thyroid hormone regulates our...

metabolism – including our body temperature, energy levels and brain function. You can think of it as a thermostat that tells our body how fast our metabolism should run. Like all our major hormones – we produce less and less of this vital hormone as we age. When thyroid hormone production is low people will typically feel cold, sluggish, fatigued and experience decreased mental sharpness, depressed mood and weight gain. When thyroid hormone is optimized, you will feel energic and mentally sharp, with an increased sense of well-being. Thyroid hormone also increases fat breakdown, resulting in weight loss and lower cholesterol – leading to decreased risk for heart disease, stroke, and dementia. Learn More

DHEA (Dehydroepiandrosterone): DHEA is considered a...

“minor” hormone – but it is still very important. DHEA has two main effects – it helps shift your body into what is called an “anabolic” state – which means that it promotes the building of new muscles and connective tissue. As a result – it promotes weight loss, and will also slow down and prevent some forms of arthritis and joint pain. Its second main effect is that DHEA protects your brain and body from the corrosive effects of chronic stress – resulting in better immune function and reduced anxiety and better sleep.

Is HRT safe?

Under US law – hormones that are made naturally by our bodies cannot be patented. Because of this – in the early days of HRT several synthetic estrogens and progestins were developed and patented by pharmaceutical companies. Synthetic estrogen (ie: Premarin) and progestins (ie: Provera) are chemically altered so that they are not identical to human hormones. They are designed to try to elicit the same responses in your body as your natural hormones). This was done under the assumption that “estrogen is estrogen” – and that altering these molecules would not change their efficacy or safety in the human body.

Sadly – the most commonly used estrogens (CEE or Premarin – which is purified from the urine or pregnant horses) bind to the human estrogen receptor much more strongly than human Estradiol does – which resulted in the increase in heart attacks, strokes, and blood clots seen in studies like the Women’s Health Initiative. A similar result was found with synthetic progestins like Provera and MPA – which caused a slight increase in breast cancer rates in the women who took them. These frightening results caused a generation of women to stop taking HRT – leading to the early deaths of approximately 600,000 women from cardiovascular disease, dementia and osteoporosis which could have been prevented if those women had continued HRT (these findings were published in the Journal of

To make matters even more confusing – the words “estrogen” and “progesterone” are used both in medical literature and in the lay press to describe any molecule in the estrogen and progesterone families – each of which includes hundreds of unique molecules. So when you search for “is estrogen dangerous” you will find results for ALL estrogens – of which some are harmful and some are not. How is a person supposed to make sense of this?

BHRT (Bioidentical Hormone Replacement Therapy) uses only bioidentical progesterone and estradiol – which are exact copies of the molecules that your body makes naturally. To date there have been no scientific studies using these exact molecules that show any increased risk of heart attack, stroke, or cancer – meaning that taking these SPECIFIC molecules is, in fact, safe.

FAQs

FAQ with Plus Sign

Are hormones dangerous?

What age should I start HRT?

Can Hormone Therapy help prevent Urinary Tract Infections?

Can HRT treat fatigue?

Can HRT help with painful intercourse and vaginal dryness?

Can HRT prevent Osteoporosis?

Can HRT help me lose weight?

How long should I stay on hormones?

Can HRT improve my sleep?

How long should I stay on hormones?

FAQ with Plus Sign

Can HRT help me with anxiety depression or irritability?

Can HRT increase my desire for intimacy?

Can HRT control vaginal bleeding?

Can HRT fix hot flashes and night sweats?

Can I use my FSA or HSA?

But isn't Menopause normal?

Can HRT help with brain fog and memory?

FAQ with Plus Sign

Am I too young to start HRT?

Am I too old to start HRT?

What can HRT do for me?

How soon will I feel the effects of Hormone Optimization?

Some people notice a difference within a few days, but for the majority it is a slow and steady improvement over weeks and months. You may notice some physical symptoms get better first, for example, at the correct dose of estrogen, hot flushes and night sweats are often much better after 4-6 weeks. However psychological symptoms, such as low mood, energy levels or anxiety, can take a few more months to improve. We tell our patients that they will begin to feel better in 3 months, will definitely feel effects by 6 months – and should be fully optimized in a year. Remember – we are not applying a band-aid. We are allowing the body to re-build itself – and like all profound changes – this one will take time.

What are the problems with synthetic hormones, and why are Bioidentical hormones better?

When first developed, synthetic hormones were well received because they provided some of the benefits of hormone replacement in controlling the symptoms of menopause. However, synthetic hormones such as Premarin (Conjugated Equine Estrogen) and Provera (Medroxy Progesterone Acetate) are not native to the body. Long-term studies with these molecules (which as the Women’s Health Initiative) have shown that synthetic hormones can cause negative outcomes – specifically increased heart attacks, strokes, and breast cancer. Additionally, some women can't tolerate synthetic hormones - often suffering with side effects such as bloating, bleeding or mood swings. BHRT (Bioidentical Hormone Replacement Therapy) uses only bioidentical progesterone and estradiol – which are exact copies of the molecules that your body makes naturally. To date there have been no scientific studies using these exact molecules that show any increased risk of heart attack, stroke, or cancer – meaning that taking these SPECIFIC molecules is, in fact, safe.

Why doesn't my gynecologist prescribe bio-identical hormones?

Molecules that our bodies make naturally – such as hormones - are protected by federal regulation and may not be patented. Major pharmaceutical manufacturers are interested only in patentable drugs that are exclusive and profitable. In Medical school physicians are primarily taught only about synthetic products. Physicians must seek out education about BHRT on their own – which can be difficult, expensive and time consuming. Additionally – most insurance plans will not cover BHRT – so many physicians do the thing that is easy and simple for them and their patients and prescribe synthetic hormones instead.

Did the Women’s Health Initiative study really show that HRT is dangerous?

The Womens' Health Initiative (WHI) is a large, long-term study that used synthetic estrogen (Premarin) and progestin (Provera). There were different "arms" of the study using different drug combinations. The arm of the study using Premarin and Provera (Prem/Pro) was discontinued before completion because of a slight increase in the risk of breast cancer. We now know that this risk was a result of the synthetic progestin Provera – and is not found when giving bioidentical Progesterone. Sadly this was not the first time progestins have shown a higher risk profile. The arm of the study using Premarin did not show an increased risk of breast cancer, but was discontinued because of an increased incidence of strokes in older women due to the fact that Premarin (which comes from the urine of pregnant horses and includes 23 different types of estrogen which are not found in humans) upregulated the body’s clotting system. Several other large studies that shown that estradiol – the estrogen that is native to the human body does not have the same negative effects. Unfortunately, the media interpreted this study to mean that all HRT was dangerous and should be discontinued. Again, the culprits were the synthetic progestin, Provera, and a horse estrogen (equilinin) - not bioidentical Estradiol or Progesterone. There are numerous studies showing the long term benefits of hormone therapy. You just need to make sure you are receiving the right hormones (bio-identical) in the right balance. It is also important to begin hormone replacement as soon as you begin to lose the hormones to avoid any length of time without their protective benefits.

What is progesterone?

Progesterone belongs to a group of hormones called ‘progestogens’. Progesterone is one of the main female reproductive hormones, responsible for regulating the menstrual cycle and supporting pregnancy. Its levels in the blood vary throughout each menstrual cycle, and drop when a woman goes through menopause, and her periods stop. Imbalances in progesterone levels can be caused by different health problems, and manifest in various ways. Low progesterone symptoms include irregular periods, spotting between periods, difficulty becoming pregnant, and a reduced sex drive.

What are the signs of low Progesterone and what are the health benefits?

Progesterone is responsible for balancing estrogen and the female reproductive cycle. Deficiency results in symptoms of PMS, bloating, headaches, cramping, mood swings, breast tenderness, and irritability. A deficiency in progesterone can be a factor in frequent miscarriages. Research shows that natural progesterone stimulates bone building osteoblasts, thus providing protection against osteoporosis. Progesterone reduces the mitotic change in breast and uterine tissue, thereby protecting against cancer (Provera – a synthetic progestin sadly does the opposite). Progesterone protects against heart disease. Progesterone is necessary for adequate sexual response, lubrication and vaginal vasodilation. Progesterone is responsible for the physiologic equilibrium with estrogen. At menopause, women lose both estrogen and progesterone - but typically we lose Progesterone a few years earlier. Progesterone replacement is important, even if you have had a hysterectomy because it does much more than just protect the uterus. Recent studies have shown that Provera (medroxy progesterone – a synthetic progestin) increases the risk of breast cancer and increases the thickening of the breast tissue. It does this by direct stimulation (up regulation) of estrogen receptor sites in the breast. One study showed that Provera increased breast stimulation by 400% over baseline. The same study showed that bioidentical Progesterone had the opposite effect and was protective.

What are the signs of low Estrogen and what are the health benefits?

Estradiol is responsible for balancing Progesterone and the female reproductive cycle. Deficiency results in hot flashes and night sweats, issues with short term memory and “brain fog”, and depression and irritability. Estradiol is responsible for cleaning our arteries of plaque – and loss of Estradiol leads to increased cardiovascular disease. Research shows that supplementing Estradiol reduces risks of heart attack, stroke and dementia. At menopause, women lose both estrogen and progesterone - but typically we lose Progesterone a few years earlier. Estrogen without Progesterone has been shown to lead to endometrial cancer – so when we supplement Estrogen it is vital that we also replace Progesterone at the same time.

What if I have been taking synthetic hormones?

You need hormones, but you need the right kind, the natural bio-identical hormones, in the right balance. Don't tolerate the risks of the synthetic hormones when a safe alternative is available. Find a physician who will prescribe natural hormones and then make the switch.

Should I take estrogen and progesterone both or not?

The risks of not taking hormone replacement therapy include elevated cholesterol, heart disease, strokes, osteoporosis, tooth loss, depression, Alzheimer's Disease, and menopausal symptoms. The side effects of the synthetic hormones such as bleeding, swelling, weight gain and breast cancer can be almost eliminated by using bioidentical Estradiol and Progesterone. Overall health and well-being are improved, long term survival is greatly improved and the quality of life greatly enhanced. In our opinion - the risks of NOT taking hormones is what should concern us and we recommend both Estradiol and Progesterone to all women who are appropriate candidates.

Do I need to have a period while I am on HRT?

There are some providers who will claim cycling (creating a period every month) is recommended and natural. The idea behind this is that since we menstruate while we are "young" and it is advantageous and natural to continue to menstruate forever if you take hormones. However – there is no science to back up this practice. For years, women have been treated with birth control pills taken continuously (as opposed to in a cyclical fashion) to control PMS. It is the fall of women's hormones that takes place right before their periods that causes the symptoms of PMS. By taking birth control pills continuously, a woman can avoid this drop of hormones and the symptoms of PMS. The pharmaceutical industry has now caught onto this and promotes a new birth control pill that is cycled for bleeding every four months instead of monthly. The researchers claim that while no menstruation is necessary, the cycling allows women to menstruate every four months to make them feel more "normal". We now realize that even pre menopausal women do not need to menstruate, let alone post-menopausal women. Remember, cycling involves stopping the progesterone for a few days. Another reason not to cycle is the loss of protection that takes place when the progesterone is not present. Bioidentical progesterone protects the breasts and uterus against cancer. It is obvious and well accepted that progesterone protects against uterine cancer. The bleeding that takes place with menstruation is not what protects the uterus against cancer. It is the direct effect of progesterone on the uterus that protects it. Stopping progesterone for a week means that the body is without the protective benefits of progesterone for those days. It makes no sense to lose the important protective benefits for even a few days every month. However – if monthly periods are important to you – they can be triggered by periodically stopping your progesterone and you can discuss organizing this with your provider.

What are common side effects of BHRT?

You may experience some breast tenderness, vaginal bleeding or spotting, or some abdominal bloating in the first few weeks after starting estrogen and progesterone treatments. Breast tenderness, bleeding, bloating and feeling low after starting HRT are not usually cause for clinical concern. If bleeding is heavy, persistent or prolonged, contains clots, or you are bleeding after sex, contact your provider to discuss this further. If using patches, sticky marks from the glue can be removed with baby oil and a cotton pad or dry flannel. If your skin becomes red from the patch, stick the next patch to a different area of skin. If skin irritation persists, mention this to your menopause doctor as there are often other brands to try that may not cause the same reaction. If any side effects from your HRT have not settled down by your 3 month follow up appointment, you can discuss these further with your provider as there are often other doses, types or routes of administration that can be tried.

How do I know if I need a change in my dose?

It is common to “titrate” hormones – which means that we will start with a low dose, and gradually increase until we have achieved the result we are looking for – or back off on the dose when we encounter a side effect. This titration will be discussed at each of your follow-up appointments until you are fully optimized and stabilized on the doses of all your hormones.

Read the Scientific Literature supporting Hormone Replacement Therapy

We are building a library of the best and most up to date medical literature on HRT, TRT, and Hormone Optimization to help our patients make the best choices for their health. Please check back soon for updates!

What To Expect

Thrive Program Medical Evaluation

At your Thrive Program Medical Evaluation, one of our experienced providers will review your medical history, labs, and goals for your health. We will use a sophisticated scoring system to determine which hormones and nutrients you may be deficient in. We will pair this information with you laboratory studies to build a comprehensive care plan designed to acheive your goals.

Bloodwork

Before we build your personalized care plan, we will do extensive screening bloodwork to assess your currently health status, risk factors, and any existing nutritional deficits.

We will assess your labs frequently during our program - to ensure that your overall health status is being fully optimized.

*If you do not have labs, you can come in for a consultation, however you will not be able to begin the Thrive Program until your labs have been reviewed. Eligibility is not guaranteed.

Pre Screening Questions

Interested?

After you complete the pre-screening questions to see if you are eligible above, you can set up your initial Thrive Program consultation to learn more about what this exciting and groundbreaking form of medicine can do for you!

*If you do not have completed labs, we can do the initial Thrive Program consultation but cannot start the program until the necessary lab are complete.

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If you want to hear about our Medical Weight Loss and Aesthetic treatments in addition to our Thrive Program (Hormone Replacement Therapy and nutritional optimization) - please book a consultation below.!

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