For Women
Women’s Hormone Therapy & Menopause Care in St. Louis
Care provided by Judy Smart, RN, BSN, in collaboration with Jennifer McDonald, DO.
Perimenopause and menopause can bring a wide range of changes — some subtle, some hard to ignore. Hormone levels, especially estradiol and testosterone, shift during this transition, and for many women that shows up as hot flashes, mood changes, sleep trouble, and more. At Smart Age STL in Chesterfield, MO, we work with women throughout the St. Louis area to check hormone levels with lab work. From there, we build an individualized treatment plan, often using hormone pellet therapy.
Perimenopause & Menopause Symptoms
Every woman's experience is different, and these symptoms can have other causes too, which is why lab work is part of every treatment plan. Symptoms many women connect to perimenopause or menopause include:
- Hot flashes and night sweats
- Sleep trouble or insomnia
- Mood changes, anxiety, or feeling on edge
- Brain fog or difficulty concentrating
- Low sex drive
- Vaginal dryness
- Weight changes, especially around the midsection
- Joint aches
Our Approach: Estradiol & Testosterone Pellet Therapy
For most women, treatment plans focus on two hormones: estradiol and testosterone. Both typically decline with age, and more suddenly if the ovaries are removed surgically. At Smart Age STL, both are commonly delivered using hormone pellets — small, rice-grain-sized pellets of compounded bioidentical hormone, inserted under the skin during a brief in-office visit. The pellets release hormone gradually over time, so there is no daily pill or cream to remember. Most patients return for a new set of pellets roughly every three to six months, based on follow-up labs and symptoms.
A Note on Progesterone
For women who still have a uterus, hormone therapy plans commonly include a discussion of progesterone alongside estrogen therapy, as part of a complete and balanced approach. Whether progesterone is right for you, and in what form, is something your provider goes over individually as part of your consultation and lab review. It is not a one-size-fits-all part of the plan.
Important information
- Bioidentical hormone pellets are compounded — a licensed pharmacy prepares them to match an individual prescription. They are not a mass-manufactured, one-size-fits-all product.
- Compounded bioidentical hormone therapy (BHRT) is not FDA-approved. The FDA does not review the safety or effectiveness of compounded medications the same way it reviews FDA-approved drugs.
- Pellet therapy requires lab work and ongoing clinical supervision. It is not a one-time treatment — dosing is adjusted based on follow-up labs and how you are responding.
- Results and timelines vary by individual. What one patient experiences is not a guarantee of what you will experience.
Questions About Menopause Hormone Therapy?
Contact our team today about a strategy that's right for you!
Frequently Asked Questions
What is women's hormone therapy?
Women's hormone therapy at Smart Age STL is individualized treatment aimed at addressing symptoms linked to hormone changes during perimenopause and menopause, most often involving estradiol and testosterone. Treatment is most commonly delivered through hormone pellets — small pellets of compounded bioidentical hormone placed under the skin. They release hormone gradually over several months rather than requiring a daily pill or cream. Every plan starts with lab work and a conversation about your symptoms, history, and goals. The right approach depends on your situation — including whether progesterone belongs in your plan, and whether you still have a uterus.
How is menopause hormone therapy different from perimenopause treatment?
Perimenopause is the transition period before menopause, when hormone levels fluctuate rather than staying consistently low, which can make symptoms feel less predictable for some women. Menopause is reached once a woman has gone twelve months without a period, at which point hormone levels have typically settled at a lower baseline. Symptoms overlap quite a bit between the two stages, but the lab picture can look different. That's part of why treatment is not one-size-fits-all, regardless of where you are in the transition. Your provider looks at your labs, your symptom history, and where you are in the transition before recommending a plan, rather than assuming one approach fits every stage equally.
Is hormone therapy safe for menopause symptoms?
Hormone therapy is provided under clinical supervision at Smart Age STL, starting with lab work and a review of your health history before any treatment begins. As with any hormone therapy, there are individual risks and considerations your provider goes over with you directly. These include whether you still have a uterus, your personal and family health history, and current medications. Compounded bioidentical hormone pellets are not FDA-approved; they are prepared by a licensed compounding pharmacy rather than manufactured as an FDA-approved drug product. Professional societies such as The Menopause Society publish general guidance on hormone therapy that your provider can discuss with you. Ongoing follow-up labs are part of treatment so your plan can be adjusted as needed.
What does women's hormone therapy cost?
Cost depends on your individual dose and treatment plan, which is based on your labs and symptoms, so it is different for every patient. Most insurance plans do not cover hormone pellet therapy, and most patients pay out of pocket for consultations, labs, and insertions. Because pricing depends on factors specific to your situation, the most accurate way to get real numbers is a consultation. There, we can walk through what a plan would likely involve before you commit to anything. That first visit typically includes a review of your symptoms and health history along with baseline lab work. That way, pricing conversations are based on your actual levels and goals rather than a one-size-fits-all quote. Call (314) 619-8848 to ask about scheduling a consultation.
Will I need progesterone too?
It depends. For women who still have a uterus, progesterone is commonly discussed as part of a complete hormone therapy plan alongside estrogen. For women who no longer have a uterus, the conversation is often different. This is exactly the kind of detail your provider goes over individually during your consultation, based on your health history and lab work. It is not something to guess at from a website, and it is not the same recommendation for every patient. Your consultation typically includes a review of your symptom history and a discussion of your surgical history. That way, this gets decided with your actual situation in view, not a generic rule.