Hormone & Wellness
Hormone Replacement & Wellness Care
Evidence-based hormone therapy and integrative wellness care for peri- and postmenopausal women — telehealth and in-office visits available.
HRT Benefits and Risks for Peri- and Postmenopausal Women
Hormone Replacement Therapy for Women
Hormone replacement therapy (HRT) remains the most effective treatment for vasomotor symptoms (VMS) and genitourinary syndrome of menopause (GSM), with a favorable benefit-risk ratio for symptomatic women under age 60 or within 10 years of menopause onset.
The timing hypothesis is central to risk stratification: initiating HRT soon after menopause (the "window of opportunity") is associated with neutral or reduced cardiovascular risk and lower absolute risks of stroke, thromboembolism, and dementia compared with delayed initiation. However, the balance shifts unfavorably for women initiating therapy beyond age 60 or more than 10 years post-menopause.
- 1.The 2022 hormone therapy position statement of the North American Menopause Society. Menopause, 2022.
- 2.Management of perimenopausal and menopausal symptoms. BMJ, 2023.
- 3.Back to the future: hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. Atherosclerosis, 2016.
- 4.Hormone-replacement therapy: current thinking. Nature Reviews: Endocrinology, 2017.
- 5.The menopause transition: signs, symptoms, and management options. The Journal of Clinical Endocrinology and Metabolism, 2021.
Evidence-Based Use of Transdermal Testosterone
Testosterone Therapy for Women
The Global Consensus Position Statement (endorsed by 10 international societies) and the 2021 ISSWSH Clinical Practice Guideline establish that systemic transdermal testosterone is the only evidence-based indication for testosterone therapy in women — specifically for postmenopausal hypoactive sexual desire disorder (HSDD).
Dosing Testim 1% gel for women (off-label): Use approximately 1/10th of the male dose. Starting dose is approximately 5 mg testosterone daily (0.5 mL or 0.5 grams) applied to the back of the calf, upper outer thigh, or buttock. May titrate to 10 mg daily (1.0 mL or 1 gram) based on clinical response and monitoring. This is equivalent to approximately 1 tube every 5–10 days.
Questions About Hormone Therapy?
Dr. Chandler offers personalized hormone consultations via telehealth or in-office in Allen, TX.