The conversation about HRT was scrambled by a 2002 study. The truth: for most women within 10 years of menopause, modern transdermal estradiol plus micronized progesterone is safe and high-yield. Here's how we screen.
Most peri- and postmenopausal women without contraindications benefit from HRT.
If any of these apply, systemic HRT is off the table at OPTML. Vaginal estradiol alone may still be appropriate, we'll advise.
Manageable, but the protocol is adjusted (transdermal preferred over oral, lower starting dose, more frequent monitoring).
Upload labs from the past 6 months or use the OPTML Optimized Health (Female) panel.
| Lab | Why |
|---|---|
| FSH, LH, estradiol | Confirm menopausal status (especially in perimenopause). |
| Progesterone | Cycle context if still cycling. |
| TSH | Thyroid mimics menopausal symptoms. |
| CMP | Liver and kidney baseline. |
| Lipid panel | Cardiometabolic baseline. |
| HbA1c, fasting glucose | Glycemic baseline. |
| CBC | Anemia and general health. |
| DHEA-S, free & total testosterone | Adrenal and androgen baseline (often low in perimenopause). |
Up-to-date mammogram and Pap are required, we'll ask for the date but won't request the report. If you've had abnormal vaginal bleeding, you'll need a workup with your gynecologist before starting.
All of these change the protocol or the route.
Take Find My Protocol or start an HRT intake. A licensed physician reviews every history and lab. We use bioidentical transdermal estradiol and oral micronized progesterone.
OPTML offers compounded semaglutide and tirzepatide, prescribed and overseen by U.S.-licensed physicians. Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the FDA. OPTML is not associated with, endorsed by, or affiliated with the manufacturers of FDA-approved branded weight-loss medications, and does not sell or supply those branded products. Anyone interested in an FDA-approved branded medication should consult a licensed healthcare provider or pharmacist. Individual results vary; no specific result is promised, and weight management requires ongoing medical guidance.
The whole picture in one sitting: who it suits, what the labs decide, what the first year actually looks like. Every clinical claim is cited.
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