Hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT), replaces the estrogen, progesterone, and sometimes testosterone your body makes less of during perimenopause and menopause. At Bespoke Rx in Tampa, board-certified nurse practitioners prescribe HRT as patches, gels, creams, and pills, and adjust your dose based on your symptoms and labs.
Menopause is 12 months in a row without a period. In the US, it happens at an average age of 51, and about 1.3 million women reach it each year. Perimenopause, the transition before it, often starts in your 40s and can last several years. (Source: The Menopause Society)
Maybe it started small.
And when you finally said something, maybe you heard:
"Your labs look normal."
"You're too young for menopause."
"Have you tried yoga?"
Here's what we want you to know:
Sometimes it's perimenopause, which can start in your late 30s or early 40s, years before your last period.
Sometimes it's menopause and the years after. Symptoms don't simply fade the way you were told they would. In the SWAN study, which followed more than 3,000 women, frequent hot flashes and night sweats lasted a median of 7.4 years.
It is real. It is common. And it is treatable.
| What you feel | Clinical term | What may help |
|---|---|---|
| Hot flashes, night sweats | Vasomotor symptoms | Systemic estrogen (patch, gel, or pill) |
| Waking at 3 a.m., can't fall back asleep | Sleep disruption | Progesterone, estrogen |
| Brain fog, losing words | Menopause-related cognitive changes | Estrogen, better sleep |
| Mood swings, new anxiety, irritability | Perimenopausal mood changes | Estrogen, progesterone |
| Dryness, painful sex, bladder urgency or repeat UTIs | Genitourinary syndrome of menopause (GSM) | Local vaginal estrogen |
| Low desire | Hypoactive sexual desire disorder (HSDD) | Testosterone, when appropriate |
| Heavy or irregular periods | Perimenopausal bleeding changes | Progesterone, after an exam |
| Joint aches | Musculoskeletal symptoms of menopause | Estrogen |
We hear some version of your story in our Tampa office every single week.
From teachers. Nurses. CEOs. Moms running carpool on four hours of sleep.
Smart, capable women who felt like they were slowly disappearing, and couldn't explain why.
You're exhausted, but not the kind of tired that sleep fixes. Your brain feels wrapped in cotton. You used to be the sharp one, the one who remembered everything. Now you're rereading the same email three times.
And we know firsthand what it feels like when your body changes and no one explains why.
That's why we built this program differently.
You'll be heard first. Then treated.
Hormones in perimenopause can swing day to day, even hour to hour.
That's why a single lab result can come back "normal" while you feel anything but. The Menopause Society does not recommend hormone blood tests to diagnose perimenopause, for this reason.
At Bespoke Rx, labs are one piece of the puzzle, not the whole picture.
We start with baseline labs to understand where you are. Then we listen. How are you sleeping? How's your mood, your energy, your desire, your cycle?
Your treatment plan is built around how you feel, and adjusted as you do.
Many Tampa women come to us after trying pellets, or have friends who swear by them. We understand the appeal: one appointment, then nothing to remember for months.
But here's what we've seen.
Pellets release a surge of hormones at first, then slowly taper off. That means peaks and valleys. The weeks you feel amazing. The weeks you start to crash. And once a pellet is placed, the dose can't be adjusted or removed.
The major medical groups agree. Hormone pellets are compounded and not FDA-approved. ACOG's 2023 Clinical Consensus on compounded hormones recommends FDA-approved hormone therapy over compounded products, including pellets, and warns that pellets can push hormone levels above the normal range.
Our goal is different.
We want to bring you to a steady, optimal state, where you feel like yourself on a Tuesday in March the same as you do in July.
With patches, gels, creams, and pills, we can fine-tune your dose as your body changes. Gently. Precisely. With you.
| Compare | Hormone pellets | Patches, gels, creams, pills |
|---|---|---|
| FDA-approved | No | Most are |
| Hormone levels | Spike, then fade | Steady |
| Dose changes | Not possible once placed | Adjusted as needed |
| Can be stopped | Not until the pellet dissolves | Any time |
| Offered at Bespoke Rx | No | Yes |
Already on pellets and not feeling steady? We're happy to talk through what transitioning could look like.
Hormone care isn't one-and-done. Your membership means you're never figuring this out alone.
Included:
| Service | Price |
|---|---|
| Hormone consultation | $150 (one-time) |
| Lab review | $75 |
| Hormone membership | $175 per month |
Bespoke Rx doesn't bill insurance for visits, lab review, or membership. Medications are paid directly to the pharmacy or billed to your insurance when covered.
Perimenopause is the transition before menopause, when hormone levels swing and periods change. It often starts in your 40s. Menopause is the point 12 months after your last period, at an average age of 51. Bespoke Rx in Tampa treats symptoms in both stages.
Probably not. Perimenopause often begins in your 40s, and for some women in their late 30s, while periods are still regular. If your symptoms are changing your life, a consultation at Bespoke Rx is worth it at any age.
Not necessarily. Many women start hormone therapy after menopause. Local vaginal estrogen can help with dryness and bladder symptoms at any age. At Bespoke Rx, your nurse practitioner reviews your history and timing to find what's safe for you.
Yes. Hormones fluctuate widely during perimenopause, so a single blood test can miss what's happening. Bespoke Rx uses labs as a baseline and treats based on your symptoms.
For most healthy women under 60, or within 10 years of menopause, yes. The Menopause Society's 2022 position statement says the benefits of hormone therapy outweigh the risks for this group. In November 2025, the FDA began removing most boxed warnings from menopausal hormone therapy labels. Bespoke Rx reviews your personal and family history before recommending anything.
The risk is small and depends on the type of hormone. In the Women's Health Initiative, estrogen alone did not raise breast cancer risk. Estrogen combined with a progestogen raised it slightly with longer use, by fewer than 1 extra case per 1,000 women per year. Your Bespoke Rx nurse practitioner will walk through your personal risk.
Pellets aren't FDA-approved, they create peaks and valleys in hormone levels, and the dose can't be adjusted once placed. ACOG recommends FDA-approved hormone therapy over compounded pellets. Bespoke Rx uses patches, gels, creams, and pills to keep you in a steady range.
Yes. Estradiol and micronized progesterone are bioidentical, and FDA-approved versions are available as patches, gels, and pills. Bespoke Rx prescribes FDA-approved bioidentical hormones first and uses a compounding pharmacy only when an approved option doesn't fit.
It can, when those symptoms come from perimenopause or menopause. Many women report clearer thinking and steadier mood once sleep and hot flashes improve. Bespoke Rx also screens for other causes, such as thyroid problems, so nothing gets missed.
Many Bespoke Rx patients notice better sleep and fewer hot flashes within a few weeks. Finding your ideal dose can take about three months, and your nurse practitioner adjusts along the way.
There's no set cutoff. The Menopause Society says there's no need to stop hormone therapy at a certain age. Bespoke Rx reviews your benefits and risks each year and adjusts as your needs change.
Usually not. Progesterone protects the uterine lining, so women without a uterus typically take estrogen alone. Some women still use progesterone for sleep. Your Bespoke Rx nurse practitioner will help you decide.
It depends on your age, health, and goals. HRT doses don't prevent pregnancy, so women in perimenopause may still need contraception. Your Bespoke Rx nurse practitioner will help you choose the right combination.
No. Studies show hormone therapy doesn't cause weight gain, though it isn't a weight-loss treatment either. Bespoke Rx members can add GLP-1 weight management, so hormones and metabolism are supported together.
At Bespoke Rx, the consultation is $150, lab review is $75, and the hormone membership is $175 per month. Medications are paid to the pharmacy or billed to insurance when covered.
Many HRT prescriptions are covered by insurance. Bespoke Rx visits, lab review, and membership are self-pay.
Bespoke Rx offers telehealth hormone visits for women anywhere in Florida.
Your first Bespoke Rx visit is an unhurried consultation with a board-certified nurse practitioner. You'll talk through your symptoms, history, and goals, then order baseline labs. You'll leave knowing your next step.
You'll work with one of Bespoke Rx's board-certified nurse practitioners at the Tampa office, across from the University of Tampa.
Medically reviewed by Amanda Conti, MSN, APRN.
Not "fine." Not "getting through it." Rested. Clear. Present. Yourself.
Your first step is simply a conversation at our Tampa office. Schedule your consultation online or call 813-203-6196.
Across from the University of Tampa, next to Oxford Exchange. Serving women from South Tampa, Hyde Park, Davis Islands, Westshore, and across Tampa Bay.
