Hormone Replacement Therapy in Holly Springs, NC

Feel like yourself again with individualized, evidence-based hormone therapy.

At Holly Springs Direct Primary Care, we understand that hormonal changes during perimenopause and menopause can significantly affect your sleep, mood, energy, and overall quality of life.

Our approach focuses on understanding your symptoms, discussing your goals, and developing an individualized treatment plan that may include hormone replacement therapy (HRT), lifestyle modifications, and other evidence-based options.

Whether you’re experiencing your first symptoms of perimenopause or struggling with ongoing menopausal symptoms, we’re here to help you navigate this transition with confidence.

Serving women in Holly Springs, Apex, Fuquay-Varina, Cary, and surrounding communities.

Many women begin experiencing hormonal changes years before their final menstrual period. Perimenopause and menopause can cause a wide range of symptoms, some of which may be overlooked or attributed to normal aging.

Common symptoms include:

• Hot flashes and night sweats
• Difficulty sleeping or frequent nighttime awakenings
• Brain fog and difficulty concentrating
• Mood changes, irritability, or anxiety
• Vaginal dryness or discomfort with intercourse
• Decreased libido
• Irregular menstrual cycles
• Joint aches and discomfort
• Changes in body composition
• Fatigue and decreased energy

You do not have to simply tolerate bothersome menopausal symptoms.  With an individualized evaluation and appropriate treatment, many women experience meaningful improvements in their symptoms and quality of life.

Hormone replacement therapy, also called menopausal hormone therapy (MHT), is an effective treatment for many symptoms associated with menopause.  As women approach menopause, estrogen and progesterone levels fluctuate and eventually decline.  These hormonal changes can contribute to hot flashes, night sweats, sleep disturbances, and vaginal symptoms. Hormone therapy can alleviate the symptoms and improve quality of life for appropriately selected patients. 

What types of hormone therapy are available?

Treatment recommendations are individualized based on your symptoms, medical history, preferences, and risk factors. Options include:

• Estrogen therapy- available in several formulations, including transdermal patches, gels, and oral medications. Systemic estrogen therapy is highly effective for treating hot flashes and night sweats.  It also has the potential to benefit things like brain fog and difficulty concentrating, mood irritability, joint aches, and vaginal dryness.

• Progesterone therapy- women with an intact uterus using systemic estrogen generally require appropriate endometrial protection, often with progesterone. Other benefits of progesterone include improved sleep and anxiety.

• Vaginal estrogen therapy- low-dose vaginal estrogen can help treat vaginal dryness, painful intercourse, and other symptoms of genitourinary syndrome of menopause.

• Testosterone therapy- possible benefits include improved libido, brain fog, and fatigue.  Therapy requires close laboratory monitoring. 

• Nonhormonal treatment options- hormone therapy is not appropriate or desired by every woman.  We also discuss evidence-based nonhormonal medications and lifestyle strategies when indicated.

Hormone therapy is not appropriate for everyone.  Treatment decisions are based on individualized assessments of potential benefits, risk, contraindications, and personal preferences.

Perimenopause and menopause treatment should never be a one size fits all approach.  We combine evidence-based medicine with the personalized attention that women deserve. 

Menopause Focused Medical Expertise

Our practice offers care from providers who have earned Menopause Society Provider Certification, demonstrating specialized knowledge in menopause and midlife women's health.

Longer, Unhurried Appointments

We take the time to understand your symptoms, medical history, and treatment goals without the pressure of a typical rushed office visit.

Individualized Hormone Therapy

We discuss available treatment options and help you select an approach based on your unique needs, preferences, and medical history.

Ongoing Monitoring and Follow-Up

Hormone therapy often requires adjustments over time. Our direct primary care model allows for ongoing communication and follow-up as your needs evolve. We have the ability to draw labs in our office should that be required. 

Comprehensive Women's Health

 We address more than just hormones. Our approach incorporates preventive care, cardiovascular risk assessment, weight management, sleep, and lifestyle medicine.

No Additional Fees

All of our expert perimenopause and menopause support is included in our regular DPC monthly membership at no additional charge. 

Menopause is a natural transition, but that does not mean you have to live with symptoms that interfere with your daily life.  At Holly Springs Direct Primary Care, we provide personalized, evidence-based care to help you navigate perimenopause and menopause with confidence.  Whether you are considering hormone replacement therapy for the first time or looking for a more individualized approach to your current treatment, we are here to help.

I am thrilled that our team has the opportunity to offer all of these excellent services within our office.  HRT truly does have the potential to make dramatic improvements in quality of life. We would love to have the opportunity to help support you at this stage of life and beyond!

Scott Bartkoski, MD

Board-Certified Family Medicine Physician

Menopause Society Certified Practitioner

Board Certified in Obesity Medicine

Board-Certified in Lifestyle Medicine

Do I Need Hormone Testing?

For most women over age 45 with typical perimenopausal or menopausal symptoms, diagnosis is based primarily on symptoms and menstrual history rather than routine hormone blood testing. However, when appropriate, additional testing may be recommended to evaluate other potential causes of symptoms or clarify the diagnosis.

Is Hormone Replacement Therapy Safe?

Hormone therapy can be an appropriate and effective treatment for many women experiencing bothersome menopausal symptoms. For generally healthy women younger than 60 or within 10 years of menopause onset, the benefit-risk balance is often favorable when no contraindications are present. However, individual risks vary based on medical history, treatment formulation, route of administration, and other factors. There is no absolute age above which hormone therapy should be stopped, but there does need to be ongoing follow up and risk/benefit analysis. Learn more from The Menopause Society and the American College of Obstetricians and Gynecologists. 

When Should I Start Hormone Replacement Therapy?

There is no single age at which every woman should begin hormone therapy. Treatment is generally considered when bothersome menopausal symptoms develop and the potential benefits outweigh the risks. Many women begin treatment during perimenopause or shortly after menopause.

Can I Take Hormone Replacement Therapy During Perimenopause? 

Yes. Hormone therapy may be appropriate for certain women experiencing bothersome symptoms during perimenopause. Treatment depends on menstrual patterns, symptoms, medical history, and contraceptive needs.

Does Hormone Replacement Therapy Cause Weight Gain? 

Hormone therapy has not consistently been shown to cause significant weight gain. However, hormonal changes associated with menopause can contribute to changes in body composition and fat distribution. Addressing nutrition, physical activity, sleep, and metabolic health remains important.

Do I Need Blood Tests Before Starting Hormone Replacement Therapy?

Not necessarily. For many women over age 45, menopause and perimenopause can be evaluated based on symptoms and menstrual history. Blood tests may be appropriate in certain situations, but routine hormone testing is not always necessary.

How Long Can I Stay On Hormone Replacement Therapy?

There is no universal maximum duration of hormone therapy. Continued treatment should be based on an individualized assessment of symptoms, benefits, risks, and preferences, with periodic reevaluation.

Where Can I Receive Perimenopause and Menopause Treatment Near Holly Springs, NC? 

Holly Springs Direct Primary Care provides individualized menopause and perimenopause care for women in Holly Springs and surrounding communities, including Apex, Fuquay-Varina, Cary, and southern Wake County.