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Just Because You Are Going Through Menopause Does Not Mean That Your Sex Life is Over!

Menopause and sex CAN go together with ease, despite what you might have heard. After all, it’s no wonder that women can lose their sex drive when hormones start to decline! Mental and physical changes can be unpleasant, and those can cause you to lose your desire for sex.

It’s easy to fall into the trap of feeling hopeless about your sex life, which may cause you to lose the vitality that you once had. Sex isn’t just about physical pleasure. It’s also a special way to experience emotional and physical intimacy with your partner. When you are having intimate sex, the feel-good hormones are released into your system such as dopamine and oxytocin.

These are good for your health and well-being. Sex also benefits your cardiovascular system. We understand that it’s not all about sex. It’s also the way you FEEL as you’re going through this time of your life. Many women, just like yourself, may feel like the “old” you are gone, but that’s not the case! Mid-life can be a beautiful time and give you more wisdom and confidence than you’ve ever had before. Not only that, but you can also feel more comfortable with your sex life than ever!
asian middle aged couple

The “Change”

As you enter mid-life, hormone levels begin to fluctuate and decline. This can affect the quality of your sex life along with other aspects of your health and well-being. Fortunately, times have changed considerably! You have a lot more options including bioidentical hormone replacement therapy.

Depending on your age, you may remember your mother or grandmother talking about “the change” and how old it made them feel. This is not the case anymore!

You might be wondering how you know that you are in menopause. It is more of a process than a one-time event. For example, “menopause” is defined as the cessation of menses. You are technically menopausal one year after you had your last menstrual cycle.

However, this process of hormonal changes can take some time. The time frame leading up to menopause is referred to as perimenopause and it’s a natural form of aging.

Perimenopause can happen over a period of just a few years for some, or it can take several years, each person is different. In general, the hormones that will decline are estrogen, progesterone, and testosterone.

Other Factors Can Hasten Onset of Symptoms

While the process of perimenopause to menopause is generally gradual, there are some factors that can bring on symptoms more suddenly including:

  • Smoking
  • Obesity
  • Diabetes and other chronic health conditions
  • Insulin Resistance
  • Family history of earlier menopause
  • Cancer – some cancer drugs cause the ovaries to stop producing hormones.
  • Hysterectomy – A hysterectomy will cause you to experience full-on menopausal symptoms just weeks after your surgery (especially if you have had your ovaries removed).

How Hormones Affect Your Sex Life

Hormones affect your overall health and mental state. You may feel like you no longer desire your partner or even dislike them. Please know that it is the decline in hormones that is causing you to feel that way. We want to reassure you that you are not crazy, even though you may feel that way at times!

There is hope and relief available for you at our clinic in Austin. Our providers are all expertly trained in bioidentical hormone therapy. They can look at your hormone levels and symptoms and help you get your vitality back…including your sex life!

What Causes Hormones to Decline?

  • Age
  • Lifestyle
  • Diet
  • Illness
  • Stress levels

Hormone Balancing

Women only need a small amount of testosterone supplementation compared to men. Most report feeling like their old selves again after just a few weeks with increased mood and motivation. Other hormonal shifts occur in the perimenopause and menopausal stages of life such as decreased progesterone and estrogen. All hormone levels should be tested for optimal health and well-being.

Symptoms of Perimenopause/Menopause Can Include:

  • Loss of the desire to have sex (libido)
  • Painful sex
  • Less frequent or weaker orgasms
  • Loss of muscle mass
  • Irregular or heavier periods
  • Brain fog
  • Irritability
  • Hot flashes and night sweats
  • Anxiety and/or depression
  • Weight gain
  • Loss of muscle mass
  • Decreased ability to handle stress
  • Insomnia
  • Excessive hair growth in unwanted places
  • Loss of energy
  • Hair loss
  • Heart palpitations
  • Changes in skin texture


While estrogen is the “primary” female hormone, progesterone and testosterone are equally important. All the cells in the vagina have both estrogen and progesterone receptors.  Estrogen is the hormone that keeps the vagina elastic, moisturized, and well-supplied with blood flow.

Estrogen levels start to fluctuate and decline during perimenopause. These fluctuations can happen in an irregular manner. This is why you may start to experience irregular or heavier periods during perimenopause.

Lower estrogen levels can cause the internal environment in the vagina to change. You are likely to experience symptoms such as vaginal dryness, atrophy, itchiness, burning, and painful sex. Sex may not be as pleasurable since dryness and atrophy can cause it to be painful.


Estrogen and progesterone complement each other. Starting in perimenopause, progesterone levels can wane before estrogen. When you don’t have enough progesterone, estrogen dominates. A lot of women do not realize that estrogen dominance is the cause of symptoms such as:

  • Low sex drive
  • Vaginal dryness
  • Depression/mood swings
  • Heavy bleeding
  • Irregular periods
  • Insomnia

As progesterone levels fall in perimenopause, estrogen can start to spike. This can cause additional issues such as thickening of the uterine lining, creating fibroids, or even causing endometriosis. Estrogen dominance can also cause periods to become much heavier with clotting.


Testosterone is a hormone that is directly related to libido. It’s a myth that only men have testosterone; women produce it too, just at much lower levels. Unlike progesterone and estrogen which fluctuate and decrease during perimenopause, testosterone is a more gradual decline.

For both men and women, testosterone usually peaks in the late twenties to early thirties and then gradually starts to wane. On average, women’s testosterone levels at age 50 will be about half of what they were in their twenties.

If a woman has had a hysterectomy, that can contribute to low testosterone (especially if the ovaries are removed). If you’ve had a hysterectomy, chances are that you have been thrown into full-blown menopause within a very short time and your symptoms are going to be much more severe.

Current research shows that testosterone supplementation can drastically affect how women feel overall. Most women noted an increased sex drive/libido.

They also see better results when exercising because muscle mass will increase, and body fat will decrease when testosterone is in balance. Studies also report that women see an overall change in mood and are more motivated and energized.

The Symphony of Hormones

menopause and sex

Hormones act in a synergistic manner with each other. If one is out of balance, others are likely to be as well. These signals “tell your body what to do and when to do it.” Proper hormone levels are essential for your health.

There are some providers out there who advertise that they can help you feel better with hormone replacement therapy. But, beware! Not all hormone replacement therapy is the same.

At Hormones by Design by Forum Health in Austin, we only use bioidentical hormones. These hormones are the same chemical structure as the hormones your body makes.  You won’t find Hormones by Design using formulas like Premarin (made from pregnant horse urine) that the female body cannot utilize properly.

Our philosophy

We understand that lab results don’t always give us the full picture. Your diagnostic testing may show that you are in the “normal” range, but you are still not feeling good. We always listen to you and what symptoms you are experiencing before we start treatment. We offer our services in a warm, compassionate, and safe environment…and we want to help YOU.

Our office in Austin, Texas is now accepting new patients. We want to help you cruise through perimenopause and menopause without the misery your mother and grandmother felt. Call us today!



The conversation around menopause should be more open, widespread, and informative, helping women prepare for this stage of their life and their wellbeing.

It’s not just the infamous hot flashes – menopause comes with a slew of symptoms that can alter your quality of life, and since it’s practically impossible to just “ignore” them, it’s best to prepare yourself beforehand and learn how to manage each one of them.

As a natural process, menopause can vary from one woman to another, but there are certain lifestyle habits as well as common symptoms that most face. With that in mind, here are a few simple tips you can take to heart if you’d like to prepare yourself or manage the symptoms more easily.

  1. Get your workout in the morning 

Controlling your body temperature during menopause is far from easy, but some simple lifestyle changes can make all the difference. For starters, consider switching your workout routine to start exercising in the morning. Training hard in the evening and too close to bedtime can trigger elevations in your body temperature, making it all the harder for you to unwind and fall asleep.

With your workout sessions scheduled for the morning, you can then set up your day more easily, so that you can dedicate your evening routine to soothing activities like reading, meditation, and gentle stretching.  These things help your body to unwind and prepare for restful sleep.

  1. Supplement support  

Consider taking immune-boosting vitamin and mineral combos to help strengthen your body’s natural defenses so that you can optimize your meals, calories, and macronutrients over time with your mind at ease. You can also check if you have specific deficiencies and then target those nutrient groups with supplementation as well as nutrition. The key thing to remember is that this is different for everyone, so it’s important not to give up until you find what works for you.

  1. Set up regular checkups 

Many women think that since their reproductive years are over, they no longer need regular well woman exams. However, even in menopause you still need to schedule regular checkups so that your physician can provide the guidance and support you need.

Your physician can also help you prevent or minimize loss of bone density, fatigue, as well as monitor your health for any issues. Keeping up with preventative health exams like mammograms and colonoscopies are also important. There’s no need to go it alone – medical professionals are able to help you when you’re not sure how to stay healthy and energized.

  1. Manage the mood swings 

Any transition in your life often comes with emotional changes. So, it’s only natural that menopause comes with mood swings. But the core culprit for those mood swings is the hormonal changes your body is going through. That’s why it’s best to focus on the cause, rather than just mitigate the consequence. One of the easiest ways to help keep your hormones in check is with your nutrition.

Make sure your nutrition is versatile and healthy, and that you spend enough time in the sun, so that you’re not depriving your body of vitamin D. In addition, choose whole foods that aren’t highly processed or packed with hormones, antibiotics, or preservatives. Go for natural sources to help keep your immune system strong and contribute to balancing your hormones.

Ensuring that you get the proper amount of (and good quality) sleep will also help keep your mood in check.

  1. Keep your mind active, too 

Is brain fog getting in the way of your work performance, social life, or enjoying a good book? Or maybe the mere idea of forgetting to turn off the stove is making you anxious? In any case, issues with focus and memory can be tricky to tackle. The most effective way to help yourself is to keep your mind active.

Take up learning a new language or a new hobby to challenge yourself. It doesn’t have to be a daily activity, but the more, the better. You can try games that involve planning and thinking, such as sudoku, and mindfulness activities like meditation and Thai chi can also help with lowering your stress levels and keeping your mind engaged.

From proper nutrition to healthy doses of exercise, your menopausal and postmenopausal years can be fulfilling and vibrant with the right tactics implemented. Remember that symptoms can be different for every woman, so if you need any help to manage those specific symptoms and issues, you can always schedule an appointment with our bio-identical hormone therapy providers and take a restorative approach to managing your menopause in the years to come.

The Austin, Texas location of Hormones by Design is now open and is accepting new patients. Call us today to schedule your new patient appointment!



Hormones are the chemical messengers of your body. They travel through your bloodstream, instructing different organs and tissues on what to do. From reproduction to regulating your metabolism, your hormones control all of your body’s major processes.

Even a small hormonal imbalance can have negative effects, including diabetes, weight gain, infertility, depression and more. A good parallel is to consider what happens when you add too much salt to your food. You ruin it! Your hormones are like ingredients that need to be properly balanced.

Hormone injections and supplements are two common methods that we use at Hormones by Design to combat hormonal imbalances. However, in this post, we take your attention to six ways you can help to balance your hormones naturally in your daily life.

Get enough sleep

Sleep is arguably the most important factor affecting hormonal balance. Nothing can save you from hormonal imbalance when you don’t get enough restorative sleep – not even nutrition or exercise! Poor sleep and sleep deprivation have been linked to imbalances in hormones like cortisol, insulin, ghrelin, and leptin.

Based on a study by the International Journal of Endocrinology, getting poor or too little sleep can result in diabetes, obesity, and problems with appetite.

Most adults need 7 to 9 hours of sleep daily, but it’s important to note that quality also matters. Going through the five stages of each sleep cycle is important for the release of growth hormones.

Exercise regularly

The right kind and amount of exercise will positively impact your body’s hormones. A major benefit of exercise is its ability to increase insulin sensitivity and decrease insulin levels.

Insulin is an anabolic hormone that allows our body’s cells to take sugar from the bloodstream and use it as energy. Low levels of insulin result in constant fatigue, anxiety, irritability, and pale skin. On the other hand, high insulin levels have been linked to diabetes, heart disease, and cancer.

Many types of physical activities, however, have been found to modify hormone levels. Aerobic exercise, strength training, walking, and many other exercises will help lower your risk of many diseases.

Manage stress

We live in an insanely fast-paced world, where no one ever seems to take a break. This high level of stress affects two main hormones – cortisol and adrenaline.

Cortisol is the stress hormone that helps us cope with long-term stress. Adrenaline is responsible for our fight or flight mechanism, which helps us to react instinctively to danger. While these hormones fluctuate depending on the current condition, they are meant to be regulated by your body.

However, in high-stress environments, cortisol levels remain high. This saps an immense amount of energy, which causes you to eat more, putting you at the risk of obesity. If your adrenaline levels remain elevated, it can result in high blood pressure and anxiety. That’s why you need to effectively manage your stress level.

Avoid sugar and refined carbs

Sugar and refined carbs have been found to play a role in issues such as insulin resistance and metabolic disease. Fructose, in particular, increases insulin levels, especially in overweight people with prediabetes or diabetes. Common sources of fructose include honey, maple syrup, high-fructose corn syrup and refined table sugar. A diet high in refined carbs like pretzels and white bread may promote insulin resistance.

That’s why it’s advisable to eliminate sugar from your diet. It is particularly important to stay away from sugary beverages. Eating a low- or moderate- carb diet instead of refined carbs may help overweight people reduce their insulin levels.

Consume healthy fats

While fat is important for the proper functioning of the body, unhealthy fats like trans fats have been found to cause insulin resistance and increase belly fat storage. That’s why it’s good to consume only high-quality natural fats.

Coconut oil, pure MCT oil, and palm oil contain medium-chain triglycerides, which help to provide the liver with energy. MCTs are also known to reduce insulin resistance.

Dairy fats and monounsaturated fats in olive oil and nuts can also help increase your insulin sensitivity. It also helps balance the hormone responsible for appetite regulation and the digestion of protein and fat.

Eat enough protein

Consuming enough protein is very important because it provides the body with amino acids, which the body can’t make on its own. Amino acids assist in the creation and growth of muscles, connective tissue and skin. They aid in healing and repair, as well as digestion.

To maintain your hormonal balance, eating protein is non-negotiable. Consuming protein decreases ghrelin (which is our hunger hormone) while stimulating the production of other hormones that make you feel full.

Common sources of protein include lean meat and poultry, fish, and eggs, among many others. Aside from being a good source of protein, fatty fish also contains long-chain omega-3 fatty acids that help decrease insulin levels while increasing insulin sensitivity.

Wrap Up

Other natural tips worth mentioning include:

  • Eating a high-fiber diet
  • Drinking green tea
  • Avoiding alcohol
  • Stopping smoking

Your hormones influence both your physical and emotional well-being. Adopting these practices into your lifestyle will help you enjoy better overall health. You can put these recommendations into practice today along with seeing a bio-identical hormone replacement therapy (BHRT) provider at Hormones by Design! Our Austin, Texas location is now open and accepting new patients! Call us today to schedule your appointment and Feel Better from Day One!


It’s no secret that hormones play a major role in our moods and emotions. This is especially true for women, as many female hormones regulate mood and feelings. As we approach menopause, many women experience a variety of symptoms that are often classified as depression.

However, before automatically prescribing antidepressants to these women, it’s important to look at all the possible causes of their symptoms. In some cases, bioidentical hormone replacement therapy can be the answer.

Menopausal Symptoms

Women in perimenopause and menopause can experience hot flashes, night sweats, insomnia, lack of sex drive and so many more symptoms that disrupt your life.

You feel like you have lost your vitality and don’t feel like yourself. It can be hard to cope with the changes. It’s no wonder that so many women end up feeling depressed during this time.

Estrogen, Progesterone, and Testosterone all Play a Role

Estradiol regulates mood and emotion by affecting the brain’s serotonin levels. As we age and approach menopause, our estradiol levels decline, which can lead to feelings of depression. Progesterone also plays a role in regulating mood and emotions. In addition, it has a calming effect on the brain and can help with anxiety and insomnia.

Testosterone is another hormone that can affect mood, although it’s often thought of as a “male” hormone. However, women also produce small amounts of testosterone, and this hormone can play a role in energy levels, sex drive, and a feeling of well-being.

When any of these hormones are out of balance, it can lead to feelings of apathy or even depression.

Bioidentical Hormone Replacement Therapy Can Help

middle aged woman feeling happy

The first step to determining if you are feeling down/depressed due to declining hormone levels is testing your hormone levels. This can be done with a simple blood test.

If your hormone levels are low, you may be a candidate for bioidentical hormone replacement therapy (BHRT). BHRT is an individualized treatment that uses hormones that are identical to the ones your body naturally produces.

These hormones can help to restore balance and alleviate many of the symptoms associated with perimenopause and menopause, including feelings of apathy or depression.

Antidepressants Also Play a Role

Antidepressants can still be necessary for some women. If you and your doctor have determined that your feelings of depression are not solely due to declining hormone levels, then antidepressants may be the best course of action.

What is the MOST IMPORTANT item to remember?  Talk to your doctor.  If you feel like you are experiencing depression or anxiety, don’t wait.   Make an appointment with your doctor to discuss your symptoms and possible treatment options.

This is the best way to determine if BHRT, antidepressants, or a combination of both is right for you.

We here at Hormones by Design understand what a huge toll all this takes on your marriage, your family, and even your work.

We can help you by testing your hormone levels and helping you get back in balance.  We want you to have clear thinking, good sleep, no hot flashes or night sweats, and the desire to be intimate with your significant other.

We understand how important it is to feel like yourself again.  Give us a call today and let’s get started on getting your life back on track.

Our newest location in New Braunfels, Texas is accepting new patients.  Call 830-627-7979 to schedule today!



According to the National Osteoporosis Foundation, 54 million Americans are at risk of developing osteoporosis.

This number is only going to increase as the population ages. One of the biggest risk factors for osteoporosis is menopause.
During this time in a woman’s life, her body undergoes many changes that can lead to a decline in bone health.

Thankfully, there are steps you can take to reduce your risk of developing osteoporosis. In this blog post, we will discuss how bioidentical hormones can help keep your bones healthy during menopause!

First of all, what is bone density and how is it measured?

Bone density is a measure of how much calcium and other minerals are in your bones.

It is usually measured using a test called dual-energy X-ray absorptiometry (DXA).

This test can be done on any part of the body, but it is most often done on the hip and spine. The results of the DXA test are used to diagnose osteoporosis, osteopenia (low bone density), and other conditions.

What exactly are osteopenia and osteoporosis?

Osteopenia is a condition in which bone density is lower than normal but not low enough to be classified as osteoporosis.

Osteoporosis, on the other hand, is a condition in which bone density is so low that bones are more likely to break. Both of these conditions are serious and can lead to additional health problems.

What are the risk factors for osteoporosis?

There are many risk factors for osteoporosis, but the most common ones are aging, being female, having a small body frame, and having a family history of osteoporosis.

Other risk factors include smoking, drinking too much alcohol, not getting enough calcium or vitamin D, and being physically inactive.

What happens during menopause?

As we age, our bodies produce less and less estrogen. This decline in estrogen can lead to changes in our bodies, one of which is a decrease in bone density.

Estrogen helps to keep our bones healthy and strong, so when levels start to decline, it’s not surprising that our risk of developing osteoporosis increases.

How can bioidentical hormones help reduce the risk of osteoporosis?

Bioidentical hormones are hormones that are structurally identical to the hormones our bodies produce. They can be used to treat a variety of conditions, including menopause symptoms.

One of the most common ways bioidentical hormones are used is in the form of hormone replacement therapy (HRT). HRT can help reduce the risk of osteoporosis by replenishing the hormones that our bodies lose during menopause.

Estrogen in particular is important for bone health, and as women approach and go through menopause, their estrogen levels drop.

Studies have shown that HRT can help reduce the risk of osteoporosis and osteopenia in postmenopausal women by increasing estrogen levels.

What are the symptoms of osteoporosis?

Osteoporosis can cause a number of different symptoms, including back pain, loss of height, and fractures.

Fractures are one of the most serious complications of osteoporosis and can occur in any bone, but they are most common in the hip, spine, and wrist. If you have osteoporosis, it is important to talk to your doctor about ways to prevent fractures.

What if I do everything recommended and still suffer from osteoporosis? What do I do then?

There are medical treatments, such as bisphosphonates, that can help treat osteoporosis. However, these treatments are not right for everyone and have several side effects. If you have osteoporosis, it is important to talk to your doctor about all your treatment options.

In conclusion, osteoporosis is a serious condition that can lead to many health problems. Menopause is one of the biggest risk factors for osteoporosis, but there are steps you can take to reduce your risk.

One of the most effective ways to reduce your risk of osteoporosis is by using bioidentical hormones in the form of hormone replacement therapy. If you are pre or postmenopausal, talk to your doctor about whether HRT is right for you. Worried about osteoporosis?

Call our New Braunfels office today to schedule your appointment, 830-627-7979. We can help you determine your current bone density and how to help you avoid having a diagnosis of osteoporosis!



If you’re like many women, you’ve probably been struggling to lose weight for years.

You may have tried every diet and exercise program out there, but nothing seems to work.

Have you ever considered hormone replacement therapy? Hormone replacement therapy can help you lose weight in a number of ways, including reducing your appetite and increasing your metabolism.

In this blog post, we will discuss the benefits of hormone replacement therapy for weight loss and how it can help you finally achieve your goal weight!

Hormone replacement therapy can help reduce your appetite

If you’re always feeling hungry, it can be difficult to stick to a healthy diet.

hrt helping with appetite

Hormone replacement therapy can help reduce your appetite, so you’ll be less likely to overeat. 

Estrogen in particular can work on the portion of the brain that is responsible for appetite, and can decrease hunger…therefore leading to a reduced calorie intake.

Reducing your calorie intake is one of the most effective ways to lose weight. And with a reduced appetite, you’ll be able to do just that.

A reduction in appetite can also help you avoid unhealthy snacks and junk food cravings. And we all know what happens when we give in to those cravings…

Hormone replacement therapy can help increase your metabolism

A slow metabolism can make it difficult to lose weight. Hormone replacement therapy can help increase your metabolism, which will help you burn more calories and lose weight. 

Some research has shown that adding estrogen hormone therapy can help the body to process starches and sugars more efficiently instead of storing them as fat.

An increased metabolism can also help you maintain your weight loss in the long term.

When your metabolism is working properly, your body will be better able to burn calories and keep off excess weight.

HRT can also help boost metabolism by regulating the production of thyroid hormones.

Thyroid hormones are responsible for regulating your metabolism.

If your thyroid hormone levels are imbalanced, it can lead to a slow metabolism.

Hormone replacement therapy can help balance your thyroid hormone levels and increase your metabolism.

As an added bonus, an increased metabolism can also give you more energy!

You’ll feel more energetic and motivated to stick to your weight loss goals.

If you have an underactive thyroid, you may find it difficult to lose weight even if you eat a healthy diet and exercise regularly.

Hormone replacement therapy can help get your thyroid back on track, so you can finally start seeing results.

Hormone replacement therapy can help you burn more calories

Exercise is one of the most effective ways to lose weight.

But sometimes, no matter how hard you try, you just can’t seem to get rid of those stubborn pounds.

Hormone replacement therapy can help by replacing estrogen levels that drop during menopause.  Estrogen can help increase metabolic rate in women and therefore can increase the number of calories you burn during exercise.

In one study, women who underwent HRT burned more calories during exercise than women who did not receive HRT.

This means that HRT can help you lose weight even if you don’t make any changes to your diet or exercise routine.

Plus, burning more calories during exercise can help you tone your body and build muscle. And we all know that muscle burns more calories than fat, so this is a great way to boost your metabolism even further.

If you’re looking for an extra edge in your weight loss journey, hormone replacement therapy may be just what you need.

hormone replacement therapy for weight loss

Hormone replacement therapy can help you lose weight in a healthy way

Losing weight quickly can be unhealthy. And often, the weight that is lost quickly is gained back just as quickly.

Hormone replacement therapy can help you lose weight in a healthy way by reducing your appetite and increasing your metabolism.

With HRT, you’ll be able to lose weight slowly and steadily. And because the weight loss is coming from a reduction in calorie intake, it is more likely to be permanent.

Losing weight in a healthy way can also help reduce your risk of developing obesity-related health problems, such as heart disease, type II diabetes, and certain types of cancer.

Hormone replacement therapy can help improve your overall health

Not only can hormone replacement therapy help you lose weight, but it can also improve your overall health.

Some studies have shown that HRT can reduce the risk of osteoporosis, heart disease, and type II diabetes. It can also help relieve symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness.

Receiving hormone replacement therapy can help you feel better both physically and mentally.

If you’re struggling to lose weight, HRT may be the answer you’ve been looking for.

Please don’t hesitate to call our New Braunfels location at (830) 627-7979 if you have any queries. We would be delighted to assist you!


What is a hysterectomy or oophorectomy?

A hysterectomy is the surgical removal of the uterus, and an oophorectomy is the surgical removal of the ovaries. Hysterectomies and oophorectomies can be performed together or separately.

Why do you get a hysterectomy or oophorectomy?

There are many reasons why a hysterectomy or oophorectomy may be recommended.

Some common reasons include:

  • Endometriosis
  • Uterine fibroids
  • Chronic pelvic pain
  • Cancer of the uterus, ovaries, or cervix
  • Severe bleeding during menses

What are the consequences of a hysterectomy and/or oophorectomy?

The loss of the ovaries can cause a woman to experience a sudden and drastic decrease in estrogen levels (also called surgical menopause).

This can lead to numerous health problems, including osteoporosis, heart disease, and cognitive decline. Symptoms of low estrogen include:

  • Hot flashes
  • Vaginal dryness
  • Mood swings
  • Sleep problems
  • Foggy thinking
  • any many more

What are my estrogen replacement options/alternatives?

Fortunately, there are several ways to increase estrogen levels naturally. One option is bio-identical hormone replacement therapy (BHRT), which involves taking estrogen injections, pills, patches, or creams.

In fact, most patients need estrogen, progesterone, and testosterone to feel their best after a hysterectomy or oophorectomy.

Natural vs. Synthetic Estrogens

There are two main types of estrogen therapy: synthetic and natural:

Synthetic estrogens are made in a laboratory and are not identical to the hormones produced by the body.

Natural estrogens, on the other hand, are derived from plant sources and are chemically identical to the hormones produced by the body. This is often termed “bio-identical.” The most common form of estrogen used for HRT is Estradiol.

woman speaking with nurse

How long should you take estrogen after a hysterectomy?

This is a question that should be discussed with your doctor. Typically, patients will take estrogen therapy for the rest of their lives. However, some women may only need to take it for a few years.

If you are considering a hysterectomy or oophorectomy, it is important to talk to your medical provider about hormone replacement before the procedure. Here at Hormones by Design, we specialize in BHRT.

We can help you with determining your estrogen levels and help you make a plan for the best method to replace all your needed hormones.

If you have any questions, please don’t hesitate to call our new New Braunfels location at (830) 627-7979. We would be happy to help!


Yet another common question we are asked is “What is Bioidentical Hormone Replacement Therapy.” 

Well, let’s break this question down into two parts, and look at the answer.

First, let’s explore Hormone Replacement Therapy (or HRT for short).  HRT has been around since the 1940s with the advent of Premarin.  Premarin is a combination of estrogens made from pregnant mare (as in horses) urine.  Early in its lifespan, Premarin was shown in short-term studies to help combat the bone loss associated with osteoporosis.  Then along came the 1960s with the advent of hormonal birth control pills.

These pills consisted of estrogen along with a synthetic progesterone called progestin.  As you can see, some of these therapies are organic in nature (like pregnant mare’s urine) while others are synthetic (like the progestins). Versions of all these substances combined to make up early treatments for Hormone Replacement Therapy.

Now, let’s fast forward to the modern-day.  Research has shown that taking synthetic hormones and even organic-based hormones like Premarin can lead to dangerous side effects such as blood clots or stroke.  Today, there is Bioidentical Hormone Replacement Therapy (or BHRT for short).  What does that mean, “Bioidentical?”.

Bioidentical means that the hormones are chemically and structurally identical to the ones your body made when you were younger. 

To put it plainly, bioidentical hormones are fitting a round peg into a round hole, where traditional HRT (like pregnant mare’s urine) is fitting a square peg into a round hole.  I don’t know about you, but I would prefer the formula that actually fits the hormone receptors in my body so that I can get the most benefit from what I am taking…

Here at Hormones by Design, we specialize in Bioidentical Hormone Replacement Therapy.  In fact, that is the only kind we offer.  Our licensed specialists can help you through the many symptoms you may be experiencing.  Feel free to call the office closest to you today!


Patients who are new to our clinic are often surprised to see that we sell vitamins (we refer to them as supplements) in all our offices. Well, we feel that supplements are an excellent natural treatment.

Here is why…

Believe it or not, there are many symptoms that can manifest due to vitamin or mineral deficiencies.  For example, patients who are constantly tired can benefit from supplementing their diet with a B-Vitamin complex.  There are many B-Complexes to choose from, but we would like to add that all vitamins are not created equal.

In general, the vitamins found in your local drugstore or grocery store are not high quality.  These are not strong enough to raise blood levels of B vitamins and are not even in the correct form for your body to absorb them.  The fastest way to check to see if you are taking the correct form is by looking at the Vitamin B12 in the complex.  You want your B12 to be in the form of Methylcobalamin.

However, most drugstore vitamins are going to be in the cheaper to manufacture form of Cyanocobalamin.   The good news, however, is that you cannot overdose on B vitamins.  They are water soluble, so any excess that your body does not use is simply eliminated in your urine.

Another typical symptom that we see is inflammation.  Inflammation can be pain in joints, muscles, or many other areas.  One typical deficiency that can add to inflammation is Vitamin D deficiency.  Most people know Vitamin D as the “sunshine vitamin”.  In reality, almost all of the population is deficient in Vitamin D.

Most of us work indoors and do not spend time outdoors without sunscreen or clothing that covers our skin.  In order to produce Vitamin D, the body requires regular exposure of the trunk (or mid-section of the body) each day…so, you would have to spend time outside in a bikini without sunscreen.

Supplementing Vitamin D can bring down levels of inflammation all over the body.  However, to reiterate, you must have a high-quality D supplement in the correct form for your body to absorb it.  Vitamin D is an oil-soluble vitamin, which means that you must have your blood levels monitored by a doctor to ensure your levels do not get too high.

Next in the lineup of symptoms is muscle cramps and restless legs.  We have patients that complain of muscle cramps during the day, and of course those who experience this at night.  Sometimes these muscle cramps and restless legs are due to a deficiency in Magnesium.  Magnesium is important for many functions in the body and helps with bone and teeth structure.

What most people do not realize is that Magnesium is a smooth-muscle relaxer.  Meaning that by taking Magnesium you may be able to eliminate muscle cramps and restless leg issues. Magnesium comes in multiple forms as well.  The Magnesium we are referring to here is di-magnesium malate.  If you are experiencing muscle cramps, you can try Magnesium supplementation.

The list of symptoms from vitamin and mineral deficiencies go on and on.  Most of our patients have some type of deficiency because let’s face it…no one eats perfect 100% of the time.  If you think you might have a deficiency, feel free to contact our office and arrange for testing.

If you are an established patient, just ask at your next visit about testing your vitamin levels.  If you decide to take a supplement, we recommend high-quality, pharmaceutical grade supplements like the ones we carry in our office.


Everyone who comes into our office has asked this question at least once, “How much does Hormone Replacement Therapy cost?”.  Well, the answer here is that it can vary.

There are some variables in whether or not you have health insurance, what type of therapy you elect to use, and of course, your budget.  The following details apply for women seeking hormone replacement therapy, before or after menopause.

First, let’s look at using your health insurance.  In our Hormones by Design offices, we do not accept health insurance for the office visit but will gladly use your health insurance for lab work once you are established as a patient.  Therefore, the cost for the office visit is usually around $100.

Labs can be sent to your health insurance if you like, or you may pay for them yourself.  We have exceptionally low lab prices.  You can see all of them at

Second, you must consider the type of therapy that you choose.  The overwhelming majority of our patients choose monthly injection therapy.  This is where the patient comes into our office for a lab draw about 3 days before their scheduled appointment, the labs are sent off, and results come back by appointment time.

These lab results are then used to craft a combination of hormones into an injection solely for that patient.  For patients that choose injection therapy, the cost per month is included in the office visit, so it is generally only the $100 per month.  No matter what therapy you choose, progesterone is almost universally needed for every patient.

This is given orally via a prescription.  The cost of a progesterone prescription varies according to each patient’s insurance.  Typically, the cost ranges from $20 per month and up.

Lastly, you need to consider your budget.  Here at Hormones by Design we will always take your budget into consideration.  We don’t ever want a patient to feel that regaining a more youthful quality of life is not attainable due to cost.

There are many ways with which to do hormone replacement.  We want to work with you to find the therapy and the price that is sustainable for you.  We strive for amazing care at affordable prices.

There are hundreds of clinics attempting to treat hormone imbalance. What makes us different? We listen, then we take action. We can start your treatment on day one. Faster treatment = feel better faster!
Hormone Replacement Therapy in Austin, San Antonio, Waco, New Braunfels, and Boerne

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