Perimenopause is the transitional period leading up to menopause, characterized by fluctuating hormone levels, particularly estrogen and progesterone, which can cause various physical and emotional symptoms. Perimenopause may start as early as age 35 and may last for several years until menopause is reached.

Menopause is defined as 12 consecutive months without a menstrual period. Menopause is caused by the decline in ovarian function and the decrease in the production of hormones such as estrogen and progesterone. This hormonal shift leads to the cessation of ovulation and menstruation. This marks the end of reproductive capability and is a biological process that typically occurs between the ages of 45 and 55, with the average age being around 51 in the United States

Perimenopause is considered a “clinical diagnosis.” This means the diagnosis is based on the patient's medical history, reported symptoms, signs observed on physical examination, and the healthcare provider's clinical judgment rather than relying solely on laboratory tests, imaging studies, or other diagnostic procedures.

Symptoms of perimenopause can start as early as age 35 and include: irregular cycles, mood changes, difficulty falling or staying asleep, hot flashes, night sweats, heart palpitations, changes in metabolism and weight gain, lack of mental clarity, hair thinning or loss, headaches, palpitations, muscle and joint pain, vaginal dryness, irritation, and burning, painful vaginal intercourse, changes in urination, and increased risk of bladder infection.

If you are experiencing any of these symptoms, schedule your initial consultation today so we can discuss your concerns and health goals in more detail.

Hormone Replacement Therapy (HRT) is used to supplement or replace hormones that the body no longer produces in optimal quantities.

Bioidentical Hormone Replacement Therapy is comprised of plant-derived hormones that are chemically similar or structurally identical to those produced by the body. Bioidentical HRT includes commercially available medications approved by the U.S. Food and Drug Administration (FDA), as well as compounded medications that are not considered FDA-approved. Bioidentical hormones include estradiol and micronized progesterone.

Synthetic Hormone Replacement Therapy is artificially manufactured from man-made chemical compounds. This does not mean these medications are inferior to bioidentical formulations, it just means they interact differently with target hormone receptors in the body and may produce more side effects. Synthetic HRT is primarily found in commercially available medications approved by the FDA.

According to the North American Menopause Society 2022 Position Statement, hormone therapy is the most effective treatment for several menopausal symptoms including hot flashes, night sweats, heart palpitations, vaginal dryness, irritation, burning, painful intercourse, urinary issues like frequent bladder infections, and prevention of osteoporosis.

According to the Women’s Health Initiative study, additional benefits of hormone replacement therapy include reduced risk of fractures, diabetes, cardiovascular disease, colorectal cancer, and death from any cause.

Even more clinically-proven benefits from other studies include reduced muscle loss, improvement in depressive symptoms in perimenopause, and improved signs of skin aging.

If you’ve been hesitant about hormone replacement therapy (HRT), you’re not alone. For years, women were misled by incomplete and inconsistent research that exaggerated risks while ignoring the overwhelming benefits

Here’s what we now know:

• HRT is safe and effective for relieving common symptoms associated with menopause (hot flashes, night sweats, heart palpitations, vaginal dryness and irritation) as well as improving sleep, mood, metabolism, and body composition.

• HRT does not increase breast cancer risk. The 2002 Women’s Health Initiative study that sparked fear was later found to be deeply flawed. More recent research confirms that properly dosed HRT does not increase the risk of breast cancer above baseline cancer risk for the general population.

• Topical estrogen (creams, gels, patches) does not increase the risk of blood clots, stroke, or gallbladder disease in the same way oral estrogen may.

• Vaginal estrogen cream for treatment of symptoms like irritation, dryness, frequent UTI’s, and painful intercourse is safe and effective menopausal women at any age.

• HRT reduces the risk of osteoporosis, diabetes, heart disease, and cognitive decline. Estrogen plays a critical role in bone, brain, and heart health—without it, these systems decline more rapidly.
  

Ultimately, the risk and benefit profile of hormone therapies differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a form of progesterone is used. Therefore, it is recommended that treatment is individualized to the patient using the best available evidence to maximize benefits and minimize risks.

Your comprehensive consultation with Resplendence will include a detailed evaluation of your past and present medical history, possible contraindications to hormone therapy, and discussion of risks, benefits, and alternatives so you can make a truly informed decision on whether hormone therapy is right for you.

Hormone replacement therapy options may include bioidentical compounded or bioidentical FDA-approved medications. These medications come in various dosages and forms including oral, cream, gel, patch, or injection. We do not offer hormone pellet therapy.

Compounding is the process of combining, mixing, or altering ingredients to create a medication that is customized to the needs of a patient. As such, compounded medications are not considered FDA approved because an individualized medications that vary in dosage or exclude certain preservatives have not been subject to clinical trials for safety and effectiveness prior to being distributed.

For example, micronized progesterone capsules in peanut oil with dosages at 100mg and 200mg are FDA approved, mass manufactured, and available at most commercial pharmacies. This specific formulation and dosage has been deemed safe and effective by the FDA, and is the only version available at a traditional retail pharmacy.

However, micronized progesterone withOUT the peanut oil (for someone who has a peanut allergy, for instance) or at a dosage of 125mg (for someone. who needs slightly more than 100mg but does not tolerate 200mg well without bothersome side effects) is only available through a compounding pharmacy. A formulation without peanut oil, or dosages other than 100 or 200mg have not been officially “approved” by the FDA. However, one can reason that if 100mg and 200mg are safe to take, 125mg is also highly likely to be safe. Similarly, the peanut oil is not a key ingredient that is required for the medication to be safely administered or required to make the medication effective. Therefore removing this particular ingredient is not likely to constitute a safety concern, despite its lack of FDA approval.

Compounding pharmacies are primarily regulated by state boards of pharmacy, which oversee their operations and ensure compliance with state laws and regulations. Compounding pharmacies are subject to FDA inspection and must adhere to safety standards set by the U.S. Pharmacopeia (USP).

Commercial pharmacies, also referred to as a retail pharmacies, include large chain stores like CVS, Walgreens, etc., as well as independent neighborhood pharmacies. The medications provided by commercial pharmacies are typically FDA-approved, pre-manufactured drugs that are available in standard dosages and forms. Commercial pharmacies are regulated by state boards of pharmacy and federal agencies like the FDA.

Your comprehensive consultation with Resplendence will include a detailed discussion of recommended medication risks, benefits, and alternatives so you can make a truly informed decision on whether compounded or conventional hormone therapy is right for you.

You can rest assured that we have done our due diligence to ensure the compounding pharmacies we utilize have been evaluated for safety, efficacy, and compliance with lawful regulatory practices.

The pharmacies we utilize have confirmed:

• they are licensed to dispense or ship medications in the state of North Carolina and Virginia;

• are accredited by the Pharmacy Compounding Accreditation Board (PCAB);

• meet USP <797> sterile compounding standards and USP <795> non-sterile guidelines;

• obtain all active pharmaceutical ingredients from a manufacturing facility that is registered with the FDA and subject to FDA inspection;

• conduct internal as well as third-party testing to ensure an independent assessment of sterility, potency, stability, and lack of endotoxins and impurities in medications; and

• do not have any unresolved Form 483 filed by the FDA.

Detailed information on the pharmacies we utilize is available upon request.

Many patients start to notice symptom improvement in as few as two weeks, but it can take up to 12 weeks to experience the full therapeutic effect of hormone therapy. Keep in mind that symptoms may not be 100% resolved. Instead, it is realistic to aim for a goal of 80% improvement in symptoms with hormone replacement therapy.

Additionally, hormone fluctuations in perimenopause vary considerably over time as a woman moves closer towards menopause. As such, medication dosage and/or formulation may require frequent adjustments to provide adequate symptom relief. The key is to communicate frequently with your provider and remain patient throughout the process.

Your initial new patient consultation will include a thorough laboratory assessment to create your Total Body Wellness Profile with recommended health solutions tailored to you that may include dietary guidelines, exercise, and weight loss medications (when appropriate) to enhance your energy levels, achieve sustainable weight loss, reduce inflammation, and stabilize blood sugar levels.

Recommended medications to assist with and amplify your weight loss efforts may include Low Dose Naltrexone, GLP-1 and/or GIP prescriptions.

At Resplendence, we focus on providing specialized care for women in the menopause transition, optimizing their hormonal and metabolic health. While we offer a range of services that complement primary care, we do not replace your primary care provider. It’s important to continue seeing your primary care provider for general health needs, routine check-ups, and management of any other health conditions.

There may be times when referral back to your primary care provider or other specialist is necessary including completion of pap smears, breast exams, mammograms, uterine ultrasound, or other needs as indicated. It is important that you inform your primary care provider of the services you are receiving from Resplendence. Our role is to work alongside your primary care provider to offer specialized support tailored to your unique needs during menopause.

Resplendence is based in Cary, North Carolina and offers telehealth consultations for patients who are physically present in the state of North Carolina or Virginia at the time the visit takes place.

Yes! The Discovery Call serves as a starting point for us to explore:

• What your body is trying to tell you and how to respond in a way that feels aligned and effective.

• Possible root causes of your most frustrating symptoms—and why past solutions haven’t worked.

• How a personalized, comprehensive approach can help you reclaim your confidence, radiance, and joy.

And if you feel that we’re the right fit for you and you’re ready to take the next step, the $47 investment for the Discovery call will go directly toward your comprehensive New Patient Consultation and Lab Panel.

If you’re ready to stop feeling stuck and start understanding what your body needs—without spending another moment suffering in silence, or following generic advice or quick fixes that don’t work—let’s connect!

Schedule your Discovery Call today

No, we do not participate in any health insurance plans and are unable to submit a claim or superbill to your health insurance company for reimbursement. Additionally, we are unable to provide any services to patients who are Medicare or Medicaid beneficiaries.

By offering a private pay health optimization model of care, your health isn’t limited to what an insurance company deems “necessary” or “cost-effective.” Here, your wellness takes priority, with no arbitrary restrictions, network limitations, or hoops to jump through. We partner with you to craft your personalized path to wellness based on your needs, not an insurance corporation’s priorities and profit margins.

By not accepting insurance, we are advocating for your wellbeing, amplifying your voice, and remaining accountable to you, not to corporate interests.

We accept Visa, Mastercard, Discover, and American Express.

We provide clear and upfront pricing for all services to ensure there are no hidden fees or unexpected bills, allowing you to make informed decisions about your health care. By choosing a private-pay wellness practice, you are investing in a model that prioritizes your health and well-being, ensuring you receive the highest standard of care without the limitations and frustrations often associated with insurance-based practices.

At Resplendence, we value your time and are committed to providing high-quality care. To ensure that we can serve all our patients efficiently, we have established the folllowing provisions regarding the scheduling, rescheduling, cancellation, and late arrival of appointments.

• Full payment of the Discovery Call fee is required at the time of scheduling. Due to the nature of this appointment type, no refunds will be given if you do not attend or if you cancel your Discovery Call. If you need to reschedule your Discovery Call, please contact us at hello@experienceresplendence.com or 984-224-7470.
  

• Full payment of your New Patient Consultation fee is required at the time of scheduling.

• New Patient Consultation Appointments must be scheduled at least 3 days in advance. If you do not see an available date or time that works for your schedule, please reach out to hello@experienceresplendence.com so we may accommodate you.

• If you need to reschedule your New Patient Consultation, you may do so without incurring any fees, provided you reschedule at least 24 hours before your appointment time.

• If you reschedule your New Patient Consultation less than 24 hours prior to your appointment time, a $50 late rescheduling fee will be automatically applied to your credit/debit card on file.

• If you need to cancel your New Patient Consultation, you may do so at least 48 hours before your scheduled time to receive a full refund of your consultation fee minus a 3% processing fee.

• If you cancel your New Patient Consultation less than 48 hours prior to your scheduled appointment time, a $150 late cancellation fee will be deducted from your consultation fee, and the remainder will be refunded to you.

• If you do not attend your New Patient Consultation and do not provide any advance notice of cancellation, you will forfeit the entire cost of your New Patient Consultation fee and will not receive any full or partial refund.

• If you are 15 or more minutes late to your appointment without any prior advance notice of your late arrival, you will be considered a “no show” and you will forfeit the entire cost of your New Patient Consultation fee and will not receive any full or partial refund.

• If you anticipate you will arrive late to your scheduled appointment, please call 984-224-7470 to notify us. If you arrive 15 or more minutes late to your appointment, you may be required to reschedule your appointment to the next available date/time.