Hormones

Feel like yourself again

Peri rewrites the rules. HRT, the energy peptides, and a provider who takes you seriously. That's the route.

$90–320/mo

The short version

What this is and why it works

Perimenopause can start in your mid-30s and last a decade. The symptoms — brain fog, tanked libido, sleep that doesn't refresh, mood swings, hot flashes — are not "just stress" and you are not imagining them. HRT (hormone replacement therapy) is the evidence-backed first line. Peptides like PT-141 and kisspeptin address the pieces HRT doesn't always fix. This plan starts with the proven foundation and builds from there.

The plan

Three levels, one stack

Start at the top. Go as deep as you want. Every item has an HOD Score (how strong the evidence is) and a real price.

Start here

Estradiol patch or gel + micronized progesterone A

The gold standard HRT combo. Estrogen for symptoms, progesterone for uterine protection. Bioidentical, not the old Premarin.

$30–90/mo HOD Score: Proven

Comprehensive hormone panel A

FSH, estradiol, progesterone, total and free testosterone, DHEA-S, thyroid. Baseline before you start anything.

$0–200 (insurance variable) HOD Score: Proven

Go deeper

Testosterone cream (compounded, low-dose) B

For libido, energy, and muscle preservation. Compounded, applied daily. Not FDA-approved for women but widely prescribed off-label.

$40–80/mo HOD Score: Strong

PT-141 (bremelanotide) B

For the part of your life nobody makes products for. FDA-approved for hypoactive sexual desire. Subcutaneous, on-demand.

$95/mo HOD Score: Strong

Full stack

DHEA (vaginal or oral, low-dose) B

For vaginal dryness and urogenital symptoms that estrogen alone doesn't fully address. Oral or vaginal insert.

$20–50/mo HOD Score: Strong

Kisspeptin D

Emerging peptide that stimulates GnRH. Early data in hypogonadism and desire. Research-grade, not mainstream yet.

$120–200/mo HOD Score: Early

What to expect

The timeline

Weeks 1–2: hot flashes and night sweats often improve first. Month 1–2: sleep and mood stabilize. Month 2–3: brain fog lifts. Month 3–6: libido, energy, and body composition start shifting. HRT is not a quick fix — it's a reset that compounds over months.

Where to go

The provider path

Find a menopause specialist or an endocrinologist who actually prescribes HRT (many don't). The North American Menopause Society has a provider directory. Telehealth options: Midi Health, Evernow, Alloy. Avoid anyone who says "you're too young for HRT" without running labs.

Go deeper

The reading list

HRT for perimenopause: the real guide Estradiol, progesterone, testosterone. What each one does and who needs what. Read → PT-141: the libido peptide FDA-approved, on-demand, and nobody talks about it. Here's the full picture. Read → Finding a menopause provider who takes you seriously The directories, the red flags, and the questions that sort the good ones from the dismissive. Read →

You've seen the plan. Now build yours.

Three questions. We show you the protocol, the prices, and the evidence before we ask for your email.

Get hotter now