BHRT and Menopause Hormone Therapy for Women in Leawood

Medically reviewed by Mark Strehlow, MD, Medical Director — October 2026

The Menopause Society calls hormone therapy the most effective treatment for hot flashes and night sweats. It also treats vaginal dryness, and some products are FDA-approved to prevent the bone loss that follows menopause. Bioidentical hormone therapy, or BHRT, uses hormones with the same chemical structure as the ones your ovaries make, such as estradiol and progesterone. At Rock Creek Wellness in Leawood, KS, we prescribe hormones only after an evaluation, and only when your symptoms and lab results support it. If hormone therapy isn’t right for you, we’ll tell you. We see women from across the Kansas City area.

At a glance

What it helps with
Hot flashes and night sweats, vaginal dryness and pain with sex, and bone loss after menopause.
Who it’s for
Women in perimenopause or after menopause whose symptoms bother them, including women who went through menopause early.
How it starts
A free consultation if you’d like one, then an evaluation and lab tests to plan your care.
Your options
Every common form: pills, patches, gels, creams, troches, injections and pellets.
Who you’ll see
Dr. Mark McPhee, Dr. Angela Barnett or Hannah Osborn, APRN.

Who hormone therapy is for

Menopause is the point when you’ve gone a full year without a period. Most women begin the transition to it, called perimenopause, between 45 and 55. Periods become irregular, and up to 80% of women have hot flashes or night sweats at some point. Many also notice changes in sleep, mood and concentration, and some find their cravings for sweets change too.

Hormone therapy is worth discussing if you:

  • have hot flashes, night sweats or broken sleep that bother you
  • have vaginal dryness, irritation or pain with sex
  • went through menopause early, or are at risk of bone loss

The balance of benefits and risks is most favorable for women who start before age 60 or within 10 years of menopause. Starting later can still be an option, but the risks of heart disease, stroke, blood clots and dementia are higher, so it needs a closer look.

Who it isn’t for. In general, hormone therapy isn’t used by women who have breast cancer, uterine cancer, unexplained vaginal bleeding, liver disease, a history of blood clots, or heart or blood vessel disease. We also don’t start care for women who are pregnant or breastfeeding, and we don’t provide postpartum care. If you’ve recently had a baby, our article on hormone changes after pregnancy explains what’s normal, and your OB/GYN is the right first call.

What hormone therapy can help with

  • Hot flashes and night sweats. Hormone therapy is FDA-approved as a first-line treatment for them, and it’s the most effective one. Fewer night sweats often means better sleep, and less of the irritability and “brain fog” that come with poor sleep.
  • Vaginal dryness and pain with sex. These are part of the genitourinary syndrome of menopause. Low-dose vaginal estrogen treats them where they are, and very little of it reaches the bloodstream. If low desire or pain with sex is your main concern, read about sex and women’s health or see our sexual wellness care.
  • Bone. Estrogen therapy prevents bone loss after menopause, and in the Women’s Health Initiative, women taking hormones had about a third fewer hip fractures than women on placebo, and fewer spine and other fractures. Some FDA-approved estrogens are approved to prevent osteoporosis, though other medicines are usually tried first when bone is the only goal. These results come from FDA-approved products; compounded hormones and pellets haven’t been tested this way. A DEXA bone density scan shows where you’re starting from.
  • Mood. Perimenopause is a time of higher risk for depression. Estrogen isn’t approved to treat depression, but there’s evidence it can improve mood in perimenopausal women, especially those who also have hot flashes. Depression itself is treated first with antidepressants or talk therapy. Our article on depression during perimenopause explains more.

How much hormone therapy helps varies from woman to woman, and it often takes some adjustment to find the right dose and form. Individual results vary.

Request a free consultationor call (913) 727-7700

What is BHRT? Bioidentical, FDA-approved and compounded hormones

“Bioidentical” began as a marketing term for hormones mixed to order by a pharmacy. Today it usually means hormones with the same chemical structure as your own, such as estradiol and progesterone.

Bioidentical doesn’t have to mean compounded. Many FDA-approved hormone products are bioidentical, and they come in a range of doses and forms, including pills, patches, gels, sprays and vaginal products.

Compounded hormones are prepared by a pharmacy for one patient, and they aren’t FDA-approved. The Menopause Society says they are not safer or more effective than approved bioidentical hormones. They haven’t been tested for safety and effectiveness, and they may not contain the amount prescribed. That matters: too little progesterone may not protect the lining of the uterus.

The hormone pellets we offer are compounded. Ask your provider whether each product you’re prescribed is FDA-approved or compounded, and why it was chosen.

What changed in the FDA’s hormone therapy labels in 2026?

In February 2026, the FDA approved updated labels for the first six menopausal hormone therapy products, and it has asked the makers of all such products to update theirs. Heart disease, breast cancer and probable dementia are no longer in the boxed warning, the FDA’s most prominent warning. The heart disease and breast cancer risks are still described in the labels’ warnings.

Estrogen-only products that act throughout the body keep a boxed warning about uterine (endometrial) cancer, because estrogen alone raises that risk in women who still have a uterus. Those women also take progesterone with estrogen. The updated labels also say to consider starting hormone therapy for moderate to severe hot flashes before age 60 or within 10 years of menopause.

This change applies only to products the FDA has approved. Compounded hormones, including pellets, aren’t FDA-approved and don’t carry FDA labeling, so it doesn’t cover them.

Testosterone for women: what the evidence supports

Some women are prescribed testosterone after menopause. The clearest guidance comes from a 2019 global consensus statement endorsed by The Menopause Society, the Endocrine Society and other medical societies:

  • Low sexual desire is the only use the evidence supports. Specifically, low desire that causes distress (hypoactive sexual desire disorder) in women after menopause, diagnosed after a full assessment. In trials, testosterone added on average one satisfying sexual experience a month compared with placebo, and improved desire, arousal, orgasm and pleasure.
  • It isn’t recommended for anything else. The evidence doesn’t support using it for energy, mood, memory, bone or muscle. In trials of female doses, testosterone didn’t change body fat, lean mass or muscle strength, so it isn’t a treatment for belly fat or weight.
  • The dose should keep levels in the normal range for a woman before menopause. A blood test can’t diagnose low desire, but levels are checked before starting, 3 to 6 weeks in, and about every 6 months after that. If there’s no benefit by 6 months, treatment should stop.
  • Side effects at these doses are mild increases in acne and body or facial hair in some women. Trials haven’t shown hair loss, voice changes or clitoral enlargement. Safety data go out only to 24 months.
  • No testosterone product is FDA-approved for women in the US. Prescribers use a men’s product at a much lower dose, off-label, or a compounded product. The consensus doesn’t recommend compounded testosterone unless no approved equivalent is available, and it advises against any form that raises levels above the normal female range, including pellets and injections. Testosterone taken by mouth isn’t recommended, because it worsens cholesterol.

If low desire is what’s bothering you, we first look at everything that can affect it: other menopause symptoms, vaginal dryness or pain, medicines, mood, sleep and your relationship. If testosterone is considered, we’ll go through this evidence with you and check your levels before and during treatment.

Risks and side effects

  • Blood clots and stroke. Estrogen, alone or with progesterone or a synthetic progestin, raises the risk of stroke and blood clots. The risk is higher with pills and may be lower with a patch, gel or spray.
  • Breast cancer. The risk usually doesn’t rise until after several years: about 3 to 5 years of estrogen with a synthetic progestin, as in the Women’s Health Initiative, or about 7 years of estrogen alone.
  • Uterine cancer. Estrogen alone raises this risk if you still have a uterus, so you’ll also take progesterone.
  • Common side effects are breast tenderness, nausea, and irregular bleeding or spotting. Changing the dose or form often helps. Tell us about any unexpected bleeding.
  • Pellet insertion can cause bruising, bleeding, infection, or a pellet working its way out through the skin.

If you can’t take hormones, or would rather not, the FDA has approved nonhormone medicines for menopause symptoms, and there are other options we can discuss.

How hormone therapy works at Rock Creek Wellness

  1. Getting started. Request an appointment to establish care. If you’re not sure yet, start with a free consultation: tell us what’s going on, and we’ll tell you honestly whether we can help.
  2. Evaluation and testing. Your provider reviews your symptoms, periods, health and family history, and medicines. Comprehensive blood testing covers your hormones, including estradiol and testosterone, along with your thyroid, blood sugar and more. Premier Care patients also have a DEXA scan, which records bone density and body composition as a baseline. HRT-Only patients can add one for a fee.
  3. A plan you decide on together. If hormone therapy suits you, you and your provider choose the hormones, the dose and the form. We prescribe hormones in every common form, including pills, patches, gels, creams, troches that dissolve under the tongue, injections and pellets, and the choice depends on your needs and preferences. Pellets are placed under the skin of the upper outer buttock through a small incision, under local anesthetic. The placement takes about 5 minutes, and they’re usually replaced every 3 to 4 months. Read more about pellet hormone therapy. If you still have a uterus and take estrogen, you’ll also take progesterone. For vaginal symptoms alone, low-dose vaginal estrogen may be enough.
  4. Follow-up. Repeat labs and check-ins show how you’re responding, and we adjust from there. We also help with sleep, nutrition, exercise and stress.

New patients see Dr. Mark McPhee, Dr. Angela Barnett or Hannah Osborn, APRN. Most of our long-term patients choose Premier Care, our most comprehensive program. It starts with a four-hour consultation and testing visit, including an EKG and a DEXA scan, followed by cardiovascular screening imaging, and continues with ongoing care for a monthly fee.

We’re a cash-pay clinic. Premier Care prices are listed on its page; for anything else, we’ll give you the price at your consultation.

Request an appointment or a free consultation, or call (913) 727-7700. Looking for hormone care for men? See BHRT and testosterone therapy for men.

Common questions

Is hormone therapy right for me?

It depends on your symptoms, your age and time since menopause, your health history, and the type and form of hormone. For women under 60 or within 10 years of menopause who have bothersome hot flashes and no medical reason to avoid it, The Menopause Society finds that the benefits outweigh the risks. We go through your own benefits and risks at your evaluation.

How long can I stay on hormone therapy?

There’s no set time to stop. Longer use should be for a clear reason, such as hot flashes that continue, with the benefits and risks reviewed regularly. When you do stop, your provider may lower the dose gradually.

Will I take something every day?

It depends on the form you choose. Some are used daily, and pellets are placed every few months instead.

Does hormone therapy cause weight gain?

Not on average. The Menopause Society says hormone therapy isn’t associated with weight gain. Midlife weight gain is common for other reasons, and our article on estrogen and weight gain explains them.

What about testosterone cream?

A testosterone cream or gel prescribed for a woman is either a men’s gel used at a much lower dose or a compounded cream.

Sources

Show all 11 sourcesHide sources
  1. The Menopause Society. Hormone Therapy (patient information). menopause.org
  2. The North American Menopause Society. The 2022 hormone therapy position statement. Menopause 2022. PubMed
  3. The Menopause Society. Perimenopause (patient information). menopause.org
  4. National Institute on Aging. What Is Menopause? nia.nih.gov
  5. U.S. Food and Drug Administration. FDA Approves Labeling Changes to Menopausal Hormone Therapy Products. 2026. fda.gov
  6. U.S. Food and Drug Administration. FDA Requests Labeling Changes Related to Safety Information to Clarify the Benefit/Risk Considerations for Menopausal Hormone Therapies. 2026. fda.gov
  7. U.S. Food and Drug Administration. Hormone Replacement Therapies Can Help Women with Bothersome Menopausal Symptoms. 2026. fda.gov
  8. Davis SR, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab 2019. PMC
  9. U.S. Food and Drug Administration. FDA issues class-wide labeling changes for testosterone products. 2025. fda.gov
  10. Maki PM, et al. Guidelines for the evaluation and treatment of perimenopausal depression. Menopause 2018. PubMed
  11. Testopel (testosterone pellets) prescribing information, implant-site reactions. DailyMed. dailymed.nlm.nih.gov