BIOIDENTICAL
HORMONE
REPLACEMENT
"A proven therapy for unexplainable symptoms"
At Koena, we believe balanced hormones are the foundation for energy, mood, metabolism, and healthy aging. Our bioidentical hormone replacement therapy is designed to restore your body to a state of balance, not just manage symptoms.
Whether you are navigating perimenopause or menopause, experiencing low testosterone, struggling with weight changes, fatigue, low libido, sleep issues, brain fog, or mood swings, we create a plan tailored to your physiology and your goals. All treatment plans are monitored by our Medical Director, Courtney Williams and Dr. Lyndsey for safety, personalization, and long-term success.
1
EvexiPEL pellet therapy
EvexiPEL pellets provide a steady, consistent release of hormones without the peaks and dips that can come with pills or creams. Pellets are placed just under the skin in a quick in-office visit and slowly dissolve over time.
Female pellet therapy is $449 for approximately four months of treatment.
Male pellet therapy is $749 for approximately six to seven months of treatment. *labs not included
Many patients choose pellets for their convenience, steady absorption, and strong symptom relief.
2
Oral hormone options
Oral therapies can include progesterone, thyroid medications, and certain estrogens or androgens, depending on your case. These are simple to take and allow for easy dose adjustments while we fine-tune your plan
3
Transdermal creams
Creams and gels are applied to the skin and absorbed into the bloodstream. This is a gentle, flexible option for patients who prefer a daily routine and want the ability to adjust doses carefully as the body responds
4
Injectable hormones
Injectable formulations, such as injectable testosterone, offer strong absorption and predictable dosing. This is a good fit for patients who want consistent levels without daily application or in-office pellet placement.
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BHRT FAQ
What are bioidentical hormones?
Bioidentical hormones are plant-derived hormones that are structurally identical to the ones your body naturally produces. Because they match your body’s chemistry so closely, they tend to feel natural, predictable, and well tolerated.
How do I know if I need hormone therapy?
Common signs include fatigue, low libido, weight changes, brain fog, hot flashes, night sweats, irregular cycles, anxiety, poor sleep, or feeling unlike yourself. Testing and a full conversation with your provider help determine whether hormones are playing a role in your symptoms.
What are hormone pellets?
Pellets are tiny, rice-sized cylinders made of bioidentical hormones combined with a natural plant-based binder. They slowly dissolve under the skin and release a steady, consistent dose of hormone. There is nothing artificial to remove later; the pellets absorb completely over time.
How are pellets inserted?
Pellets are placed just under the skin, usually in the upper hip or buttock area, during a quick in-office visit. The area is numbed first, so most patients feel only light pressure. A tiny opening is made, pellets are placed through a small sterile device, and a thin pressure bandage and steri-strip is applied. The entire procedure takes about 15 minutes.
Is the pellet procedure painful?
Most people describe the numbing as a quick pinch and the rest as pressure, not pain. The area may feel tender or bruised for a few days, similar to a mild workout. Over-the-counter pain relief is usually all that is needed, if anything.
How long do pellets last?
Female pellets last an average of four months.
Male pellets last about six to seven months.
Your metabolism, activity level, and absorption can influence timing slightly.
Can I feel the pellets under my skin?
You may feel a small firmness as the tissue heals, but most people cannot feel them once everything settles.
Are pellets better than creams or oral medications?
Pellets provide the most steady, consistent hormone release without daily dosing. Creams and oral medications allow for more frequent dose adjustments. Injectables provide strong and predictable absorption. The best option depends on your lifestyle, symptoms, and how your body responds.
How soon will I feel better?
Some patients notice improvements within one to two weeks. Others may take four to eight weeks as their body finds a new equilibrium. Hormone balance is a gradual process.
Is hormone therapy safe?
Yes. When done correctly and monitored closely, bioidentical hormone therapy is safe and well tolerated. At Koena, all treatment plans are overseen by Dr. Lyndsey and Medical Director, Courtney Williams. Regular lab work and follow-ups ensure your therapy remains balanced and personalized.
Do hormones increase the risk of cancer?
Risk varies from person to person. Bioidentical hormones are processed more naturally by the body, and when monitored appropriately, they do not inherently increase risk. Your provider will review your family history, personal history, and lab results to create a safe, individualized plan.
Can I do hormone therapy if I still have a menstrual cycle?
Yes. Many women begin experiencing hormone shifts years before cycles stop. Perimenopause can start up to a decade before menopause, and support during that time can significantly improve quality of life.
Do men benefit from hormone therapy too?
Absolutely. Low testosterone in men can cause fatigue, irritability, low libido, weight gain, decreased strength, and slower recovery. Restoring testosterone levels can improve mood, energy, performance, and overall vitality.
What tests are used to evaluate hormone health?
We offer serum blood work, DUTCH testing, and saliva testing. Each method reveals different layers of information about hormone levels, adrenal function, and metabolism. Your provider will help choose the best testing for your symptoms.
Do you offer telehealth for hormone therapy?
Yes. Many aspects of hormone management can be handled virtually, including consultations, follow-ups, lab reviews, symptoms check-ins, and treatment adjustments.
What makes Koena’s hormone program unique?
At Koena, we take an integrative and functional approach. Hormones are only one part of your health story. We also consider gut health, detox pathways, sleep, minerals, stress, nervous system balance, nutrition, and your lifestyle.
Ready to feel like you again? Book a consult here