Hormone Replacement Therapy (HRT & BHRT) in Vancouver, WA
Personalized hormone care in Vancouver and by telehealth in Washington and Oregon
Prevail Wellness Center offers hormone replacement therapy for women in perimenopause and menopause, plus hormone care for men. Our licensed naturopathic physicians and nurse practitioners review your symptoms, health history, and labs. Then we build a plan with you that may include estrogen, progesterone, or testosterone when it is medically appropriate. We see patients in person in Vancouver and by telehealth across Washington and Oregon.
Questions? Call us at 360-558-3990.
Could HRT help you?
- Hot flashes or night sweats
- Trouble falling or staying asleep
- Mood changes, anxiety, or irritability
- Brain fog or trouble focusing
- Low sex drive
- Vaginal dryness or pain with sex
- Urinary urgency or frequent bladder infections
- Joint aches that started in midlife
Common signs of hormone change
Hormone changes in your late 30s, 40s, and 50s can show up in many ways. HRT may help if you are dealing with:
HRT is not right for everyone
That is why every plan starts with a full evaluation.
What do HRT and BHRT mean?
Hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT), replaces hormones your body makes less of during perimenopause and menopause, mainly estrogen and progesterone.
Bioidentical hormone replacement therapy (BHRT) uses hormones with the same chemical structure as the ones your body makes, such as estradiol and progesterone. Many bioidentical hormones are FDA-approved and available at regular pharmacies.
FDA-approved vs. compounded bioidentical hormones
What "bioidentical" means
"Bioidentical" describes the hormone's structure. It does not tell you whether a product is FDA-approved.
FDA-approved bioidentical hormones
Examples include estradiol patches, gels, or pills, vaginal estradiol, and oral micronized progesterone. They are tested for safety, effectiveness, and consistent dosing, and are often covered by prescription insurance. We use them when a standard dose and form fit your needs.
Compounded bioidentical hormones
Custom creams, capsules, or troches mixed by a compounding pharmacy. They are not FDA-approved as finished products. Quality comes from the pharmacy, so we use vetted compounding pharmacies that test for potency and purity. They are often not covered by insurance. We use them when a custom dose, form, or ingredient fits you better, such as an ingredient allergy, a dose that is not made commercially, or testosterone for women.
Our approach
We choose FDA-approved or compounded hormones based on your situation and needs, and we explain why we recommend each one.
Prefer a quick explanation? Watch how BHRT works and who it helps.
Hormones we prescribe when appropriate
Estrogen (estradiol)
The most effective treatment for hot flashes and night sweats. It also helps vaginal dryness and protects against bone loss. Patches and gels go through the skin and may carry a lower blood clot risk than pills.
Progesterone
If you have a uterus and use estrogen, you need progesterone to protect the uterine lining. Many women also find oral micronized progesterone helps with sleep and anxiety.
Testosterone for women
Research supports testosterone for low sexual desire in postmenopausal women. We use doses aimed at the normal female range and check levels over time. Early research is also looking at testosterone for memory and focus, though that evidence is still limited.
Vaginal estrogen
A low-dose option for vaginal dryness, pain with sex, and urinary symptoms. Very little reaches the bloodstream.
Hormone care for men. We evaluate and treat men with symptoms and lab-confirmed low testosterone.
If HRT is not a good fit for you, we also offer non-hormonal options.
What to expect at your first hormone visit
1. Your story
We talk through your symptoms, cycles, health history, and goals.
2. Your risks
We review personal and family history of breast cancer, blood clots, stroke, heart disease, and liver disease.
3. Labs when useful
Menopause is usually diagnosed from your age and symptoms, not one blood test. Labs help us check thyroid, iron, metabolic health, and starting hormone levels when needed.
4. Your plan
We explain your options, including benefits, risks, and costs, so you can decide with us.
5. Follow-up
We see you 6 to 8 weeks after you start, adjust your dose as needed, then see you regularly. Lab results and dose changes are reviewed during visits, so each follow-up has your full attention.
Benefits and risks of HRT
- Fewer and milder hot flashes and night sweats
- Better sleep and mood
- Relief from vaginal dryness and some urinary symptoms
- Long-term protection against bone loss and fractures
- Possible support for heart and brain health, especially when started near menopause (research is ongoing)
We use HRT to relieve symptoms and to support long-term health as you age.
Risks depend on your health history, how long it has been since menopause, and the type, dose, and form of hormone. We offer HRT at any age after a careful review of your personal risks. Risks to discuss include:
- Blood clots and stroke (lower with patches and gels than with pills)
- Uterine cancer if estrogen is used without progesterone in women with a uterus
- Breast cancer: the higher risk seen in older studies was tied mainly to synthetic progestins. Studies of estradiol with micronized progesterone are more reassuring. We review your personal and family history with you.
HRT may not be safe if you have had breast cancer, a blood clot, a stroke, active liver disease, or unexplained vaginal bleeding. If that is you, we will talk through other options.
Have questions about your hormones?
Get clear answers and personalized guidance from our team.
Why patients choose Prevail for hormone care
Menopause and hormone focus
Hormone care is what we do every day.
A team approach
Licensed naturopathic physicians and nurse practitioners work together on your plan.
Time to listen
Visits are built around your full story, not a quick symptom checklist.
Options that fit you
FDA-approved or compounded hormones, chosen for your needs.
Telehealth: available for patients in Washington and Oregon.
Insurance: in network with Regence, Premera, Moda, PacificSource, and LifeWise.
Prevail is a specialty clinic. We work alongside your primary care provider and do not replace one.
Meet your hormone care team
Dr. Natalie Hanan, ND, LAc
Naturopathic Physician and Acupuncturist. Founder and Medical Director. Menopause, perimenopause, hormone therapy, and thyroid care.
Dr. Goldis Faghihi, ND, DC
Naturopathic and Chiropractic Physician. Hormone optimization, metabolism, and weight management.
Sarah Mann, FNP
Family Nurse Practitioner, AANP board certified. Hormone health, menopause, and perimenopause care.
Frequently Asked Questions About Hormone Replacement Therapy
Is hormone replacement therapy safe?
For many women, the benefits of HRT outweigh the risks. Safety depends on your health history, timing, and the type and form of hormone. We offer HRT at any age after reviewing your personal risks with you.
What is the difference between bioidentical and synthetic hormones?
Bioidentical hormones have the same structure as the hormones your body makes. Some older products use different structures, such as conjugated estrogens or medroxyprogesterone. Many bioidentical options are FDA-approved.
Do I need lab tests before starting HRT?
Not always. Menopause is diagnosed mostly from age and symptoms. We order labs when they help, for example to check thyroid function, iron, or metabolic health, or to get a baseline before testosterone.
Can I start HRT if I am still having periods?
Yes. Many women start treatment during perimenopause, while periods are still coming but changing.
How soon will I feel better?
Hot flashes often improve within a few weeks. Full benefits can take about 3 months.
How long can I stay on HRT?
There is no set cutoff. We review your benefits and risks with you at least once a year.
Does insurance cover HRT?
Visits are covered by many plans. We are in network with Regence, Premera, Moda, PacificSource, and LifeWise. FDA-approved hormones are often covered by prescription insurance. Compounded hormones usually are not.
Do you offer telehealth for hormone therapy?
Yes, for patients in Washington and Oregon.
Do you treat men?
Yes. We evaluate and treat men with symptoms and lab-confirmed low testosterone.
Ready to feel like yourself again?
Book a hormone consult online or call us at 360-558-3990. We are open Tuesday to Friday, 9am to 5pm.
