TREATMENTS
Hormone medications, weighed by evidence.
Every option we discuss, from estradiol and progesterone to non-hormonal NK blockers, testosterone and thyroid replacement: how it works, what the trials show and what to watch for. Status labels show what is FDA-approved and what is off-label.
Hormone therapy
·
FDA-approved
Transdermal & oral estradiol
The most effective treatment for hot flashes and night sweats.
Key evidence:
WHI · KEEPS · ELITE
Read the evidence →
Hormone therapy
·
FDA-approved
Micronized progesterone
Protects the uterus when estrogen is used.
Key evidence:
PEPI
Read the evidence →
Local therapy
·
FDA-approved
Vaginal estrogen
Local relief for genitourinary symptoms.
Key evidence:
Menopause Society GSM statement (2020)
Read the evidence →
Non-hormonal
·
FDA-approved
Fezolinetant (Veozah)
A non-hormonal pill that targets the brain’s temperature center.
Key evidence:
SKYLIGHT 1 · SKYLIGHT 2 · SKYLIGHT 4
Read the evidence →
Non-hormonal
·
FDA-approved
Elinzanetant (Lynkuet)
A dual NK1/NK3 blocker for hot flashes and sleep.
Key evidence:
OASIS 1 · OASIS 2 · OASIS 3
Read the evidence →
Non-hormonal
·
FDA-approved
Low-dose paroxetine (Brisdelle)
The only SSRI approved specifically for hot flashes, at a low nightly dose.
Key evidence:
Simon JA, et al. Menopause. 2013 (two phase 3 RCTs)
Read the evidence →
Men’s health
·
FDA-approved
Testosterone therapy for men
For confirmed deficiency, not just a low number.
Key evidence:
TRAVERSE
Read the evidence →
Women’s health
·
Off-label
Testosterone for women
One evidence-based use: low sexual desire after menopause.
Key evidence:
Global Consensus Position Statement (2019)
Read the evidence →
Thyroid
·
FDA-approved
Levothyroxine
Standard treatment for an underactive thyroid.
Key evidence:
TRUST
Read the evidence →
Thyroid
·
FDA-approved
Methimazole
The first-line antithyroid medicine for Graves' disease.
Key evidence:
ATA 2016 and ETA 2018 Graves' guidelines
Read the evidence →
BEFORE ANY HORMONE
Four questions worth asking first.
Good hormone care starts before the prescription. These are the checks we walk through with every patient.
01
Is the diagnosis confirmed?
Perimenopause is usually a clinical diagnosis after 45. Low testosterone needs symptoms plus two low early-morning levels. Thyroid disease needs TSH and free T4.
02
Are there contraindications?
A history of breast or endometrial cancer, blood clots, stroke, heart disease, liver disease or unexplained bleeding changes the conversation.
03
Which route fits best?
Patches and gels bypass first-pass liver metabolism and, in observational data, carry a lower clotting risk than tablets.
04
What is the follow-up plan?
Review symptoms and side effects at around three months, then at least yearly. Men on testosterone need hematocrit and PSA checks.
PERSONALIZED CARE
Ready to talk through your options?
Youthful Vitality & Longevity Medicine offers in-person visits in Doylestown, PA and Manhattan, and telemedicine in 12 states plus DC.