What hormone replacement therapy is
Hormone replacement therapy (HRT) uses prescription hormones, such as estrogen, progesterone or testosterone, when your own levels have dropped and that drop is causing symptoms. Hormones influence energy, metabolism, mood, focus, sleep and sexual health. Changes can come gradually with age, or more suddenly during perimenopause and menopause. Patients often come in with:
- Persistent fatigue or low energy
- Brain fog or trouble concentrating
- Weight gain or difficulty losing weight
- Low libido or sexual health concerns
- Mood changes, anxiety or irritability
- Poor or unrefreshing sleep
- Hot flashes, night sweats, hair thinning or skin changes
These symptoms have many possible causes besides hormones, including thyroid disease, sleep apnea, anemia, depression and medication side effects. Sorting them out is exactly what internal medicine training is for.
How Dr. Pabona decides whether therapy is appropriate
Hormone care here is led by Dr. John Mark P. Pabona, MD, FACP, board certified in internal medicine (ABIM) and a Fellow of the American College of Physicians. His post-doctoral research at the University of Arkansas for Medical Sciences focused on molecular endocrinology. He is a member of The Endocrine Society, peer-reviews for endocrinology journals, and completed advanced training in bioidentical hormone therapy through Evexias Health Solutions.
The decision rests on symptoms and lab results together, read alongside your history. If your labs are normal but symptoms continue, Dr. Pabona looks for other causes, such as thyroid, sleep or medication effects. He has also presented on endocrinology and metabolism internationally; see his international recognition.
How the program works
Consultation and baseline labs
Care begins with an in-depth review of your symptoms, goals and medical history, plus baseline blood work. The initial panel includes:
- Complete blood count (CBC) and comprehensive metabolic panel (CMP)
- C-reactive protein (CRP), DHEA-sulfate and HbA1c
- Testosterone, free and total, with SHBG
- Thyroid panel and TPO antibodies
- Vitamin B12 and vitamin D (25-hydroxy)
- PSA, free and total, for men
Results review, about two weeks later
Dr. Pabona goes through your results in detail and, if treatment is appropriate, explains your options. For patients choosing pellet therapy, pellet insertion takes place at this visit when appropriate.
Follow-up labs and monitoring
About four weeks after pellet insertion, repeat labs check your response and help guide dosing. Follow-up labs, symptom tracking and dose reviews continue for as long as you’re on therapy.
Hormone therapy options
Your plan may include one or more of these, depending on your health profile, labs and preferences:
Bioidentical hormone pellets
Small pellets placed under the skin release hormones steadily over several months, with no daily dosing. Dr. Pabona is an Official EvexiPEL® provider and uses the EvexiPEL® Method for pellet therapy. Once a pellet is placed, its dose can’t be adjusted until it wears off.
Injectable hormone therapy
Injections allow flexible dosing, with adjustments guided by your lab results and symptoms under medical supervision.
Topical or oral hormone therapy
Creams, gels or oral forms are taken daily. They need consistent use, and absorption varies from person to person.
FDA-approved, compounded and bioidentical
Many hormone medicines, including some bioidentical estradiol and progesterone products, are FDA-approved for specific uses; other uses may be off-label. Compounded hormones, including hormone pellets, are not FDA-approved. “Bioidentical” describes a hormone’s molecular structure. It doesn’t by itself make a hormone safer, more natural or more effective.
Risks, safety and monitoring
Hormone therapy has risks as well as benefits, and they depend on the hormone, the dose, how it’s given and your health history. Depending on the treatment, risks can include blood clots, stroke, effects on breast, uterine or prostate tissue, and a raised red blood cell count. A history of hormone-sensitive cancer, clots, stroke, heart disease or liver disease shapes what’s safe for you.
That’s why monitoring is built in: follow-up labs, symptom checks and dose reviews for as long as you’re on therapy.
Care for women, men and the wider plan
Women’s hormone and menopause care
For perimenopause and menopause symptoms such as hot flashes, night sweats, sleep changes and mood shifts. Read more about women’s hormone and menopause care.
Men’s hormone and testosterone care
For symptoms that may point to low testosterone, confirmed with repeat morning blood tests before any treatment. Read more about testosterone therapy for men.
Related wellness care
Your plan can connect with medical weight loss, peptide therapy when a physician evaluation shows it’s appropriate, B12 shots, and guidance on nutrition, sleep and stress.
Cost and insurance
Hormone services are typically self-pay. Pricing depends on the type of therapy and the labs you need, and it’s reviewed with you at your consultation. CareCredit financing is accepted.
The clinic is at 4328 Central Ave, Suite B, in Hot Springs, about 35 minutes from Hot Springs Village, and open Tuesday–Saturday until 8 PM.
Whole body
Works throughout the body rather than in one skin layer.
Questions
Common questions about hormone therapy
How do you qualify for hormone replacement therapy?
You may qualify if you have symptoms linked to a hormone change, such as menopause symptoms or signs of low testosterone, and your evaluation and labs support treatment. Your history matters too: past blood clots, stroke, hormone-sensitive cancers or liver disease can rule out some options. A consultation with Dr. Pabona is required to decide what’s safe and appropriate.
Do you offer hormone pellets in Hot Springs?
Yes. Embrace Eternal Beauty is an Official EvexiPEL® provider, and Dr. Pabona uses the EvexiPEL® Method for bioidentical pellet therapy in appropriate candidates. Pellets release hormones steadily over several months. Because the dose can’t be changed once a pellet is placed, your labs are reviewed carefully before insertion and rechecked about four weeks later.
How long does it take to feel results from HRT?
Some patients notice improvement within a few weeks, while others see gradual changes over one to three months. Timing depends on the hormone, how it’s given, your starting levels and your overall health. Results vary by individual, and follow-up labs and symptom checks help Dr. Pabona adjust your plan along the way.
Will insurance pay for hormone replacement therapy?
Hormone services at Embrace Eternal Beauty are typically self-pay. Some insurance plans cover certain FDA-approved hormone prescriptions or lab tests, but coverage for pellets and compounded hormones is uncommon. Your pricing and treatment options are reviewed during your consultation, and CareCredit financing is accepted.
What is the average cost of hormone replacement therapy?
Costs vary widely with the type of hormone, how it’s given, the labs you need and how often you’re monitored. Pellets, injections and creams are priced differently, and lab work is a separate cost. At Embrace Eternal Beauty, pricing is reviewed with you during your consultation so you know the full picture before you start.
Are bioidentical hormones safer than other hormones?
Not by that fact alone. “Bioidentical” means the hormone has the same molecular structure as the one your body makes. Some bioidentical products are FDA-approved and others are compounded, so they haven’t all been tested the same way. Safety depends on the hormone, dose, route and your health history, which Dr. Pabona weighs with you.
Do men and women both qualify for hormone therapy?
Yes. Embrace Eternal Beauty offers hormone care for women and men, including evaluation for perimenopause, menopause and low testosterone. The approach differs: women’s care centers on menopause symptoms and the balance of estrogen and progesterone, while men’s care starts with confirming low testosterone on repeat morning blood tests. Both begin with a consultation and labs.
