Bioidentical Hormone Replacement Therapy

Offering private-pay and OHIP-covered options (see below)
Offering private-pay and OHIP-covered options (see below)

Are you suffering from hot flashes, night sweats, mood changes or other perimenopausal / menopausal symptoms?

Have you tried non-hormonal treatments with only lackluster results?

Are you curious about hormone replacement therapy (HRT) but are unsure about embarking on this because you’ve heard that it’s dangerous?

If so, you’ve come to the right place! I have a keen interest in the use of HRT as a treatment for perimenopausal and menopausal symptoms, in large part because the treatment results are so gratifying. It’s remarkable how minute quantities of hormones delivered in the right way at the right time can make all the difference in a woman’s quality of life.

Millions of women suffer unnecessarily with perimenopausal and menopausal symptoms due to a fundamental misunderstanding of the relative benefits and risks of HRT among the general public and doctors alike. HRT is not a panacea and it’s not right for everyone. But for many women, HRT is safe choice that provides welcome relief from perimenopausal and menopausal symptoms in addition to providing a variety of collateral health benefits.

Working together, we can figure out what hormonal (and possibly non-hormonal) issues are contributing to your symptoms and devise a safe and effective treatment regimen intended not only to provide symptom relief but to enhance your overall health and mitigate the potential risks of HRT.


Established benefits of HRT:

  • Reduction in vasomotor symptoms (i.e. hot flashes and night sweats) 
  • Reduction in symptoms of vulvovaginal atrophy (i.e., vaginal dryness, painful sex)
  • Preservation of bone mineral density and reduction in fracture risk

Potential benefits of HRT:

  • Decreased all-cause mortality*
  • Decreased risk of coronary artery disease/cardiac events*
  • Decreased risk of cognitive impairment and Alzheimer’s disease*
  • Improved body composition (i.e., more muscle and less body fat)
  • Improved sexual function
  • Decreased visible signs of aging
  • Decreased incidence of recurrent urinary tract infections (vaginal estrogen)


*Only if initiated with or soon after menopause.

Why should I see you for hormone replacement therapy?

#1 Because there’s a heck of a lot more to HRT than prescribing bioidentical hormones and, as a Certified Menopause Practitioner, I have the knowledge base and experience to get it right the first time. There are a number of problems with HRT as it is often prescribed and managed:

  • Women are too often prescribed HRT without being properly informed about the potential benefits and risks of HRT.
  • Suboptimal hormonal preparations, including non-bioidentical preparations, are too often employed.
  • A suboptimal method of administration is too often employed (oral versus transdermal estrogen).
  • Insufficient attention is paid to individualizing the dosage, with many women being prescribed dosages that are unnecessarily high.
  • HRT is often prematurely discontinued under the guise that HRT should always be used for the shortest time possible.
  • Hormones are often prescribed where none are required. For example, many perimenopausal women require only progesterone for symptom management and yet end up on combined HRT for unclear reasons.
  • Little to no attention is paid to identifying and addressing other hormone imbalances that may be contributing to a patient’s symptoms.
  • Little to no attention is paid to ensuring that the administered hormones are being metabolized in an optimal fashion.
  • Insufficient attention is paid to mitigating the potential risks of HRT through lifestyle modification.
  • There is insufficient acknowledgment that lifestyle factors alone can precipitate or contribute to hormone imbalances.


#2 Although there is considerable uncertainty regarding to extent to which bioidentical HRT increases the risk of breast cancer, with studies suggesting no or very little increased risk, it is safest to proceed under the assumption that it does confer a small increased risk of breast cancer and to proceed accordingly. I therefore include an integrative treatment plan for breast cancer prevention as part of every private-pay HRT consultation.


#3 I am comfortable prescribing transdermal testosterone and other medications to address sexual dysfunction as an add-on to HRT. 


Patients interested in pursuing HRT with have 2 options:

1) Private pay (recommended). This service includes a more comprehensive assessment of hormonal status and integrative treatment recommendations. Note that the total cost of private-pay HRT is $400 (special, limited-time rate for a 2-appointment initial consultation). This means that if you’re on HRT for 1 year, 3 years, 5 years, or longer, you’ll only pay $400. This is because follow-up appointments to tweak your HRT regimen are OHIP-covered. However, this requires that the first appointment takes place in person. In addition, at least one appointment must be conducted in person every 24 months. Follow-up appointments to address issues other than your hormone replacement regimen are not free of charge/included in this $400 fee.

2) OHIP-covered (starting summer 2024). This service includes straight HRT without a more detailed assessment of hormonal status or integrative treatment recommendations. In order to qualify, the first appointment must take place in person. Subsequent appointments may take place by videoconference but at least one appointment must be conducted in person every 24 months. Note that due to payment restrictions  put in place by the Ministry of Health, I am only able to see a certain number of patients for OHIP-covered HRT per year. If you are interested in OHIP-covered HRT, please contact us at [email protected].


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