Hormone Optimization and HRT in Roseville, CA
Many women come to me after feeling dismissed, even though their symptoms are real. I start by listening, then build a plan around your symptoms, your history and, when it makes sense, your labs.
Initial visit
$250, in Roseville or by telehealth across California
Then
$90 per month
Prescriptions
Billed separately; the cost varies by patient
Labs
Used when clinically appropriate, billed separately
Hormones set the recipe for everything else
Hormones play a major role in energy, metabolism, mood, sleep, body composition and mental clarity. When the recipe is off, everything else is affected. That is why this sits at the bottom of the plan I build with patients.
At NP Empowered Wellness in Roseville, I provide personalized hormone care for women and men. I lead with listening, because many women seek care after feeling dismissed despite meaningful symptoms. Every plan is based on your symptoms, medical history, risk review and goals, with labs when they are clinically appropriate.
Hormone therapy is not a weight-loss drug, but improving appropriate symptoms may make healthy habits easier to sustain. I would rather look at the full picture than treat half of it, which is why thyroid evaluation can be part of your visit when it fits.
Candidacy, risks, benefits, alternatives, monitoring and contraindications all require a clinical evaluation. Hormone therapy is not right for everyone, and I will tell you plainly if something is not a good fit.
Signs your hormones may need a closer look
- Hot flashes and night sweats
- 3 a.m. wakeups and trouble sleeping
- Brain fog and attention issues
- Anxiety, or not feeling like yourself
- Low libido
- Decreased strength and low energy
- Vaginal dryness or painful sex
- Fatigue, unexplained weight changes or hair thinning that may point to thyroid
Hormone optimization pricing
Transdermal estradiol (patch, spray or gel)
For women in perimenopause or menopause with symptoms that affect daily life, when it is appropriate for you. Estradiol replaces estrogen your body is no longer making and may support temperature regulation, mood, focus, bone health, skin and energy. Dosing is individualized and adjusted over time.
- Hot flashes
- Night sweats
- Brain fog
- Bone health
Oral micronized progesterone (capsule)
Progesterone balances estrogen and protects the uterine lining. It is typically taken at night and may support deeper sleep and a sense of calm. It is needed if you have a uterus and take systemic estrogen.
- Sleep
- Nighttime anxiety
- Uterine protection with estrogen
Vaginal estrogen
A low-dose therapy that works directly on vaginal and urinary tissues with minimal systemic absorption. You may be a candidate even if you are not on systemic hormones, or if you cannot or prefer not to use them.
- Vaginal dryness or burning
- Pain with intercourse
- Recurrent UTIs or urgency
- Tissue thinning
Men’s hormone care
It begins with an individualized evaluation of your symptoms and history. Depending on what is appropriate for you, care may include topical or prescribed home-injection pathways. Candidacy, monitoring and contraindications are reviewed with you first.
- Low energy
- Low libido
- Fatigue
- Mood changes
Thyroid evaluation and support
Lab testing alongside your hormone evaluation when it is clinically appropriate, with ongoing monitoring. If needed, treatment may include thyroid medication, nutritional and lifestyle support, and dose adjustments based on labs and symptoms.
- Fatigue
- Weight changes
- Hair thinning
- Dry skin
- Cold sensitivity
Prices are starting points. Your exact plan, with the price of each step and the total, is written out at your consult. Cherry and CareCredit payment plans are available.
Where it fits in the Cake System
Foundation layer, Plan A: Inside first
Hormone care is the foundation layer of Plan A, Inside first. If your hormones are off, skin heals and builds collagen more slowly, so the treatments above this layer may do less than they should. It pairs with weight management and hair restoration, and it comes before most skin work.
- Foundation
- Structure
- Surface
- Expression
- Holding it
How hormone care works
01
Listen and evaluate
A symptom-led evaluation with your health history, a risk review and education, so I understand how your hormones may be affecting your energy, mood, sleep and metabolism. Labs are ordered when they are clinically appropriate.
02
Build your plan
Based on what we learn, we build an individualized plan that may include hormone therapy, other medications and supportive supplements.
03
Start and stabilize
Consistent, guided treatment, with follow-up to see how you respond.
04
Refine and maintain
Follow-ups let us adjust your plan as needed and support long-term hormonal health.
Hormone optimization membership
$90 a month, after a $250 initial consultation
Personalized hormone care doesn’t end with a prescription. My ongoing hormone care membership provides continued clinical monitoring, follow-ups and treatment adjustments based on your individual needs.
Prescription medications and labs are billed separately.
Ongoing hormone care
Prescription management as your plan needs it.
Clinical follow-ups and monitoring
Regular check-ins so your plan keeps matching how you feel.
Review of symptoms and appropriate lab results
Labs are used when they are clinically appropriate.
Treatment adjustments when medically indicated
Changes are made with you, not on a fixed schedule.
In-office and telehealth care
Visit in Roseville or by telehealth across California.
Before and after hormone optimization
Before your appointment
- Complete your forms in the Prospyr Patient Portal before you arrive: the Medical Intake Form and the other questionnaires we send you.
- If you have recent labs, bring them. If labs make sense for you, I will tell you which ones.
- Bring a list of all current medications and supplements, and any records from other providers.
- Write down your top 3 to 5 symptoms in order of priority.
- If you are still cycling, note your cycle length and any recent changes.
After your appointment
- Some people notice early changes in sleep, mood and energy in the first weeks. Libido, skin hydration and mental clarity may take longer. Everyone responds differently, and results are not guaranteed.
- Mild breast tenderness or bloating in the first weeks can be normal as your body adjusts. Mild spotting or irregular bleeding in the first 1 to 3 months can be normal, but always report it.
- Give each dose adjustment at least 6 to 8 weeks. Do not stop medication abruptly or self-adjust your dose.
- Take progesterone at bedtime. Rotate injection and application sites. Avoid skin-to-skin transfer of gels or topical medications, especially to children or partners.
- Follow-up labs are used when they are clinically appropriate.
Call right away if
Call 911 or contact me for sudden severe headache, vision changes or slurred speech, chest pain, shortness of breath, calf pain or swelling, heavy or prolonged vaginal bleeding or any bleeding after menopause is established, severe abdominal or pelvic pain, a new breast lump or nipple discharge, severe mood changes or thoughts of self-harm, or an allergic reaction. Contact me if an injection site becomes increasingly red, warm or swollen after 48 hours. Call or text (916) 280-0949.
Full instructions for every treatment, with printable PDFs, are on the prep and aftercare page.
Hormone optimization questions
Text me at (916) 280-0949 if your question isn’t here. I would rather answer it before your visit than have you guess.
How much does hormone therapy cost in Roseville, CA?
The first hormone visit is $250 and can be in Roseville or by telehealth across California. After that, care is $90 per month. Prescriptions and labs are billed separately, and that cost varies by patient depending on whether a compounding pharmacy or a commercial pharmacy is used. We do not bill insurance.
Do I need labs before I start?
Not necessarily. Labs are used when they are clinically appropriate, and I will tell you at your visit whether they make sense for you. I do not require labs before every prescription.
Is hormone replacement therapy safe?
Hormone therapy is not right for everyone, which is why I review your health history, symptoms and risk factors before recommending anything. When it is appropriate, it is prescribed with ongoing monitoring and follow-up. I will tell you plainly about risks, benefits, alternatives and contraindications.
Can I do hormone therapy by telehealth in California?
Yes. NP Empowered Wellness offers telehealth hormone consultations for patients across California. You can complete your first visit with NP Sarah virtually and receive prescriptions electronically when they are appropriate. Wednesdays are telehealth only.
Is hormone therapy a weight-loss treatment?
No. Hormone therapy is not a weight-loss drug. Improving appropriate symptoms, such as poor sleep or low energy, may make healthy habits easier to sustain. If weight is your main concern, ask about weight management at your visit.
How long does it take for hormone therapy to start working?
It varies. Some people notice early changes in sleep, mood or energy within weeks, while brain fog, libido and vaginal dryness may take longer to settle. I follow up and adjust, since finding the right dose takes time. I cannot promise that every symptom will resolve.
What is the difference between bioidentical and synthetic hormones?
Bioidentical hormones are chemically identical in structure to the hormones your body makes. Estradiol and progesterone are the most common examples. Synthetic progestins were used in older formulations and carry a different risk profile. I prescribe estradiol by patch, spray or gel, and oral micronized progesterone.
What does men’s hormone care involve?
It starts with an individualized evaluation of your symptoms and history. When it is appropriate, care may include topical or prescribed home-injection pathways. Not everyone is a candidate, and I do not make promises about specific outcomes.
Who may not be a candidate for testosterone therapy?
You may not be a candidate if you have prostate cancer or a history of it, elevated PSA without medical clearance, untreated sleep apnea, uncontrolled heart failure, severe lower urinary tract symptoms, hematocrit above 54%, or fertility concerns, since testosterone can suppress sperm production. It requires a proper evaluation and close monitoring.
Are your medications compounded?
Some medications are compounded when it is clinically appropriate. Compounded medications come from a licensed 503A or 503B compounding pharmacy. Compounded medications are not FDA-approved and have not been evaluated by the FDA for safety, efficacy or quality. They are prescribed under the supervision of a licensed nurse practitioner and should be used only as directed.
Often paired with hormone optimization
Weight management
GLP-1 plans that protect muscle, in person or telehealth
Hair restoration
Scalp and follicle care for thinning hair, non-surgical
Start with one hormone visit
Your first visit covers your symptoms, history and a risk review, and ends with a plan you understand. Patients in Rocklin, Folsom and beyond can join by telehealth.
Call or text (916) 280-0949 to learn which layer belongs first.
In-person visits are in Roseville, and patients come from Rocklin, Granite Bay, Loomis, Lincoln, Folsom, Citrus Heights, El Dorado Hills, Auburn and Sacramento. Follow-ups and many wellness visits happen by telehealth, available across California.