Bioidentical Hormone Replacement Therapy (BHRT)
Medically reviewed by Dr. Patricia Sitnitsky, M.D. · Last reviewed July 2026
Avita MD provides bioidentical hormone replacement therapy (BHRT) for adults experiencing hormonal imbalances at our clinics in Los Altos, Mountain View, and Los Gatos. We use comprehensive lab work to identify deficiencies, prescribe hormones that are structurally identical to your body's own, and monitor your levels over time to ensure safe and effective treatment.
We are a physician-owned practice with 12 providers, on-site phlebotomy for convenient lab work, and same-day appointment availability. We accept Medicare, most major PPO plans, and HMO plans.
How Hormonal Imbalances Affect Your Health
Hormones regulate nearly every system in your body, from metabolism and mood to sleep, immune function, and cardiovascular health. As you age, hormone production naturally declines. For women, menopause brings a sharp drop in estrogen and progesterone. For men, testosterone typically decreases by about 1% per year after age 30. Chronic stress, poor sleep, and certain medical conditions can accelerate these changes at any age.
The symptoms of hormonal imbalance are often vague enough to be dismissed or attributed to aging. Fatigue, weight gain that does not respond to diet or exercise, low libido, irritability, difficulty concentrating, poor sleep, hot flashes, night sweats, and loss of muscle mass all have potential hormonal causes that we can measure and treat.
Our Approach to BHRT
Comprehensive Testing First
We never prescribe hormones based on symptoms alone. Every BHRT program at Avita MD starts with detailed blood work, including testosterone (total and free), estradiol, progesterone, DHEA-S, cortisol, thyroid hormones (TSH, free T3, free T4), and sex hormone-binding globulin (SHBG). We also check metabolic markers, liver function, and a complete blood count to get the full picture before making any treatment decisions.
When a deeper view of your hormones is helpful, we use advanced hormone testing through the DUTCH test (Dried Urine Test for Comprehensive Hormones), which shows not only your hormone levels and also how your body metabolizes them. We pair this with dedicated testosterone testing and cortisol and adrenal testing to pinpoint imbalances and tailor your treatment accordingly.
Personalized Prescribing
Bioidentical hormones are chemically identical to the hormones your body makes. They can be prescribed in standardized FDA-approved forms or as custom-compounded formulations tailored to your exact dosing needs. Available delivery methods include pellet therapy, topical creams, gels, troches, and injectable therapy. Your provider recommends the method that best fits your hormone profile, lifestyle, and preferences.
Pellet therapy uses small, U.S.-manufactured pellets placed just under the skin during a quick in-office procedure, where they release a steady dose of hormones over time. Pellets last about 3 to 4 months in women and about 4 to 6 months in men before re-dosing. Many patients begin to notice results within a few weeks, with full benefits developing over two to three months as your levels stabilize.
Ongoing Monitoring
We schedule follow-up labs at four to six weeks after starting treatment, then every three to six months to track your levels and adjust dosing. The goal is to bring your hormones into an optimal range, not just a "normal" one, while monitoring for any side effects. On-site phlebotomy at all three of our locations makes this convenient.
BHRT for Women
For women in perimenopause or menopause, BHRT can relieve hot flashes, night sweats, vaginal dryness, mood swings, and sleep disruption. Beyond symptom relief, maintaining healthy estrogen and progesterone levels supports bone density, cardiovascular health, and cognitive function. We work with each patient to weigh the benefits and risks based on her individual health history. Learn more about our women's health services.
BHRT for Men
Low testosterone in men can cause fatigue, reduced muscle mass, increased body fat, low libido, irritability, and difficulty concentrating. We evaluate whether testosterone replacement is appropriate, rule out other causes (thyroid dysfunction, sleep apnea, medication side effects), and monitor treatment closely. Learn more about our men's health services.
Schedule Your Hormone Evaluation
Call Avita MD at (408) 495-5770 or book online. Your first visit includes a thorough consultation and lab orders. If you have recent lab results from another provider, bring them along and we will review them. Same-day appointments are available at our Los Altos, Mountain View, and Los Gatos clinics.
Related conditions we treat
This page is for general educational purposes and is not medical advice. Individual results vary. Talk with an Avita MD provider about your specific health needs.
Frequently Asked Questions About BHRT
What is bioidentical hormone replacement therapy?
Bioidentical hormone replacement therapy (BHRT) uses hormones that are chemically identical to the ones your body produces naturally. At Avita MD, we prescribe BHRT to address hormonal imbalances caused by aging, menopause, andropause, stress, or other medical conditions. The hormones are typically derived from plant sources and compounded to match your specific needs.
How do I know if I need BHRT?
Common signs of hormonal imbalance include fatigue, weight gain, low libido, mood changes, poor sleep, brain fog, hot flashes, night sweats, and loss of muscle mass. Avita MD starts with comprehensive blood work to measure your hormone levels and determine whether BHRT is appropriate for your situation.
Is BHRT safe?
BHRT has a strong safety profile when prescribed and monitored by a qualified physician. At Avita MD, we use evidence-based protocols, start with the lowest effective dose, and monitor your levels through regular lab work. We discuss the benefits, risks, and alternatives with every patient before starting treatment.
What forms of BHRT does Avita MD offer?
Avita MD offers BHRT in several forms, including pellet therapy, topical creams, gels, troches, and injectable therapy. The best delivery method depends on the hormones being replaced, your lifestyle, and your preferences. Your provider will recommend the option that fits your needs.
What is the DUTCH test?
The DUTCH test (Dried Urine Test for Comprehensive Hormones) is an advanced hormone test that Avita MD uses to get a detailed picture of your hormone levels and how your body processes them. We pair it with testosterone testing and cortisol and adrenal testing to identify imbalances precisely before designing your treatment plan.
How long do hormone pellets last?
Hormone pellets last about 3 to 4 months in women and about 4 to 6 months in men. The pellets Avita MD uses are U.S.-manufactured and placed during a quick in-office procedure, after which they release a steady, low dose of hormones over time. Your provider schedules re-dosing based on your symptoms and follow-up lab results.
How long does it take to feel the effects of BHRT?
Most patients begin to notice results within a few weeks, with improvements in energy, sleep, and mood. Full benefits, including changes in body composition, libido, and cognitive clarity, typically develop over two to three months. Avita MD schedules follow-up labs at regular intervals to fine-tune your dosing.
Does insurance cover BHRT?
Some forms of BHRT are covered by insurance, while compounded formulations are often self-pay. Avita MD accepts Medicare, most major PPO plans, and HMO plans. We will clarify costs before starting any treatment.
Ready to Schedule?
Book online, call us at (408) 495-5770. Same-day and next-day appointments are available.