Bioidentical Hormone Therapy for Women: Perimenopause, Menopause & Beyond
What changes during perimenopause and menopause, and how bioidentical estrogen, progesterone, and testosterone therapy can help.
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Key takeaways
- Hormones influence energy, mood, metabolism, sleep, and intimacy — and they shift through perimenopause and menopause.
- Bioidentical hormones are molecularly identical to those your body makes; Axiva uses bioidentical estrogen, progesterone, and testosterone.
- Therapy is individualized and guided by testing, and can be delivered by pellet or non-pellet (gels, creams, tablets) methods.
- Peer-reviewed research links individualized hormone therapy to relief of menopausal symptoms, guided by testing and ongoing medical oversight.
What is bioidentical hormone therapy for women?
Bioidentical hormone therapy (BHRT) is physician-supervised treatment that restores hormonal balance using bioidentical hormones — estrogen, progesterone, and testosterone that are molecularly identical to what your body produces.
Rather than only treating deficiency, the focus is proactive optimization for vitality, sexual wellness, and long-term health. Each plan begins with a female-specific hormone panel and evolves with you through perimenopause, menopause, and beyond.
What happens to hormones during perimenopause and menopause?
During perimenopause, levels of estrogen and progesterone fluctuate and then decline through menopause.
Those shifts can drive hot flashes, night sweats, disrupted sleep, mood changes, brain fog, weight changes, and reduced libido. The experience is different for every woman, which is why individualized care — not a generic protocol — matters.
What symptoms can hormone therapy help with?
Women most often seek hormone optimization for symptoms that are hard to manage on their own, including:
- Decreased energy, persistent fatigue, or unexplained weight changes
- Mood changes, brain fog, or sleep disturbances and night sweats
- Hot flashes and reduced libido during perimenopause or menopause
- A desire for proactive, long-term vitality — not just symptom relief
Individual responses vary, and therapy is always guided by testing and medical oversight.
Which hormones are used — and why testosterone too?
Estrogen and progesterone are central to female hormone therapy. Testosterone is sometimes added as well, because it contributes to energy, mood, and sexual desire in women.
Clinical guidelines support testosterone specifically for postmenopausal women with low sexual desire, used under medical supervision — one reason individualized testing and monitoring are essential. Your provider determines which hormones, and how much, based on your results and goals.
Pellet vs. non-pellet: what are the options?
Axiva offers two delivery methods with identical testing and monitoring: quarterly pellet therapy implants, or non-pellet gels, creams, and tablets.
You can switch between methods at any time. Research suggests the transdermal (through-the-skin) route with natural progesterone may offer advantages for some women — another decision you make with your provider based on your needs.
What does the research show?
A substantial research base supports individualized hormone therapy for relief of perimenopausal and menopausal symptoms and for quality of life, when guided by testing and ongoing oversight.
Because every woman’s history is different, the evidence points toward personalized care rather than one-size-fits-all dosing. See our Clinical Evidence page for the studies behind our protocols.
What does care look like at Axiva?
Care begins with a comprehensive female panel and wellness assessment to establish your baseline, followed by a personalized protocol using your choice of pellet or non-pellet delivery. Hormones are tracked every 6 to 8 weeks with dose adjustments along the way. Possible early effects — mild breast tenderness, minor mood or menstrual changes — are usually temporary and resolve as balance is restored. See our hormone-therapy FAQs for details.
Glossary
- Bioidentical hormones (BHRT)
- Hormones structurally identical to those the body produces, used to restore hormonal balance.
- Estrogen
- A primary female sex hormone that influences the menstrual cycle, bone health, mood, and more; levels fall around menopause.
- Progesterone
- A hormone that balances estrogen and supports sleep and mood; often paired with estrogen in therapy.
- Perimenopause
- The transition leading up to menopause, when hormone levels fluctuate — often for several years.
- Menopause
- The point when menstrual periods have stopped for 12 months; hormone levels are lower afterward.
- Pellet therapy
- Small bioidentical hormone implants placed under the skin during a quick in-clinic visit, releasing hormone steadily over about three months.
Sources & references
- Santoro N, et al. Menopausal Symptoms and Their Management. Endocrinol Metab Clin North Am, 2015 (PubMed 26316239).
- L’hermite M, et al. Could transdermal estradiol + progesterone be a safer postmenopausal HRT? Maturitas, 2008 (PubMed 18775609).
- Wierman ME, et al. Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2014 (PubMed 25279570).
- Further citations behind our Female Hormone Therapy: Axiva Clinical Evidence →
Medically reviewed by Dr. Deep Trivedi, MD
Chief Medical Officer & Medical Director, Axiva Wellness Centers
Last reviewed June 9, 2026.
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Our licensed medical team will walk you through your options — pressure-free, built around your labs and goals.