Services · Hormone Therapy

Bioidentical Hormone Replacement Therapy

Energy, sleep, mood, libido, and clarity often come down to hormones. We test thoroughly and optimize precisely — for men and women. Start with an initial appointment.

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Hormone optimization, personalized

Bioidentical hormone replacement therapy (BHRT) uses hormones structurally identical to the ones your body makes. After comprehensive lab work, Dr. Hoff designs a regimen tailored to your levels, symptoms, and goals — then monitors and fine-tunes it over time.

Many patients describe it as getting themselves back: steadier energy, better sleep, sharper focus, and renewed vitality.

Who it’s for

Who BHRT helps

If your labs and how you feel point to hormone imbalance, optimization can change your quality of life.

For women

Perimenopause & menopause

Hot flashes and night sweats, disrupted sleep, mood swings, low libido, brain fog, and stubborn weight. Bioidentical hormone therapy, dosed to your labs and symptoms, helps you feel steady and like yourself again.

Menopause & perimenopause

For men

Low testosterone

Fatigue, brain fog, low drive, and loss of strength and motivation often trace back to declining testosterone. We test thoroughly and optimize precisely, monitored over time — safely, not a mail-order kit.

Low testosterone

What is bioidentical hormone replacement therapy?

Hormones are chemical messengers that regulate energy, sleep, mood, metabolism, sexual health, and how you recover. With age and life transitions — perimenopause and menopause in women, a gradual decline in testosterone in men — levels shift and symptoms follow.

Hormone replacement therapy (HRT) restores hormones your body is no longer making in the right amounts. Bioidentical hormone replacement therapy (BHRT) uses hormones with the same molecular structure as your own. At True You, BHRT isn’t a standard dose handed to everyone: Dr. Hoff chooses which hormones, which form, and what dose based on your labs, symptoms, history, and goals — and adjusts as your body responds.

Hormone therapy at every stage

Hormone needs change over a lifetime. In perimenopause, fluctuating estrogen and progesterone can disrupt sleep, mood, and cycles years before periods stop. In menopause, lower estrogen can bring hot flashes, night sweats, vaginal dryness, and changes in body composition. In men, testosterone usually declines gradually, which can affect energy, drive, strength, and libido.

Symptoms can also appear earlier than expected. Whatever your age, the approach is the same: test thoroughly, treat what the results and your symptoms show, and monitor carefully. If hormones aren’t the driver, we’ll look further — often at the thyroid, blood sugar, or stress.

Symptoms hormone therapy may help

When labs confirm an imbalance, the right plan can improve how you feel day to day.

Hot flashes & night sweats

Temperature swings that disrupt your day and your sleep.

Poor sleep

Trouble falling asleep, staying asleep, or waking rested.

Mood, focus & memory

Irritability, low mood, anxiety, and brain fog.

Low libido

Reduced desire and changes in sexual function.

Low energy

Fatigue and low motivation that rest doesn’t fix.

Body composition

Lost muscle, slower recovery, and weight that settles around the middle.

Before we prescribe

What your hormone testing includes

Estradiol and progesterone for women, matched to your stage of life
Total and free testosterone and SHBG — for women and men
A full thyroid panel, because a slow thyroid mimics many “hormone” symptoms
Metabolic markers such as fasting insulin and A1c
Cortisol when stress and energy patterns point to it
General health and safety markers we track over time

How it works

Your BHRT process, step by step

Thorough at the start, closely monitored after.

01

Step 1

Initial appointment

An in-person visit at our Fredericksburg office to go through your symptoms, history, and goals.
02

Step 2

Comprehensive labs

Hormone, thyroid, and metabolic testing so the plan is based on data, not guesswork.
03

Step 3

Your personalized plan

Dr. Hoff explains what your results mean, the options that fit, and the benefits and risks of each.
04

Step 4

Start and follow up

Repeat labs and check-ins after you begin so dosing can be fine-tuned to how you feel.
05

Step 5

Ongoing monitoring

Regular reviews over time — many of them virtual — as your body and needs change.

Is hormone therapy safe? How we approach it

Every medical treatment has benefits and risks, and hormone therapy is no exception. The difference is in how carefully it’s done. Before recommending BHRT, Dr. Hoff reviews your personal and family history, your labs, and anything that could make hormones a poor choice for you. If hormone therapy isn’t appropriate, we’ll say so and talk through other ways to address your symptoms.

Once you start, we don’t set it and forget it. Follow-up testing and regular conversations let us keep your levels in a healthy range and adjust when something changes. We’re also glad to coordinate with your other physicians so everyone has the full picture.

Bioidentical hormones in Fredericksburg, with care that continues

Your first visit and lab work happen in person at our downtown Fredericksburg office. Once your plan is set, many follow-ups can be virtual, which makes the regular monitoring hormone therapy needs far easier to keep up with — whether you live in the city or drive in from Stafford, Spotsylvania, or King George. True You is a cash-based practice, and we’re transparent about costs at your consultation.

BHRT — common questions

What’s the difference between BHRT and traditional HRT?

Bioidentical hormones are molecularly identical to those your body produces. We tailor dosing to your individual labs and symptoms and monitor closely over time.

How soon will I feel a difference?

It varies, but many patients notice improvements in energy and sleep within the first several weeks, with fuller benefits as your regimen is optimized.

Who is a good candidate for hormone replacement therapy?

Women in perimenopause or menopause and men with low testosterone are the most common candidates — especially when symptoms like poor sleep, hot flashes, low energy, or low libido are affecting daily life. Your labs and history determine whether therapy is appropriate.

How long should someone stay on hormone therapy?

There’s no single answer. It depends on your goals, symptoms, and health over time. We review your plan regularly and make that decision together, rather than on a fixed timeline.

Do you offer hormone therapy for men?

Yes. We evaluate and treat low testosterone in men with physician-guided testosterone replacement therapy when it’s clinically appropriate. See our low testosterone page to learn more.

Will I need follow-up labs?

Yes. Follow-up testing is how we make sure your levels are where they should be and that therapy is working safely for you.

Can my follow-up visits be virtual?

Many can. Your first visit and lab work are in person at our Fredericksburg office; much of the ongoing management can then be handled virtually.

Can BHRT help with weight gain?

Hormone shifts can make weight harder to manage, and balancing them may make it easier. Hormone therapy isn’t a weight-loss treatment on its own, so we often pair it with nutrition guidance or medical weight loss.

Will hormone therapy help my libido?

When low hormones are part of the cause, optimizing them often helps desire and sexual function. We also look at other contributors, such as sleep, stress, and medications.

Can I start hormone therapy while I’m still having periods?

Yes. Perimenopause symptoms often begin while cycles are still regular or only slightly irregular. Testing and a tailored plan can help well before menopause.

What forms of hormone therapy do you use?

Hormones can be delivered in different ways. Dr. Hoff will explain the options that suit your labs, symptoms, and routine, and why he recommends one over another.

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