Step 1: Notice what's changed, and write it down
Most people come in because something feels different: sleep, energy, mood, sex drive or body composition. These changes have many possible causes, and hormones are only one of them. Before your visit, it helps to jot down:
- What you've noticed and roughly when it started
- Any medications and supplements you take
- Your menstrual history, if it applies (for example, irregular or missed periods)
- Questions you want to ask a provider
If you'd like a structured place to start, take our perimenopause quiz or the testosterone quiz. A quiz is not a diagnosis. It simply helps you organize what you're noticing before you talk with a provider.
Step 2: Get your blood work done
Every hormone plan at Onus starts with labs. You can't tell whether hormones are involved from symptoms alone, so testing comes first.
- Where: any Onus clinic along the Front Range.
- When: 7 days a week. Mon–Thu 10–4, Fri 10–3, Sat–Sun 10–2.
- Prep: no fasting needed.
- Results: usually ready in about 2 to 5 days.
- Cost: the initial hormone lab panel is $195 and includes one follow-up lab draw.
Women's and men's panels differ. Both measure hormones such as testosterone and estradiol along with other biomarkers, and the men's panel includes PSA. See the full list on our lab draw page, or read what our comprehensive lab panel tests.
Step 3: Review your results with a nurse practitioner
Next, you meet one-on-one with a licensed nurse practitioner. Depending on your situation, the visit may be in person or by telehealth, and an in-person evaluation may be required, especially for testosterone, which is a controlled substance. A visit does not guarantee a prescription. Therapy is only prescribed after your provider reviews your labs and history. The 1-hour consult is $150. Your provider goes through your results and your history with you and talks through your options. Hormone therapy is not right for everyone, and sometimes the right next step is something else entirely. You can schedule a consultation online.
Good questions to bring:
- Which of my results are outside the reference range, and what could that mean?
- Is hormone therapy appropriate for me, and why or why not?
- What are the risks for someone with my history?
- What would follow-up and monitoring look like?
Step 4: If therapy is a fit, your plan is built around your levels
If you and your provider decide to move forward, your plan depends on your labs, history and preferences. At Onus, that usually means one of two paths.
Bioidentical hormone replacement therapy (BHRT)
BHRT uses hormones with the same chemical structure as those the body makes. Bioidentical does not mean safer or more effective, and compounded hormone products, including compounded pellets, are not FDA-approved. At Onus, BHRT is often delivered as hormone pellets:
- Lab draw and a consult with a nurse practitioner.
- If your provider recommends pellet therapy and you decide to move forward, insertion may be scheduled at the same visit or a later one. Insertion is a small in-office procedure with risks, such as bruising, infection or pellet extrusion, that your provider will review with you. If you choose to have pellets placed at the same visit as your consult, $50 of the consult fee is credited toward the procedure. There is no obligation to proceed, and you are welcome to take time to decide.
- Follow-up labs about 4 weeks after insertion. Your provider reviews the results and decides whether any change to your plan is appropriate.
- Ongoing check-ins with your provider throughout treatment.
Pellet insertion is $375 for women and $750 for men. Learn more on our BHRT page.
Testosterone replacement therapy (TRT)
TRT focuses on testosterone and is prescribed only after an individual evaluation. It's available as injections, sublingual troches, topical cream or oral capsules, starting from $130 depending on the formulation. The FDA has not approved a testosterone product for women, so when a provider prescribes it for a woman, that use is off-label and based on an individual evaluation. Learn more on our TRT page.
Step 5: Follow-up and monitoring
Hormone levels change over time, so a hormone plan is never set-and-forget. Expect follow-up labs and check-ins with your provider, who adjusts your plan as needed. Timing and response vary by person and plan, and no specific result is promised. Your provider will tell you what follow-up to expect.
Your provider may also discuss over-the-counter supplements. Supplements are not FDA-approved to treat any condition, so ask before adding anything new. Onus sells some supplements, and you are never required to buy from us.
What about safety?
Hormone therapy has real risks, and they vary by hormone, dose, delivery method and the person. Depending on the therapy, risks can include blood clots, stroke, certain cancers, higher red blood cell counts, high blood pressure and effects on fertility. That's why every plan at Onus starts with labs and a provider review, and why monitoring continues for as long as you're on therapy. If anything changes in your health, tell your provider.
Who you'll work with
Onus's medical team includes licensed nurses, nurse practitioners and physician assistants with emergency-room experience. Onus's medical director, Dr. Benjamin Wilks, MD, an emergency-room physician and Onus co-founder, provides medical oversight of Onus's clinical services. Hormone consults and treatment are provided by Onus nurse practitioners. Labs, consults, treatment and follow-up all happen with the same Onus team, at 7 Front Range locations.
Ready to start?
The simplest first step is a lab draw or a consult. Schedule a consultation, book a lab draw, or compare all your options on our hormone replacement therapy in Denver page. Members save 10% on select hormone replacement services, which may include testosterone and BHRT, and on lab bundles. Ask us which services qualify.
This article is educational and is not medical advice. A provider decides whether any treatment is appropriate after an individual evaluation. Compounded hormone products, including compounded pellets, are not FDA-approved. Risks and results vary.