At Three Rivers Medicine in St. Louis and Creve Coeur, Missouri, our physician-led primary care hormone replacement therapy (HRT) focuses on evidence-based, medically supervised hormone management for adults experiencing symptoms related to declining or imbalanced hormone levels. Our approach is rooted in comprehensive primary care, ensuring hormone therapy decisions are integrated with your overall health status, chronic disease management, preventive planning, and long-term wellness.
Hormones play a central role in many body systems — metabolic function, mood regulation, energy, sexual health, bone density, and cognitive performance. Research indicates that up to 30% of adults over age 40 experience clinically significant hormone imbalance symptoms that may benefit from evaluation and structured management. Without proper physician oversight, HRT can be ineffective or risk adverse effects such as cardiovascular strain or metabolic disruption.
Hormone replacement therapy at Three Rivers Medicine is delivered as part of your ongoing primary care — not as a standalone prescription. This ensures labs are interpreted in context, medical history is considered, and treatment is updated based on your changing health profile. We avoid simplistic “one-size-fits-all” hormone panels and instead use clinical judgment to guide testing, dosing, and monitoring over time.
What Is Hormone Replacement Therapy?
Hormone replacement therapy (HRT) refers to medical treatments designed to restore or balance hormone levels that decline due to aging, surgical removal of hormone-producing organs, chronic illness, or endocrine dysregulation. The most commonly addressed hormones include estrogen, progesterone, testosterone, thyroid hormones, and, in select cases, adrenal support.
HRT can alleviate symptoms like fatigue, mood changes, low libido, weight fluctuations, sleep disruption, and cognitive challenges when appropriately prescribed. However, hormone systems are complex and highly individual. Effective HRT requires careful diagnosis, thoughtful dosing, and ongoing clinical oversight — all of which are cornerstones of physician-led primary care.
Why Primary Care-Led HRT Matters
Many clinics or direct-to-consumer programs focus solely on dispensing hormones with minimal medical evaluation or follow-up. Hormone replacement therapy without proper clinical context can lead to imbalanced dosing, missed diagnoses, or unintended side effects. Primary care physicians are uniquely positioned to:
- Review your full medical and medication history
- Interpret labs in context with symptoms and risk factors
- Assess cardiovascular, metabolic, and endocrine health
- Coordinate care across specialties when needed
- Monitor treatment response and side effects over time
Evidence supports that structured, physician-managed hormone therapy leads to better health outcomes and fewer complications than unsupervised or episodic care. For adults considering HRT as part of overall wellness, primary care integration ensures continuity and safety.
Three Rivers Medicine also offers concierge medicine, enhancing this approach with extended visits, preventive planning focus, and personalized follow-up tailored to you.
How Primary Care-Based HRT Works
Step 1: Detailed Symptom and Medical Review
Your physician begins with a thorough evaluation of symptoms, medical history, and prior lab work. This assessment clarifies whether symptoms likely relate to hormone changes or other underlying conditions.
Step 2: Targeted Diagnostic Testing
Not every patient requires extensive hormone panels. Labs are ordered selectively to clarify clinical questions and rule out other causes such as thyroid dysfunction, adrenal imbalance, chronic inflammation, or metabolic issues. This prevents unnecessary testing and avoids misinterpretation of results.
Step 3: Personalized Treatment Planning
If hormone replacement is indicated, your physician designs a tailored regimen based on your symptoms, lab findings, risk profile, and personal goals. This plan may include bio-identical or conventional formulations, administered via appropriate delivery methods.
Step 4: Ongoing Monitoring and Adjustment
Hormone therapy is dynamic. Regular follow-up visits and labs allow your clinician to adjust dosing, monitor effectiveness, and reduce risk of side effects such as cardiovascular strain, hematologic changes, or metabolic disruptions.
Schedule a Complimentary Consultation During this brief, no-obligation call, you will speak with a clinician, review your symptoms, and determine next steps in evaluation or care planning.
Evidence and Best Practices in Hormone Therapy
Clinical evidence supports the value of physician-supervised hormone replacement therapy when indicated and monitored appropriately. Hormones influence multiple systems in the body, and imbalances are associated with metabolic shifts, decreased bone density, mood disorders, and cardiovascular risk. In adults receiving structured HRT with primary care oversight, studies have shown improvements in quality of life metrics and symptom burden versus unsupervised supplementation approaches.
Hormone therapy decisions in primary care take into account not only symptom relief, but also long-term health planning and risk mitigation. This contrasts with feature-driven or test-panel marketing often seen outside of medical settings.
