Hormone Replacement Therapy in Fulton and Marriottsville, MD
When Hormones Shift, Everything Shifts: Hormone Replacement Therapy Helps
Balanced hormones, restored vitality
Perimenopause, menopause, andropause, and thyroid changes can quietly rewrite how you feel each day. Women in their late 30s through 60s often describe hot flashes, night sweats, brain fog, mood swings, weight gain around the midsection, vaginal dryness, painful intimacy, and a libido that no longer matches their partner's. Sleep becomes fragmented, anxiety creeps in, and the energy that used to power busy days in Columbia, Ellicott City, and Maple Lawn feels harder to summon. These are not character flaws, they are measurable shifts in estradiol, progesterone, testosterone, and thyroid hormones that respond to thoughtful treatment.
Men experience a parallel story. Low testosterone (low T) can show up as persistent fatigue, reduced motivation, soft muscle tone despite training, slower recovery, dwindling libido, erectile changes, irritability, and a general sense that the spark has dimmed. At Pura Vida, hormone replacement therapy starts with a comprehensive lab panel and a careful conversation. From there, Dr. Apgar and our medical team match the right form to your physiology, including bioidentical creams, oral capsules, injections, and Evexias subcutaneous pellets at our Fulton location. The goal is balance you can feel: clearer thinking, steadier mood, restored intimacy, and energy that lasts through your day.
What Is Hormone Replacement Therapy?
Hormone replacement therapy (HRT) restores hormones the body no longer produces in optimal amounts, and at Pura Vida we focus on bioidentical hormone replacement therapy—compounded estradiol, progesterone, and testosterone molecularly identical to your own—with traditional FDA-approved options and Evexias pellets also available. Patient education from the North American Menopause Society and the U.S. Food and Drug Administration outlines how individualized therapy addresses moderate to severe menopausal symptoms.
For Women: Perimenopause and Menopause Support
For women, bioidentical HRT typically combines estradiol, progesterone, and, when indicated, low-dose testosterone, built from your symptoms and labs and refined over time.
For Men: Andropause and Low T
For men, HRT most often means testosterone optimization via injections, creams, or pellets, restoring testosterone into a healthy range while monitoring estradiol, hematocrit, and PSA.
Comprehensive Lab Workup (Both Locations)
Every plan begins with a comprehensive lab panel—CBC, CMP, full sex hormone and thyroid panels, plus markers like vitamin D and PSA as appropriate—so we tailor your protocol based on data, not assumption.
Evexias Pellets (Fulton Only)
Evexias pellets are rice-sized bioidentical pellets inserted under the skin that release testosterone or estradiol steadily over 3-5 months, offered exclusively at our Fulton, MD location.
Treatment Timeline:
Consultation:
60 minutes plus blood draw
Pellet Insertion:
15-20 minutes per visit
First Signs:
2-4 weeks after starting therapy
Full Effect:
2-3 months with dose optimization
Benefits of Hormone Replacement Therapy
Whole-body renewal
Symptom Relief
Reduces hot flashes, night sweats, mood swings
Better Sleep
Promotes deeper, more restorative sleep
Restored Libido
Improves sexual desire for men and women
Energy
Rebuilds daytime energy and exercise tolerance
Composition
Supports muscle retention and metabolic balance
Hormone Replacement Therapy vs Alternatives
Compare delivery methods
| Treatment | Form | Cadence | Onset | Monitoring | Locations | Best For |
|---|---|---|---|---|---|---|
| Bioidentical HRT (Cream/Capsule) | Compounded creams, oral capsules | Daily | 2-4 weeks | Labs every 3-6 months | Fulton and Marriottsville | Patients wanting daily titration and flexibility |
| Bioidentical HRT (Injection) | Weekly testosterone injection | Weekly | 2-3 weeks | Labs every 3-6 months | Fulton and Marriottsville | Men seeking precise testosterone control |
| Evexias Hormone Pellets | Subcutaneous testosterone or estradiol pellets | Every 3-5 months | 2-4 weeks | Labs before each reinsertion | Fulton only | Patients who prefer steady release, low maintenance |
Who Is a Good Candidate for Hormone Replacement Therapy?
Hormone replacement therapy suits adults experiencing measurable hormonal changes that noticeably affect their quality of life.
Ideal Candidates for Hormone Replacement Therapy
- Women in perimenopause or menopause with hot flashes, night sweats, sleep changes, or vaginal dryness
- Women with low libido, mood changes, or brain fog confirmed by hormone testing
- Men with symptoms of low testosterone (fatigue, low libido, mood, body composition changes) plus lab confirmation
- Patients with subclinical thyroid changes contributing to fatigue, weight, and mood
Who Should Wait or Avoid Hormone Replacement Therapy
- Patients with a personal history of hormone-sensitive cancer (such as breast or prostate cancer) without specialist clearance
- Patients with unexplained vaginal bleeding, untreated DVT or pulmonary embolism, or active liver disease
- Pregnant or breastfeeding individuals
- Men with severe untreated sleep apnea, elevated hematocrit, or untreated prostate concerns
Talk to Us First If…
- You have a history of hormone-sensitive cancer or a clotting disorder
- You take medications that interact with hormone therapy
- You'd like baseline lab work reviewed before starting
- You're unsure whether your symptoms are hormone-related
During your consultation, we review your full medical history, current medications, and family history to design a plan that is both effective and safe.
Treatment Overview
What HRT looks like at Pura Vida
Comprehensive Labs
Consultation
Therapy Initiation
Follow-Up Labs
Ongoing Monitoring
Side Effects and Safety
Hormone replacement therapy has a well-studied safety profile when prescribed by an experienced physician and monitored with regular labs. Most patients tolerate HRT well, especially when bioidentical formulations are individualized to need.
Common, Expected Side Effects
Common, usually mild side effects can include breast tenderness, light spotting in women, bloating, fluid retention, mood adjustments, and mild acne or oily skin (more common with testosterone). Pellet insertion can produce a small bruise, mild soreness, or rarely pellet extrusion at the insertion site.
Less Common Reactions to Watch For
Less common but more important risks discussed at consultation include changes in clotting risk, breast cancer risk in some women (especially with combined oral therapy), gallbladder issues, sleep apnea worsening in men on testosterone, and elevated hematocrit in men.
Rare Risks and Important Safety Screening
Patients with a history of hormone-sensitive cancer, unexplained vaginal bleeding, active clotting disorders, untreated cardiovascular disease, severe liver disease, or pregnancy should not begin HRT without specialist guidance. For balanced patient education, see the FDA guide to menopause medicines. At Pura Vida, Dr. Apgar reviews your medical history, family history, and labs before prescribing, and we recheck hormones, hematocrit, and other markers on a regular schedule to keep your protocol both effective and safe.
Cost of Hormone Replacement Therapy in Fulton and Marriottsville
Transparent, personalized pricing
Hormone replacement therapy investment varies based on the form of therapy, lab frequency, and whether you choose creams, capsules, injections, or Evexias pellets. Pricing is finalized after your consultation and comprehensive lab review with our medical team.
Bioidentical HRT (creams, capsules, injections) is offered at both our Fulton, MD and Marriottsville, MD locations. Evexias hormone pellet therapy is offered exclusively at our Fulton, MD location (8110 Maple Lawn Blvd, Suite 145).
Typical Pricing Ranges
- Comprehensive HRT lab panel: typically $250-$500 depending on add-ons
- Bioidentical HRT (creams, capsules, injections): typically $150-$400 per month depending on regimen
- Evexias pellet insertion for women: typically $400-$600 per visit, every 3-5 months
- Evexias pellet insertion for men: typically $700-$1,100 per visit, every 3-5 months
- Follow-up labs and dose adjustments: per-visit pricing
Financing
To keep premium hormone care accessible, Pura Vida partners with CareCredit and Cherry for flexible monthly payment plans. Many patients spread their annual HRT investment across low monthly payments.
Call (301) 604-8432 or schedule online for a personalized HRT quote at our Fulton or Marriottsville, MD med spa.
Why Choose Pura Vida Med Spa for Hormone Replacement Therapy in Fulton, MD
Founded by Dr. Leslie Apgar, MD, Pura Vida guides every hormone replacement therapy protocol in Fulton and Marriottsville - calibrating your plan from lab data, symptoms and long-term goals.
Physician Founded
HRT plans overseen by Dr. Leslie Apgar, MD, board-certified physician.
Comprehensive Lab Workup
CBC, CMP, full hormone panel, and thyroid testing guide every protocol.
Bioidentical and Pellet Options
Creams, capsules, injections, plus Evexias pellets at Fulton.
Two Convenient Locations
HRT at Fulton and Marriottsville, pellets exclusively in Maple Lawn.
Ongoing Monitoring
Follow-up labs and check-ins keep levels optimal, with protocols adjusted over time.
Whole-Body Perspective
We coordinate HRT with IV therapy, weight loss, and aesthetic treatments for whole-body care.
Related Services in Fulton and Marriottsville
Pair your hormone replacement therapy results with these popular Pura Vida treatments.
IV Therapy
Customized IV Drips for Hydration, Energy and Immune Support
- Generally healthy adults seeking hydration and wellness support
- Patients recovering from travel, jet lag, intense workouts, or social events
- Individuals with mild seasonal fatigue or low energy who have been medically cleared
Vaginal Rejuvenation
FemiLift Laser Treatment for Comfort, Confidence and Intimate Wellness
- Postpartum women experiencing vaginal laxity after one or more vaginal deliveries
- Perimenopausal and post-menopausal women with vaginal dryness, burning, or painful intimacy
- Women with mild stress urinary incontinence (occasional leakage with cough, sneeze, laugh, or exercise)
GLP-1 Weight Loss
Semaglutide Program with Weekly or Monthly Provider Support
- Adults with BMI of 30 or higher
- Adults with BMI of 27 or higher and at least one weight-related comorbidity such as hypertension, prediabetes, type 2 diabetes, or dyslipidemia
- Patients committed to weekly injections and provider check-ins
Hormone Replacement Therapy Questions
Answers from our medical team
01 What is bioidentical hormone replacement therapy?
Bioidentical HRT uses compounded estradiol, progesterone, and testosterone that are molecularly identical to the hormones your body naturally produces. At Pura Vida, we prescribe bioidentical and traditional FDA-approved options based on your symptoms, labs, and medical history.
02 Are Evexias pellets available at both Pura Vida locations?
No. Evexias hormone pellets are offered exclusively at our Fulton, MD location in Maple Lawn. Bioidentical HRT in cream, capsule, and injection form is available at both Fulton and Marriottsville.
03 How long do Evexias hormone pellets last?
Most patients see steady benefit for 3 to 5 months per insertion. We recheck labs before each reinsertion to confirm levels and refine the dose to your needs.
04 What does the lab panel for HRT include?
Our comprehensive HRT panel includes a CBC, CMP, full sex hormone panel (estradiol, progesterone, total and free testosterone, SHBG, DHEA-S), and thyroid panel (TSH, free T3, free T4). Vitamin D, HbA1c, lipids, and PSA (for men) are added when appropriate.
05 When will I feel better after starting HRT?
Most patients notice early improvements in sleep, mood, and energy within 2 to 4 weeks. Full benefits in libido, body composition, and overall balance typically arrive around 2 to 3 months once dosing is optimized through follow-up labs.
06 Can men get hormone replacement therapy at Pura Vida?
Yes. We treat both women and men. Male HRT typically involves testosterone optimization with injections, creams, or Evexias pellets (Fulton only), guided by labs and Endocrine Society best practices.
07 Is HRT safe?
When prescribed and monitored by an experienced physician, HRT has a well-studied safety profile. Dr. Apgar reviews your full medical and family history, monitors hormones, hematocrit, and other markers regularly, and adjusts your protocol to balance effectiveness with safety.
Schedule Your Hormone Replacement Therapy Consultation
References
- The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause 2022. PubMed (PMID: 35797481).
- Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018. PubMed (PMID: 29562364).
- Stuenkel CA, Davis SR, Gompel A, et al. Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2015. PubMed (PMID: 26444994).
- Davis SR, Baber R, Panay N, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab 2019. PubMed (PMID: 31498871).
- Manson JE, Aragaki AK, Rossouw JE, et al. Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials. JAMA 2017. PubMed (PMID: 28898378).
- Pinkerton JV, Aguirre FS, Blake J, et al. The 2017 Hormone Therapy Position Statement of The North American Menopause Society. Menopause 2017. PubMed (PMID: 28650869).