How do I pick a legitimate BHRT clinic and avoid the hormone mills?

Picking a Legitimate BHRT Clinic vs. Hormone Mills

Red Flags of "Hormone Mills"

• Diagnose and prescribe hormones based on symptoms alone (no bloodwork)
• One-size-fits-all pellet dosing
• High-pressure sales tactics or expensive packages upfront
• Little follow-up testing after starting treatment
• No licensed physician oversight

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What Legitimate Clinics Do

Testing First

• Comprehensive baseline bloodwork (estradiol, progesterone, testosterone, DHEA, cortisol, thyroid)
• Some also test saliva or urine (DUTCH test) for metabolites

Physician Oversight

• Look for board-certified OB/GYNs, endocrinologists, or internists
• BodyLogicMD and Bioidentical Hormone Network maintain physician directories with credentialing standards

Reputable Compounding

• Ask if they use PCAB-accredited compounding pharmacies like Belmar Pharmacy or Strive Pharmacy

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Good Starting Points

• Menopause Society (NAMS) provider finder – menopause.org lists certified practitioners
• Institute for Functional Medicine (IFM) – ifm.org for metabolically-trained physicians
• Your current OB/GYN or internist for a referral

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Key Questions to Ask

• "What bloodwork do you run before prescribing?"
• "How often do you retest levels?"
• "Are you a licensed MD/DO?"

The presence of thorough follow-up testing is usually the clearest sign of legitimacy.