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

Picking a Legitimate BHRT Clinic

Red Flags to Avoid ("Hormone Mills")

• Prescribe hormones without comprehensive bloodwork
• One-size-fits-all dosing (everyone gets the same pellet dose)
• Heavy upselling of supplements and add-ons
• No follow-up testing after starting treatment
• Online-only with no real medical oversight
• Dismissive of symptoms that don't fit their protocol

What Legitimate Clinics Do

• Comprehensive baseline labs before prescribing anything
• Follow-up testing at 6-12 weeks, then regularly
• Board-certified physicians (not just NPs working unsupervised)
• Discuss risks honestly, including breast tissue and cardiovascular considerations
• Use FDA-approved options alongside compounded hormones when appropriate

Reputable Starting Points

• Cleveland Clinic or Mayo Clinic functional/integrative departments - highest credibility
• Midi Health (telehealth) - physician-led, menopause-specialized, good reputation
• Alloy (telehealth) - evidence-based, transparent protocols
• Gennev - menopause-focused with board-certified OB-GYNs

Best Verification Steps

• Check if the prescriber is board-certified in OB-GYN, endocrinology, or has NAMS (North American Menopause Society) certification
• Ask specifically: "What labs do you run before and after starting treatment?"

Would you like guidance on specific hormone types or conditions?