Hormone replacement therapy in Mission Viejo
Bioidentical pellet therapy for women and men, dosed against a full hormone panel rather than a questionnaire. Run by a board-certified nurse practitioner, with a free consultation.
Medically reviewed by Lindsay Short, NP-BC, Board-Certified Nurse Practitioner · last reviewed September 2026
What hormone therapy costs here
Priced per procedure, with lab work listed separately because it is a real cost and hiding it inside a package makes the comparison dishonest.
- HRT pellet procedure, women
- HRT pellet procedure, men
- Hormone lab panel
- Follow-up consultation
Pellets last three to five months, so most patients are treated two to three times a year. HRT is billed separately from membership: the Feel Great tier gives member pricing on the program, not the treatment itself.
Hormone therapy is quoted after your bloodwork, because the protocol and the delivery route are decided on your labs rather than before them.
- Quoted in writing before anything starts. You hear the full figure at your consultation, not after treatment and not on the day.
- The consultation is free, with no obligation to book and no charge if you decide against it.
- We do not bill insurance. No prior authorization, no coverage denial part-way through, and no treatment decision made by a plan rather than by your clinician.
- Cherry and CareCredit financing are available, and membership pricing is lower than standard rates.
Pellets, injections or creams
All three deliver bioidentical hormones. They differ in how steady the level stays and in what the treatment asks of you day to day.
| Pellets | Injections | Creams and gels | |
|---|---|---|---|
| How often | Every 3 to 5 months | Weekly or twice weekly | Daily |
| Level over time | Steady release | Peak after dosing, trough before the next | Steady if applied consistently |
| What it asks of you | Nothing between visits | A self-injection routine | A daily application |
| Transfer risk | None | None | Real, to partners and children |
| Easy to stop | No, it is in place until it dissolves | Yes | Yes, immediately |
Pellets are what most of our patients choose, and the honest reason is adherence rather than pharmacology: a treatment you do not have to remember is a treatment you actually continue. If you want the ability to stop immediately, creams are the better fit and we will say so.
Why we will not prescribe from a questionnaire
A great deal of hormone therapy is now sold online against a symptom checklist, with no blood drawn before or after. Fatigue, low mood, poor sleep and low libido are real, and they are also the symptoms of thyroid disease, anemia, depression, sleep apnea and simply being under-slept.
Every protocol here starts with a comprehensive panel and is rechecked at six to eight weeks. That second panel is the part most programs skip, and it is the one that tells you whether the dose is right rather than merely present.
Sometimes the panel says the answer is not hormones. That is a useful result, and you will be told it plainly rather than sold a pellet anyway.
What happens at your first visit
A conversation about symptoms, in your words
Sleep, energy, mood, libido, recovery, concentration. About thirty minutes, and it covers medical history and family history because both change what is appropriate.
A comprehensive hormone panel
Drawn before anything is prescribed. Quoted separately, and it establishes the baseline every later decision is measured against.
A protocol built on your numbers
Reviewed with you rather than emailed at you, including which delivery method suits you and why. You see the total cost before agreeing to anything.
Repeat labs at six to eight weeks
The step that separates a managed protocol from a prescription. Dose is adjusted on labs and symptoms together, because the two do not always agree.
What the first six months look like
Hormone therapy is not a treatment you judge in a fortnight, and knowing the sequence prevents the two mistakes people make: stopping too early, and increasing the dose because week three feels no different.
Weeks one to three. The insertion site is tender for a few days, and heavy lower-body exercise waits about a week. Sleep is usually the first thing to shift, and it often shifts before anything else is noticeable.
Weeks six to eight. Repeat labs. This is the step most programs skip and the one that tells us whether the dose is right rather than merely present. How you feel and what your levels are doing do not always agree, and the dose is adjusted on both.
Months two to four. Libido, mood, body composition and recovery change over this window rather than suddenly. Pellets begin tapering toward the end of it, and the return of the original symptoms is usually what tells us it is time rather than the calendar.
Months three to five. Reinsertion, timed to your symptoms and your labs. Most patients settle into two to three procedures a year.
Who this is for, and who it is not
Women in perimenopause or menopause with hot flashes, disrupted sleep, mood changes or low libido. Men with fatigue, lost muscle, poor recovery and low mood where labs confirm low testosterone.
Who it is not for
HRT is not a weight loss treatment. It can help body composition alongside a managed plan, but if weight is the primary concern, that is a medical weight loss conversation and we will point you there instead of prescribing hormones for it.
There are real contraindications, certain hormone-sensitive cancers, some clotting disorders, active liver disease, pregnancy. We screen for them, and where the panel or the history says no, the answer is no.
Managed over months, not merely started
- Credential
- Board-certified nurse practitioner
- Who treats you
- Lindsay Short, NP-BC, every visit
- Baseline labs
- Required before prescribing
- Recheck
- Six to eight weeks, included
Hormone therapy is a long-term treatment with genuine contraindications and a dose that needs adjusting over time. The distinction between a clinic that draws labs twice and a service that ships a prescription is not marketing. It is the difference between a treatment being managed and being merely started.
The same clinician runs it throughout. That matters more here than on a single-visit treatment: your dose at month six is decided by what your labs did after month one, and that continuity is lost when a program is handed between whoever is available.
Book your free consultationWhat we actually test, and why one number is not enough
A great deal of hormone treatment is prescribed off a single total testosterone or a single TSH, and that is how people end up medicated for the wrong thing. The panel matters because the symptoms, fatigue, low mood, poor sleep, weight that will not shift, low libido , are produced by several different systems that feel identical from the inside.
For men, total testosterone alone is misleading, because much of it is bound and unavailable. Free testosterone, SHBG and oestradiol together tell you whether the level is genuinely low and how it is being converted, which is what determines the dose and whether anything needs managing alongside it.
For women, where perimenopause is concerned, oestradiol and progesterone move so much across a cycle that a single draw can be actively misleading, and timing matters as much as the value. FSH gives context on where you are in the transition.
For both, we run thyroid properly rather than TSH alone, plus a metabolic panel and vitamin D. Thyroid and iron deficiency mimic low hormones closely enough that treating the hormones first is a common and expensive mistake. Sometimes the answer to the fatigue is not hormone therapy, and we would rather find that in the bloodwork than after six months of pellets.
Related treatments
24002 Via Fabricante, Suite 201, Mission Viejo
Centrally located in Orange County. Easy parking, friendly front desk, and a comfortable waiting space designed for genuine conversation about your goals.
Saturday: Closed
Sunday: Closed
Answers before you book
How much does hormone replacement therapy cost?
The pellet procedure is the same for women and men and takes about 30 minutes, with lab work quoted separately. Pellets last three to five months on average, so most patients are treated two to three times a year. The consultation itself is free.
Do I need blood work first?
Yes, and this is not negotiable. A comprehensive panel before anything is prescribed, and repeat labs at six to eight weeks to see how you have responded. Prescribing hormones from a symptom questionnaire alone is not medicine, and we do not do it.
Is HRT included in the membership?
No. HRT is billed separately. The Feel Great membership tier gives you member pricing on the HRT program rather than including the treatment itself. That distinction matters and we would rather state it plainly here than have it discovered at the front desk.
How long do pellets last?
Three to five months on average, for both women and men, though it varies with metabolism and activity level. Very active patients often metabolize faster. We time the next insertion from your symptoms and your labs rather than from the calendar.
Pellets, injections or creams, which is better?
Pellets deliver a steady level without a daily task, which is why most of our patients choose them. Injections are cheaper up front but produce a peak and trough pattern that some people feel. Creams are the gentlest to start and stop but need daily application and carry a transfer risk to partners and children. The right answer depends on your labs, your symptoms and honestly on whether you will remember a daily routine.
What symptoms does HRT actually treat?
For women: hot flashes, night sweats, sleep disruption, mood changes, low libido, brain fog and vaginal dryness through perimenopause and menopause. For men: fatigue, loss of muscle mass, low libido, poor recovery, low mood and difficulty concentrating. What it does not do is act as a weight loss treatment on its own, and we will say so if that is the expectation.
When will I feel different?
Sleep and energy often shift within two to three weeks. Libido, mood and body composition take longer, commonly six to twelve weeks. The six-to-eight-week lab recheck exists because how you feel and what your levels are doing do not always agree, and the dose is adjusted on both.
Is bioidentical the same as natural?
No, and the marketing around this word is unhelpful. Bioidentical means the molecule is structurally identical to the hormone your body makes. It is still manufactured in a laboratory. The meaningful question is whether it is dosed against your actual labs by a clinician, not whether the word "natural" appears on the packaging.
Who will I actually see?
Lindsay Short, NP-BC, a board-certified nurse practitioner, who runs the program and performs the procedure. You see the same clinician at every visit, which matters more than usual on hormone therapy because the dose is adjusted over months against your labs and how you feel. The practice is physician-owned by Dr. Nezar Dahdal.
Start with the panel, not the prescription
A free consultation with a licensed provider, a comprehensive hormone panel, and a plan dosed against your actual numbers. No insurance, no referral, and no obligation to start.