Hormone Replacement Therapy

Bioidentical hormone replacement therapy

Hormone Replacement Therapy at The Lee Clinic

The Lee Clinic has been a leader in hormone replacement therapy in Northern Virginia for over 40 years. Founded by Dr. William Lee, MD — a pioneer in hormone medicine since the early 1990s — the clinic is now led by his daughter, Megan Lee, DO, who brings that same philosophy into a modern, evidence-based practice: that hormones matter, and that feeling like yourself again is not too much to ask.

The Science Has Caught Up

For decades, many women were told that hormone therapy was too risky — a message rooted largely in a 2002 study that has since been widely criticized for its flawed methodology. That study used older women, later in life, on synthetic hormones — and its conclusions were broadly misapplied to all women and all hormone therapies.

In February 2026, the FDA approved labeling changes to menopausal hormone therapy products, removing risk statements related to cardiovascular disease, breast cancer, and probable dementia from the black box warning — the agency's most prominent safety label. This is a significant shift, and one that validates what clinicians like Drs. Lee have understood for years.

Randomized studies now show that women who begin HRT within 10 years of the onset of menopause — generally before age 60 — have a reduction in all-cause mortality and fractures. Timing matters. Starting earlier, in the right candidate, changes the risk-benefit equation entirely.

Hormone therapy safety depends on how treatment is designed and who receives it — risk varies based on multiple clinical factors that must be evaluated together, not in isolation. This is exactly how we practice.

Why Hormones Matter

We are now living a third of our lives beyond our reproductive years. Hormonal decline doesn't just cause symptoms — it drives aging, affects brain health, bone density, cardiovascular function, and quality of life. The goal of BHRT is not to chase youth; it's to maintain the function and vitality you deserve.

Key hormones for women — and what happens when they decline:

Estradiol · Progesterone · Testosterone · DHEA

An imbalance in these hormones can show up as:

Hot flashes · Night sweats · Vaginal dryness · Low sex drive · Mood swings · Brain fog · Memory difficulties · Insomnia · Depression · Fatigue · Irregular or heavy periods · Weight gain · Hair loss · Bone loss

Key hormones for men — and what happens when they decline:

Testosterone · Estradiol · DHEA

Men lose roughly 2% of testosterone per year after age 25. Left unaddressed, this can lead to:

Decreased sex drive and performance · Loss of muscle mass · Fatigue · Depression · Weight gain · Memory loss · Sleep disorders · Urinary problems · Reduced cardiovascular health

Our Approach

We use bioidentical hormones — estradiol and progesterone in women, rather than synthetic progestins or conjugated equine estrogens (like Premarin). Bioidentical hormones are structurally identical to what your body makes, allowing for a more precise, personalized fit.

Every patient receives a thorough clinical evaluation: a detailed symptom history, physical assessment, and targeted laboratory testing. From there, we build a treatment plan tailored specifically to you — not a one-size-fits-all protocol. Follow-up lab testing ensures we stay within optimal ranges and that your symptoms are fully addressed.

HRT remains the most effective treatment for hot flashes, night sweats, vaginal dryness, sexual dysfunction, and mood changes — and it also prevents bone loss, improves lean body mass, and reduces fracture risk.

Frequently Asked Questions

What hormones do you use? We use bioidentical estradiol and progesterone for women, and bioidentical testosterone for men — not synthetic hormones. These are matched to your body's own molecular structure for better precision and tolerability.

How do you know which hormones are out of balance? Through a combination of symptom review and laboratory testing, we can identify deficiencies and imbalances quickly and accurately. For women who are still cycling, timing of labs matters and we guide you through that process.

Is treatment customized to me? Yes, completely. Starting doses are based on your labs and symptoms, and we adjust over time until you feel your best — not just until your numbers look normal on paper.

Is HRT safe? When initiated in the right candidate, at the right time, using the right formulation and route — yes. The outdated black box warnings that frightened patients and providers for over 20 years have now been formally removed by the FDA. We have always practiced with this individualized, evidence-based approach.

Want to Learn More?

The New Menopause — Dr. Mary Claire Haver, MD

Estrogen Matters — Dr. Avrum Bluming & Carol Tavris

Ready to get started? Call The Lee Clinic at 540-542-1700 or contact us online to schedule your first appointment. We'd love to help you feel like yourself again.

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Hormone Replacement Therapy

Hormone Replacement Therapy at The Lee Clinic

The Science Has Caught Up

Randomized studies now show that women who begin HRT within 10 years of the onset of menopause — generally before age 60 — have a reduction in all-cause mortality and fractures. Timing matters. Starting earlier, in the right candidate, changes the risk-benefit equation entirely.

Hormone therapy safety depends on how treatment is designed and who receives it — risk varies based on multiple clinical factors that must be evaluated together, not in isolation. This is exactly how we practice.

Why Hormones Matter

Key hormones for women — and what happens when they decline:

Estradiol · Progesterone · Testosterone · DHEA

An imbalance in these hormones can show up as:

Hot flashes · Night sweats · Vaginal dryness · Low sex drive · Mood swings · Brain fog · Memory difficulties · Insomnia · Depression · Fatigue · Irregular or heavy periods · Weight gain · Hair loss · Bone loss

Key hormones for men — and what happens when they decline:

Testosterone · Estradiol · DHEA

Men lose roughly 2% of testosterone per year after age 25. Left unaddressed, this can lead to:

Decreased sex drive and performance · Loss of muscle mass · Fatigue · Depression · Weight gain · Memory loss · Sleep disorders · Urinary problems · Reduced cardiovascular health

Our Approach

We use bioidentical hormones — estradiol and progesterone in women, rather than synthetic progestins or conjugated equine estrogens (like Premarin). Bioidentical hormones are structurally identical to what your body makes, allowing for a more precise, personalized fit.

HRT remains the most effective treatment for hot flashes, night sweats, vaginal dryness, sexual dysfunction, and mood changes — and it also prevents bone loss, improves lean body mass, and reduces fracture risk.

Frequently Asked Questions

What hormones do you use? We use bioidentical estradiol and progesterone for women, and bioidentical testosterone for men — not synthetic hormones. These are matched to your body's own molecular structure for better precision and tolerability.

How do you know which hormones are out of balance? Through a combination of symptom review and laboratory testing, we can identify deficiencies and imbalances quickly and accurately. For women who are still cycling, timing of labs matters and we guide you through that process.

Is treatment customized to me? Yes, completely. Starting doses are based on your labs and symptoms, and we adjust over time until you feel your best — not just until your numbers look normal on paper.

Want to Learn More?

The New Menopause — Dr. Mary Claire Haver, MD

Estrogen Matters — Dr. Avrum Bluming & Carol Tavris

Ready to get started? Call The Lee Clinic at 540-542-1700 or contact us online to schedule your first appointment. We'd love to help you feel like yourself again.