Hormone Replacement Therapy for Menopause


Hormone Replacement Therapy for Menopause 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, Dr. 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.

What Is Menopause?

Menopause is defined as 12 consecutive months without a menstrual period. It is not a single event but a permanent shift in your hormonal landscape — one that affects virtually every system in your body. The average age of menopause in the United States is 51, though it can occur earlier or later.

Once you reach menopause, estrogen, progesterone, and testosterone levels settle at a significantly lower baseline than your reproductive years. For many women, this brings relief from the unpredictable fluctuations of perimenopause — but for many others, the sustained loss of hormones produces its own significant and ongoing symptoms.

We are now living a third of our lives beyond our reproductive years. Going without hormonal support for that stretch of life has real consequences for brain health, bone density, cardiovascular function, metabolism, and quality of life. Hormone replacement therapy is the most effective and well-studied tool we have to address that.

How Do I Know If I Am in Menopause?

Menopause is confirmed when you have gone 12 consecutive months without a menstrual period and there is no other medical explanation. At that point, you are considered postmenopausal — and that status does not change.

Common symptoms of menopause include:

· Hot flashes and night sweats · Vaginal dryness and discomfort with intimacy · Disrupted sleep · Mood changes, irritability, or low mood · Brain fog or memory difficulties · Fatigue · Joint aches · Low libido · Weight gain, particularly around the midsection · Thinning hair or skin changes

Blood work can support the clinical picture. Elevated FSH and low estradiol are consistent with menopause, though a single lab value is never the whole story — symptoms and history matter just as much.

If you have had a hysterectomy, the 12-month rule does not apply. In that case, symptoms and laboratory testing guide the diagnosis.

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. Randomized studies now show that women who begin hormone therapy within 10 years of the onset of menopause — generally before age 60 — have a reduction in all-cause mortality and fractures. Timing matters enormously. The window of greatest benefit is earlier than most women realize.

How Hormone Therapy Can Help

Hormone replacement therapy is the most effective treatment available for the symptoms of menopause. It also provides long-term protection for your bones, brain, heart, and metabolism — benefits that extend well beyond symptom relief.

Estradiol is the cornerstone of treatment for most menopausal women, addressing hot flashes, sleep, mood, vaginal health, bone density, and cardiovascular protection. Progesterone — in its bioidentical micronized form — is added for women with a uterus to protect the uterine lining and also supports sleep and mood. Testosterone addresses libido, energy, muscle tone, and cognitive sharpness. For some patients, clinical needs may call for additional or alternative hormonal formulations, and we will always tailor treatment to what is most appropriate for you.

Every patient receives a thorough clinical evaluation — a detailed symptom history, physical assessment, and targeted laboratory testing. From there, we build a treatment plan specific to you. Follow-up testing ensures we stay within optimal ranges and that your symptoms are fully resolved.

Is Hormone Therapy Safe?

When initiated in the right candidate, at the right time, using the right formulation and route — yes. The outdated black box warnings that discouraged women and providers for over 20 years have now been formally removed by the FDA. Hormone therapy safety depends on how treatment is designed and who receives it. We evaluate each patient individually, and we have always practiced this way.

Cost of Hormones

We believe hormone replacement therapy should be accessible. Our approach is designed with that in mind:

Most of the hormones we prescribe — including estradiol and progesterone — are FDA-approved medications available at standard pharmacies and are covered by most insurance plans, meaning your out-of-pocket cost is often no more than a standard prescription copay.

Testosterone for women, while widely used, is prescribed off-label and may not be covered by all insurance plans, though it is available at low cost through many pharmacies.

Compounding is used only when a patient's clinical needs cannot be met by a commercially available product. Compounded medications are not covered by insurance, and we will always discuss cost and options with you before going that route.

Want to Learn More?

The New Menopause — Dr. Mary Claire Haver, MD

Estrogen Matters — Dr. Avrum Bluming & Carol Tavris

Not sure you're quite there yet? Click here to learn more about perimenopause and whether that might better describe where you are right now.

Ready to talk? Fill out the form below and we will be in touch shortly. You can also call us directly at 540-542-1700.