Are your menopause symptoms affecting your quality of life?
Hormone Replacement Therapy (HRT) is one of the most effective and now better-understood treatments for menopause symptoms. Our physicians in Novi, MI can help you determine if HRT is right for you.
| ✓ Hot flashes & night sweats | ✓ Sleep disruption |
| ✓ Mood changes & anxiety | ✓ Brain fog & memory issues |
| ✓ Joint pain & fatigue | ✓ Reduced libido |
| Schedule a consultation | 📞 (248) 426-7200 |
Serving Novi, West Bloomfield, Commerce Township, Wixom, Northville and surrounding Oakland County communities
SYMPTOM ASSESSMENT
The Greene Climacteric Scale — how are your symptoms?
The Greene Climacteric Scale is a validated tool used by physicians to assess menopause symptom severity. Review the symptoms below and rate each from 0 (not at all) to 3 (extremely). A total score of 15 or more may indicate you are a good candidate for HRT.
0 = Not at all | 1 = A little | 2 = Quite a bit | 3 = Extremely | 🌡️ 15+ You may be a good candidate for HRT If you score 15 or more on the Climacteric Scale — or if any individual symptom is rated as significant — we encourage you to schedule a consultation to discuss your options. Score interpretation: 0–7: Minimal symptoms 8–14: Moderate — worth a conversation 15+: Significant — likely a good HRT candidate This scale is a screening tool only. Final candidacy is determined by your physician after a full consultation including medical history and lab work. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
UNDERSTANDING HRT
What is hormone replacement therapy — and what does the latest research say?
Hormone Replacement Therapy (HRT) — also called Menopausal Hormone Therapy (MHT) — replaces the estrogen and progesterone your body stops producing during menopause. For decades, fears driven by a 2002 study caused many women to go without treatment they could have benefited from. The science has since moved significantly forward.
🔬 Recent research — JAMA, November 2025
In a landmark viewpoint published in JAMA (Makary et al., 2025), FDA physicians reported that hormone therapy initiated within 10 years of menopause onset has been associated with significant long-term benefits for younger postmenopausal women. As a result, the FDA updated HRT labeling in early 2026 — removing the black box warnings that had discouraged appropriate use for over two decades.
25–50% Reduction in fatal cardiovascular events associated with HRT | 50–60% Reduction in bone fractures when HRT started within 10 years of menopause | 64% Reduction in cognitive decline associated with early HRT initiation | 35% Decreased risk of Alzheimer’s disease associated with hormone therapy |
⏱ The timing window matters
Research consistently shows that HRT is most beneficial when started within 10 years of menopause onset or before age 60. This is known as the “timing hypothesis” or “window of opportunity.” Starting earlier appears to be critical in determining whether you get the cardiovascular, bone, and cognitive benefits of therapy. If you are in perimenopause or early menopause, now is the optimal time to have this conversation.
* Statistical associations cited from Makary MA, Nguyen CP, Høeg TB, Tidmarsh GF. Updated Labeling for Menopausal Hormone Therapy. JAMA. 2026;335(2):117–118. doi:10.1001/jama.2025.22259. This information is for educational purposes. Individual risk-benefit assessment with your physician is essential.
IS HRT RIGHT FOR ME?
Understanding your candidacy
✅ You may be a good candidate if: ✓ You are in perimenopause or within 10 years of menopause onset ✓ You score 15 or more on the Greene Climacteric Scale ✓ Hot flashes or night sweats are disrupting your sleep or daily life ✓ You have significant mood changes, brain fog, or anxiety ✓ You are concerned about bone density or fracture risk ✓ You have genitourinary symptoms — vaginal dryness, recurrent UTIs ✓ You are under 60 years old with no significant contraindications | ⚠️ HRT may not be appropriate if: ! You have a personal history of estrogen receptor-positive breast cancer ! You have a history of blood clots (DVT, pulmonary embolism) ! You have active or recent liver disease ! You have unexplained vaginal bleeding ! You have untreated endometrial cancer These are general guidelines. Many women with complex histories can still access forms of HRT — including topical vaginal estrogen — that carry different risk profiles. Only a physician consultation can determine your specific options. |
TYPES OF HRT WE DISCUSS
Formulation options — one size does not fit all
Transdermal estrogen Patches, gels or sprays applied to skin. Does not pass through the liver — generally lower clot risk than oral forms. | Oral estrogen + progesterone Tablet form — convenient but has different risk profiles. Micronized progesterone (Prometrium) is preferred over older synthetic progestins. | Topical vaginal estrogen Cream, ring or tablet for local symptoms. Very low systemic absorption — now has its own updated FDA labeling separate from systemic HRT. |
COMMON QUESTIONS
Frequently asked questions about HRT
Does PrimeCare of Novi offer hormone replacement therapy?
Yes. Our physicians at PrimeCare of Novi offer menopause consultations and hormone replacement therapy for appropriate candidates. We serve women in Novi, West Bloomfield, Commerce Township, Wixom, Northville and surrounding Oakland County communities. Call (248) 426-7200 or request an appointment online.
Is HRT safe? I heard it causes breast cancer.
The concerns about breast cancer were largely driven by a 2002 Women’s Health Initiative study that has since been significantly reanalyzed. The increased risk observed was attributed to a specific progestin formulation (medroxyprogesterone acetate) that is not commonly used today. The FDA updated HRT labeling in early 2026, removing black box warnings and clarifying that modern formulations — particularly when started within 10 years of menopause — have a different and more favorable benefit-risk profile for younger women. Your physician will review your individual history to determine what is appropriate for you.
How do I know if I need HRT?
The Greene Climacteric Scale above is a good starting point. If you score 15 or more, or if any individual symptom — particularly hot flashes, sleep disruption, mood changes or brain fog — is rated as significant, you may be a good candidate. A consultation with your physician, including a review of your medical history and lab work, is the only way to make a definitive determination.
When is the best time to start HRT?
Research consistently shows that HRT is most beneficial when started within 10 years of menopause onset or before age 60 — what researchers call the “window of opportunity.” Starting during perimenopause or early menopause appears to be optimal for cardiovascular, bone, and cognitive protection. If you are approaching or in menopause and experiencing symptoms, now is the time to have this conversation.
What types of HRT are available?
There are many formulations including transdermal patches and gels, oral tablets, and topical vaginal preparations. The right choice depends on your symptoms, medical history, and personal preference. Transdermal estrogen generally carries a lower clot risk than oral forms. Micronized progesterone is preferred over older synthetic progestins for women with a uterus.
Will HRT help my sleep and mood?
For many women, yes. Estrogen has a direct effect on sleep architecture and mood regulation. Night sweats that disrupt sleep, mood instability, anxiety, and brain fog are often significantly improved with appropriate HRT. These improvements are frequently among the first that women notice after starting treatment.
Does insurance cover HRT consultations and prescriptions?
Menopause consultations are typically covered as an office visit under most major insurance plans. HRT prescription coverage varies by plan and formulation. We accept Blue Cross Blue Shield, Aetna, United Healthcare, Priority Health, Medicare, and more. Call our office at (248) 426-7200 for specific coverage questions.
How long will I need to take HRT?
Treatment duration is individualized. The 2026 FDA labeling update specifically removed the previous recommendation to use HRT at the “lowest dose for the shortest duration” — recognizing that treatment decisions should be based on individual clinical judgment. Many women use HRT for years with ongoing monitoring. Your physician will work with you to find the right approach for your specific situation.
TAKE THE NEXT STEP
You deserve to feel like yourself again
If your symptoms are affecting your quality of life, you don’t have to accept them as inevitable. Schedule a menopause consultation at PrimeCare of Novi and let’s talk about whether HRT is right for you.
| Schedule a menopause consultation | 📞 (248) 426-7200 |
📍 39555 W. Ten Mile Rd, Suite 302 Novi, MI 48375 | Mon–Fri 8AM–5PM Same-week appointments often available | Serving Oakland County Novi · West Bloomfield · Northville · Wixom |
This page is for informational and educational purposes only and does not constitute medical advice. Individual treatment decisions should be made in consultation with a qualified physician who can review your complete medical history.