✦ Alchemy of Renewal ✦
Perimenopause & Menopause Care at Milford Med Spa & Wellness
Perimenopause and menopause are natural transitions, but they don’t have to mean losing your spark. At Milford Med Spa & Wellness, we believe this stage of life can be a season of empowerment, vitality, and confidence when guided with the right care.
Our providers combine medical expertise with compassionate support to help you navigate symptoms, balance hormones, and rediscover your glow.
✧ Why This Care Matters to The Alchemista
For Dr. Courtney Holmes, APRN (The Alchemista), hormone care isn’t just professional, it’s personal.
When she entered perimenopause in her mid-thirties, life changed in ways she wasn’t prepared for. New anxiety, crushing fatigue, unexplainable joint pain, restless nights, and a complete loss of libido began to erode her confidence and her marriage. She and her life partner struggled with mismatched intimacy and years of frustration that felt out of her control.
Everything shifted when she finally found a provider who understood, prescribed hormones, and helped her body return to balance. It was nothing short of life-changing, her energy returned, sleep stabilized, and intimacy with her spouse blossomed again.
Because of how profound this transformation was, Courtney went on to pursue specialty education in hormone care for men and women, determined to bring the same renewal to others who are suffering silently. Today, she offers this deeply personal, highly specialized care through Milford Med Spa & Wellness, ensuring no one has to walk through perimenopause or menopause alone.
✧ Menopause Advocacy Beyond the Treatment Room
Courtney’s commitment to improving menopause care extends beyond her work with individual patients. She speaks to healthcare professionals, students, and community audiences about the frequently overlooked connections between hormonal changes, mental health, cardiovascular health, sexuality, and healthy aging.
Her advocacy includes presenting on the neuroendocrine effects of perimenopause and menopause at the Women’s Mental Health Conference at Yale School of Medicine and speaking through the American Heart Association’s STEM Goes Red initiative about women’s heart health and hormones across the lifespan.
✧ What Happens in Perimenopause & Menopause?
Hormones like estrogen, progesterone, and testosterone begin to shift, and with them, so does the way you feel. You may experience:
Hot flashes & night sweats
Sleep disturbances
Mood swings or increased anxiety
Vaginal dryness or discomfort with intimacy
Weight changes or stubborn belly fat
Brain fog & memory lapses
Decreased libido
Loss of muscle tone or energy
These symptoms are common, but they don’t have to define you. With the right support, you can move through this chapter feeling vibrant and in control.
✧ The Forgotten Hormone: Testosterone in Women ✧
When people think of hormones and menopause, estrogen and progesterone usually come to mind. But there’s another key player often overlooked: testosterone.
In women, testosterone naturally declines with age, often even earlier than estrogen, and low levels can contribute to:
Loss of energy and stamina
Decreased libido and sexual satisfaction
Mood changes and irritability
Brain fog and reduced motivation
Loss of lean muscle and strength
Restoring testosterone balance can be life-changing, helping women feel stronger, more focused, and more connected to themselves and their partners. At Milford Med Spa & Wellness, we make sure this essential hormone isn’t left out of your care plan.
✧ How to Get Started
Getting started with hormone care at Milford Med Spa & Wellness is a guided, step-by-step process designed for safety, clarity, and thorough provider review.
Step 1: Book “Request Hormone Labs” (Administrative Setup Visit)
This visit is used by our team to get you started behind the scenes.
After booking, you’ll receive initial forms that include demographic and insurance information only.
Please do not attend this appointment.
This time is reserved for our staff to:
enter your demographic and insurance information
place your hormone lab orders
prepare your chart for care coordination
Clinical questions and medical decision-making do not occur at this stage.
Step 2: We Schedule Your Quest Lab Appointment
Once your administrative setup is complete, our scheduler will contact you within the same week to:
schedule your Quest Diagnostics lab appointment for you
review lab instructions
Lab requirements:
Fasting is required
Labs must be drawn between 7:00–9:00 AM due to cortisol testing
Step 3: Book Your Initial Hormone Evaluation (In-Person Visit)
After your Quest labs are scheduled, we will book your in-person Initial Hormone Evaluation with our Nurse Practitioner.
At that time, you will receive a second set of intake forms specific to hormone evaluation and medical decision-making.
📋 Important safety policy:
These hormone-specific intake forms must be completed at least 1 week prior to your Nurse Practitioner visit
This advance completion is required so the provider can review your history thoroughly and safely
Incomplete forms may result in cancellation and rescheduling per policy
Step 4: In-Person Nurse Practitioner Visit
During your visit, your Nurse Practitioner will:
review your symptoms, labs, and medical history
discuss hormone patterns and treatment options
create an individualized care plan based on evidence-based medicine
This is where all medical evaluation, diagnosis, and treatment decisions occur.
⚠️ Please note:
We do not provide gender transition hormone care.
✧ Our Approach to Care
We see perimenopause and menopause as a whole-body transformation, not just a list of symptoms. That’s why our care includes:
Comprehensive Evaluation & Labs with a root-cause approach: we turn over every stone that could be contributing to your symptoms. If something beyond hormones is identified, we’ll refer you to a trusted provider.
Individualized Hormone Prescriptions using estrogen, progesterone, and testosterone in oral, topical, patch, injectable, or pellet formulations
Ongoing Monitoring & Adjustments so your plan evolves with your needs
Integrative Support from nutrition and Certified Menopause Coaches to enhance results
✧ Been Told You’re “Not a Candidate”? Let’s Take a Closer Look.
If it has been more than 10 years since your final menstrual period, you may have been told that you are “too late” to consider menopause treatment. We do not use an arbitrary date as an automatic reason to turn women away.
Starting systemic hormone therapy later in menopause requires a more careful, individualized assessment of potential benefits and risks—but being more than 10 years past menopause does not mean you should assume there are no options for you.
At Milford Med Spa & Wellness, we evaluate your health history, symptoms, personal and family risk factors, medications, appropriate screenings and preventive care to determine what treatment options may be appropriate and safe for you.
A History of Cancer Does Not Mean You Have to Suffer in Silence
If you have had breast cancer or another cancer that may be hormone-sensitive, we encourage you not to assume that menopause care is off the table.
Some hormone therapies may not be appropriate depending on the type of cancer, receptor status, treatment history and individual risk. But menopause care is much broader than simply prescribing systemic estrogen.
We will:
Review your individual history, risks and current symptoms.
Consider hormonal and nonhormonal treatment options when appropriate.
Review relevant evidence, clinical guidelines and evolving research.
Work collaboratively with your oncologist, gynecologist, primary-care provider or other specialists when needed.
Reassess your treatment over time as your health, the evidence and clinical recommendations evolve.
Our goal is not to fit every woman into the same protocol. It is to understand your individual situation and help you determine the safest, most effective path forward.
You do not have to decide on your own that you are “too old,” “too late,” or “too complicated” to ask for help.
Let us evaluate the whole picture with you.
✧ Having Trouble Finding Your Estradiol Patch? You Have Options.
The current estradiol patch supply challenges have been frustrating and stressful for many women—especially after finally finding a hormone regimen that helps them feel comfortable and well in their bodies.
We are committed to helping our patients avoid unnecessary interruptions in their hormone therapy.
If your usual estradiol patch is unavailable, please contact us rather than simply going without your medication. During your visit, we can discuss alternative options based on your symptoms, medical history, current dose, preferences and individual risk factors.
Depending on what is appropriate for you, options may include:
A different estradiol patch or formulation, depending on pharmacy availability
Daily estradiol gel
Injectable estradiol, including weekly treatment for appropriate patients
Estradiol pellet therapy for appropriate patients
Other individualized strategies to maintain your treatment while patch availability is limited
Already Receiving Testosterone Pellets?
Many of our patients who receive testosterone pellet therapy have chosen to add estradiol pellets at no additional cost when estradiol is medically appropriate for them. This can provide another option for patients who prefer not to rely on patch availability.
We’re Also Working on a Backup-Patch Option
We are currently working to make it possible for established patients to purchase one box of estradiol patches out of pocket as a backup supply for times when their pharmacy or commercial insurance cannot reliably meet their needs.
We will share additional information with our patients as this option becomes available.
If you and your clinician have decided that continuing estrogen therapy is right for you, a pharmacy shortage should not leave you without a plan.
Please reach out to us. There are options, and we will work with you to find the safest and most practical approach for maintaining your care.
✧Getting Started with Hormone Care
- Book your “Request Hormone Labs” setup visit (complimentary, not attended)
After booking your “Request Hormone Labs” visit and completing the initial demographic and insurance forms, our scheduling team will reach out to you directly to:
schedule your Quest Diagnostics lab appointment
schedule your in-person Nurse Practitioner hormone evaluation once labs are coordinated
You do not need to book labs or provider visits on your own.
✧ Pricing & Insurance Information
Initial Nurse Practitioner Evaluation
Cost: $200 (private pay or insurance)
We now accept most health insurance plans for women’s hormone care. If your insurance plan is accepted and applied, the initial Nurse Practitioner evaluation may be covered. If insurance is not used or not accepted for your plan, the private-pay cost for the initial evaluation is $200.
Testosterone therapy is not covered by insurance and is always private pay.
Ongoing Care
Insurance-Based Ongoing Care
We accept most health insurance plans for ongoing visits when treatment includes estrogen and/or progesterone only and prescriptions are filled through commercial pharmacies.
Private-Pay / Compounded Hormone Care
$167 per month (3 month commitment) when using one compounded hormone, such as:
testosterone (cream, injection, or pellet)
estrogen or progesterone compounded to meet individualized dosing or absorption needs when commercial options are not effective or appropriate
Compounded medications allow for personalized treatment but are not covered by insurance.
Important Notes
Insurance coverage varies by plan and carrier
Patients are responsible for verifying benefits and provider participation
All treatment decisions are based on medical necessity, safety, and response to therapy
✧ What’s Included in Your Care Plan?
Your care goes beyond prescriptions. It includes:
Access to our nurses & Certified Menopause Coaches anytime for support and guidance
Exclusive Discounts on select spa & wellness services, such as:
15 % off PRFM hair restoration treatment
50% off IPL hair removal for the face
50% off waxing of face
Flexible Formulations: oral pills, Topiclick™ creams, patches, injections, and pellets customized for your body
✧ Sexual Wellness & Intimacy Support
Hormone changes can affect much more than hot flashes and sleep. Changes in libido, arousal, orgasm, vaginal comfort, body confidence, intimacy and connection are common concerns during perimenopause and menopause—and they deserve to be part of the conversation.
Ashley Fox, LPN, Certified Menopause Coach & Sex Therapy Practitioner, provides a comfortable, inclusive and shame-free space to talk about sexual wellness, changing desire, intimacy, pleasure and communication.
Ashley works alongside our hormone-care providers so that when sexual concerns may have a medical or hormonal component, your care can be approached collaboratively and as a whole person.
There is no single definition of a “normal” sex life. Our goal is to help you better understand what you are experiencing, explore what you want, and feel comfortable talking about concerns that are often left unspoken.
[READ ASHLEY’S BLOG: A LEGACY OF SEXUAL WELLNESS — WHY YOU CAN TALK TO ME ABOUT SEX]
Diana Greenia, APRN — Nurse Practitioner with advanced training in women’s hormone health and an Integrative Nutrition Health Coach Certificate. Fluent in Spanish and English, Diana provides thoughtful, individualized hormone care throughout perimenopause and menopause.
Courtney Holmes, APRN (The Alchemista) — Founder, Medical Director and Menopause & Hormone Care Specialist. After her own transformative experience with perimenopause and hormone therapy, Courtney made comprehensive midlife hormone care a cornerstone of Milford Med Spa.
Kelly Cahill, LPN — Certified Menopause & Nutrition Coach — Offers practical education, encouragement and support for symptoms, nutrition, body changes and everyday life throughout the menopause transition.
Ashley Fox, LPN — Certified Menopause Coach & Sex Therapy Practitioner — Supports patients navigating menopause, hormone changes and sexual wellness, including changes in desire, intimacy, pleasure, body confidence and communication.
Nevaeh Cortez — Scheduler — Manages initial setup visits, demographic and insurance intake, and behind-the-scenes coordination with Quest Diagnostics and our clinical team to keep your care on track and stress-free.
✧ Recommended Resources ✧
Education is power. Alongside your personalized care at Milford Med Spa & Wellness, we encourage you to explore these trusted resources to better understand the menopause journey:
📚 Reading
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Navigating Perimenopause: A published conversation in Milford City Lifestyle with Dr. Courtney Holmes, APRN (The Alchemista), sharing insights on symptoms, treatments, and the importance of support.
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The New Menopause by Mary Claire Haver, MD: A practical guide to thriving through midlife with medical, nutritional, and lifestyle strategies.
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The Menopause Brain by Lisa Mosconi, PhD: Groundbreaking science on how hormones affect memory, mood, and brain health.
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Estrogen Matters by Avrum Bluming, MD & Carol Tavris, PhD: An evidence-based look at hormone therapy and why estrogen deserves a place in women’s health.
✧ Upcoming Hormone & Sexual Wellness Events
Education and community are an important part of our mission. Milford Med Spa & Wellness hosts special events throughout the year focused on hormone health, menopause, sexual wellness and healthy aging.
SEX OVER 35
Hormones. Desire. Pleasure. Connection.
Tuesday, September 29, 2026 | 6–8 PM
Milford Med Spa & Wellness
99 Cherry Street, Milford, CT
Free to attend • Ages 18+
Join Dr. Courtney Holmes, DNP, APRN and Ashley Fox, LPN, Sex Therapy Practitioner, for a candid, inclusive and shame-free conversation about how hormones, health, relationships and changing bodies can affect sexuality after 35.
All genders, sexualities and relationship structures are welcome. Come alone, with a partner or with friends.
[LEARN MORE & RSVP FOR SEX OVER 35]
Check back for additional upcoming educational events from Milford Med Spa & Wellness.
✧ Do You Use Testosterone? The FDA Wants to Hear From Women.
For decades, women have had no FDA-approved testosterone product specifically formulated for them in the United States, even though testosterone is prescribed off-label for some menopausal women when clinically appropriate.
Right now, women have an opportunity to make their voices heard.
The FDA’s Office of Women’s Health and Center for Drug Evaluation and Research are holding a public workshop on Testosterone Use in Menopausal Women and have opened a public docket seeking comments about the risks and benefits of testosterone therapy in menopausal women.
The information gathered will help inform future research and the potential development of testosterone products specifically for women.
If You Take Testosterone, Consider Sharing Your Experience
If testosterone therapy has been part of your menopause care, your lived experience matters. Patients may submit their own comments directly to the FDA about their experiences, concerns, benefits, side effects, treatment access and what they believe researchers and regulators should understand about testosterone use in women.
Public comments are being accepted through October 19, 2026.
[SUBMIT A PUBLIC COMMENT TO THE FDA]
You do not need to be a healthcare professional to comment. Patients and members of the public are invited to participate.
Please remember that comments submitted to the federal docket are public. Do not include personal health information or other information you do not want publicly available.
FDA Public Workshop
Testosterone Use in Menopausal Women
September 17, 2026
9:00 AM–4:30 PM ET
Virtual and in-person participation available
Not Sure What to Write?
You do not need medical or scientific language to submit a comment. The FDA is interested in hearing from patients about their real-world experiences.
You may use the message below as a starting point, then add your own experience in your own words.
Suggested Comment
I am a woman who has used testosterone as part of my medical care, and I appreciate the opportunity to share my experience with the FDA.
I encourage the FDA to consider both the available scientific evidence and the experiences of women who are currently receiving testosterone therapy under the care of qualified healthcare professionals.
There are currently no FDA-approved testosterone products specifically designed and dosed for women in the United States. This can create challenges related to access, dosing, insurance coverage, cost and consistency of treatment.
My experience with testosterone has been:
[Tell the FDA what symptoms led you to consider testosterone and what your experience has been.]
For me, testosterone has affected:
[Examples: sexual desire, arousal, sexual satisfaction, energy, well-being, muscle strength, motivation, mood, or other symptoms that are important to you.]
Before treatment, I experienced:
[Describe how you felt and how these symptoms affected your quality of life, relationships or daily activities.]
Since beginning testosterone, I have noticed:
[Describe any benefits, lack of benefit or side effects you have experienced.]
One challenge I have experienced in accessing testosterone treatment is:
[Examples: cost, insurance not covering treatment, difficulty finding knowledgeable clinicians, limited formulations for women, pharmacy availability, stigma or other barriers.]
What I would most like the FDA to understand about testosterone treatment for women is:
[Your own words.]
I hope the FDA will continue to evaluate the evidence regarding testosterone therapy in women and support rigorous research and the development of safe, appropriately dosed treatment options specifically for women.
Thank you for considering the experiences of women who are directly affected by this issue.
Your Experience Matters
There is no “right” answer. You can support testosterone treatment, express concerns about it, describe mixed results, or simply tell the FDA what you believe should be studied.
Please do not include your name, date of birth, medical-record information or other private health information that you do not want publicly available. FDA docket comments are public.
✧ Begin Your Transformation ✧
Perimenopause and menopause are inevitable, but suffering through them is not. At Milford Med Spa & Wellness, we help you reclaim energy, balance, and self-expression during this powerful life transition.
✧ Couples Hormone Health
Hormonal changes rarely affect just one person in a relationship. Many of our female clients tell us that while they’re navigating perimenopause or menopause, their partner is also noticing the effects of declining testosterone.
That’s why we offer hormone care for men as well as women, and many couples choose to come in together for back-to-back evaluations.
💡 Special Offer: When you and your partner both schedule your hormone evaluations, you’ll receive $50 off your initial visit for the man (men’s evaluations and ongoing care are not covered by health insurance).
✨ Supporting each other through this transformation can make the journey more successful and more connected.