--- title: "HRT Hormone Replacement Therapy" url: https://spokemed.com/clinical-services/hrt-hormone-replacement-therapy/ date: 2026-02-17 modified: 2026-08-22 lang: en author: "support@totoseo.com" description: "Bioidentical Hormone Replacement Therapy Schedule an Exploration Call Bioidentical Hormone Replacement Therapy for Perimenopause and Menopause Are you experiencing hot flashes, night sweats, mood changes, or other symptoms of menopause?..." word_count: 2736 --- # HRT Hormone Replacement Therapy # Bioidentical Hormone Replacement Therapy [Schedule an Exploration Call](https://spokemed.com/book-now/) ## Bioidentical Hormone Replacement Therapy for Perimenopause and Menopause Are you experiencing hot flashes, night sweats, mood changes, or other symptoms of menopause? At SPOKEmed, we provide personalized bioidentical hormone replacement therapy (BHRT) - also known as Menopause Hormone Therapy (MHT) - designed to help you feel like yourself again. Our approach focuses on addressing your unique symptoms while providing protective benefits for your long-term health. [Michelle Middleton, PA-C](https://spokemed.com/about/), takes time to understand your specific concerns and develops a customized treatment plan that aligns with the latest medical research. Experience relief from debilitating menopausal symptoms while potentially gaining protective benefits for your heart, brain, and bones. [Schedule Your BHRT Consultation](https://spokemed.com/book-now/) ## Understanding Bioidentical Hormone Therapy for Menopause Bioidentical hormone replacement therapy addresses the natural decline in hormone levels that occurs during perimenopause and menopause. When your body produces less estrogen, progesterone or testosterone, you may experience a range of uncomfortable symptoms that affect your quality of life, which can be alleviated through the use of bioidentical hormone therapy. BHRT works by supplementing these hormones to: - Relieve hot flashes and night sweats - Improve sleep quality and insomnia - Stabilize mood fluctuations - Address vaginal dryness and discomfort - Prevent bone loss that can lead to osteoporosis - Potentially reduce risk of heart disease and dementia when hormone replacement therapy is started at the appropriate time. Recent research has significantly changed our understanding of Menopause Hormone Therapy (MHT). The benefits and risks of bioidentical hormones now appear to favor treatment for most women when started before age 60 or within 10 years of menopause. ## The Four Pillars of Hormonal Health ![Icon Hormonla Balance - SPOKEmed telehealth wellness](https://spokemed.com/wp-content/uploads/2026/02/icon-hormonla-balance.png) ### Personalized Hormone Optimization Evidence based hormone therapy recommendations tailored to your symptoms, goals, medical history, and laboratory findings. ![Icon Nutrition - SPOKEmed telehealth wellness](https://spokemed.com/wp-content/uploads/2026/02/icon-nutrition-1-1.png) ### Nutrition and Metabolic Health Personalized nutrition strategies to support hormone production, blood sugar regulation, body composition, and overall wellness. ![Icon Strss Management 1 - SPOKEmed telehealth wellness](https://spokemed.com/wp-content/uploads/2026/02/icon-strss-management-1.png) ### Exercise and Physical Resilience Strength training, cardiovascular fitness, mobility, and movement recommendations designed to support muscle health, bone density, metabolic function, and healthy aging. ![Icon Sleep Optimization - SPOKEmed telehealth wellness](https://spokemed.com/wp-content/uploads/2026/02/icon-sleep-optimization.png) ### Sleep and Stress Recovery Strategies to improve sleep quality and manage stress, helping to optimize cortisol balance, recovery, energy, and hormone function. ## Our Bioidentical Hormone Replacement Approach At SPOKEmed, we take a thoughtful, evidence based approach to hormone therapy. We prioritize FDA approved bioidentical hormone options whenever appropriate, providing treatments that have undergone rigorous testing for safety, quality, and efficacy. These options are also often more affordable than compounded alternatives and are typically covered by insurance. Our recommendations are personalized to your symptoms, goals, health history, and laboratory findings to help you feel your best while supporting long term health. ## Benefits and Risks of BHRT ### Benefits Bioidentical hormones are made to be chemically identical to the hormones your body naturally produces. As hormone levels decline during menopause, bioidentical hormone therapy can help restore levels closer to what your body once produced. Similar to how you might supplement vitamin D when levels are low, hormone therapy replaces hormones that have decreased over time. Because bioidentical hormones have the same molecular structure as the body's natural hormones, they are recognized and utilized by the body in the same way as endogenous hormones, meaning the hormones naturally made by your own body, such as estrogen and progesterone. Potential benefits include: - Weight management and metabolic health support - Relief from hot flashes and night sweats - Improved sleep quality and reduced insomnia - Enhanced mood stability and emotional well being - Better cognitive function and mental clarity - Increased energy levels and vitality - Improved sexual function and vaginal comfort - Support for cardiovascular health, which often begins to decline during the perimenopausal transition - Protection against bone loss and osteoporosis risk ### Risks of BHRT ![icon-breast-cancer](https://spokemed.com/wp-content/uploads/2026/07/icon-breast-cancer.png) #### Breast Cancer The relationship between hormone therapy and breast cancer risk is often misunderstood. Risk depends on the type of hormones used, duration of treatment, and individual risk factors. In the Women's Health Initiative, the increased risk of breast cancer associated with estrogen plus a synthetic progestin was approximately 1 additional case per 1,000 women per year (0.1%). Research suggests that bioidentical micronized progesterone may have a more favorable breast safety profile than older synthetic progestins, although ongoing research continues to evaluate long term outcomes. ![icon-cardiovascular-problem](https://spokemed.com/wp-content/uploads/2026/07/icon-cardiovascular-problem.png) #### Cardiovascular Effects The cardiovascular effects of hormone therapy depend on factors such as age, existing cardiovascular health, timing of initiation, dose, route of administration, and type of hormone therapy used. For healthy women who begin hormone therapy before age 60 or within 10 years of menopause, current evidence suggests the benefit-risk profile is generally favorable. Starting hormone therapy later, particularly after age 60 or more than 10 years after menopause, may be associated with greater cardiovascular risk and requires a more individualized assessment.  ![icon-blood-clot](https://spokemed.com/wp-content/uploads/2026/07/icon-blood-clot.png) #### Blood Clots Hormone therapy can increase the risk of blood clots in some individuals, particularly with oral estrogen. Route of administration matters. Transdermal estrogen, such as a patch or gel, bypasses first pass liver metabolism and is associated with a lower risk of clotting compared with oral estrogen. Risk can be further minimized through appropriate patient selection, regular monitoring, and maintaining hormone levels within physiologic ranges rather than exceeding levels naturally seen in healthy before the perimenopausal transition. ![icon-liver-disease](https://spokemed.com/wp-content/uploads/2026/07/icon-liver-disease.png) #### Liver Disease Hormone therapy may not be appropriate for individuals with active liver disease or significantly impaired liver function. Because the liver plays an important role in hormone metabolism, underlying liver conditions can affect both the safety and effectiveness of treatment. A thorough medical evaluation is necessary to determine whether hormone therapy is appropriate and which route of administration may be safest. ## Bioidentical Hormone Delivery Methods At SPOKEmed, we offer several FDA-approved delivery methods for bioidentical hormones: - ### Transdermal (Skin) These methods allow hormones to be absorbed through the skin directly into the bloodstream, bypassing first pass liver metabolism. Transdermal estrogen is often preferred because it may offer a more favorable safety profile for some women.Patches: often the preferred transdermal option due to consistent absorption- Gels- Creams****While creams and gels can be effective options, absorption may be more variable depending on factors such as application technique, skin characteristics, and individual response.** - ### Oral Oral medications are convenient and effective for many women. Oral micronized progesterone is often a first line option when progesterone is needed. Oral estrogen undergoes first pass liver metabolism, which may influence hormone processing and certain risks. Oral micronized progesterone- Estrogen tablets- ### Other Methods Additional delivery methods may be appropriate depending on symptoms, goals, and individual needs. Vaginal estrogen for localized genitourinary symptoms such as dryness, irritation, recurrent urinary tract infections, and discomfort with intercourse- Testosterone injections when clinically indicated- Compounded hormone preparations, such as troches and creams may be considered in select situations when commercially available FDA approved options do not adequately meet a patient's needs, but they are generally not the first line approach **We do NOT use pellet therapy** due to concerns about inconsistent hormone levels and inability to adjust or remove if side effects occur. ## Hormone Replacement Therapy Success Stories - [Weight frustration ](javascript:void(0);) - [Hormonal Fog ](javascript:void(0);) - [Painful intimacy ](javascript:void(0);) Weight frustration ### Weight Frustration #### "I wasn’t doing the wrong things. I just needed a plan that was personalized for my body" - Susan #### When She First Came to SPOKEmed Susan came to SPOKEmed just a few months before her 60th birthday with one goal: to lose weight and feel confident celebrating this milestone. She had been working with a personal trainer for over a year, strength training several days a week, doing regular cardio, and meticulously tracking everything she ate. Despite all of her hard work, she continued gaining weight, especially around her midsection. Her trainer believed her metabolism had adapted and encouraged her to increase her calorie intake, but the weight continued to climb. She was exhausted, discouraged, and beginning to wonder if her body was simply changing because of age. She told us, “I’ve never worked this hard and seen so little progress.” #### What We Did Together Rather than recommending another diet, we took a comprehensive look at what was happening beneath the surface. We reviewed her hormones, metabolic health, body composition, nutrition, exercise routine, and lifestyle. We optimized her existing hormone replacement therapy to better support her symptoms and metabolic health. Because insulin resistance appeared to be contributing to her inability to lose weight, we added a GLP-1 medication and adjusted her macronutrient goals to support fat loss while preserving lean muscle. We also started her on a continuous glucose monitor (CGM), which helped identify how different foods affected her blood sugar and allowed us to personalize her nutrition even further. Throughout the process, we met regularly to review her CGM data, monitor her progress, and make adjustments based on her body’s response. After About 3 Weeks Within a few weeks, Susan noticed she had more consistent energy throughout the day and found it much easier to follow a lower-carbohydrate nutrition plan because her blood sugar was becoming more stable. Seeing her glucose patterns in real time helped her make small dietary changes that significantly improved her metabolic health and insulin resistance. Most exciting of all, for the first time in years, the scale finally started moving in the right direction. After 2–3 Months By her 60th birthday, Susan had lost weight, reduced body fat while preserving muscle, and was finally seeing results that reflected the effort she had been putting in all along. Her clothes fit comfortably again, she felt stronger during her workouts, had more energy, and regained confidence in her body. > "I Was Doing Everything Right but Kept Gaining Weight." - SUSAN Hormonal Fog ### Hormonal Fog #### “I finally feel like my brain is starting to wake up." - Lisa #### When She First Came to SPOKEmed Lisa, 48, came to SPOKEmed feeling overwhelmed and frustrated. She had been hesitant to start hormone replacement therapy because she wanted to take a more “natural” approach first. Over the past few years, she had tried numerous supplements, worked with different providers, and spent countless hours researching her symptoms online. Despite her best efforts, she continued to struggle with hot flashes, night sweats, vaginal dryness, midsection weight gain, poor sleep, and brain fog. Eventually, she stopped everything because she wanted to start over with a clear, personalized plan. She told us, “I used to be sharp. Now I walk into a room and forget why I’m there.” Her energy was low, she had no motivation to exercise, and her primary care provider told her her hormone levels were “normal,” but she knew something wasn’t right. #### What We Did Together Rather than focusing on a single lab value, we took a comprehensive look at Lisa’s health. We reviewed her symptoms, medical history, lifestyle, goals, DUTCH test results, and 3X4 Genetics report to better understand how her hormones, metabolism, inflammation, and genetics were contributing to her symptoms. Together, we developed a personalized treatment plan that included bioidentical hormone replacement therapy (estradiol patch, oral micronized progesterone, vaginal estrogen, and testosterone gel), targeted nutritional support, anti-inflammatory strategies, strength training, sleep optimization, and supplements to support recovery and reduce joint aches. We followed her closely, making adjustments based on her progress. After About 3 Weeks Lisa was sleeping more soundly, waking less often during the night, experiencing fewer hot flashes, and noticing more energy and mental clarity. After 2–3 Months By the three-month mark, Lisa’s hot flashes had nearly disappeared, she was sleeping through the night, exercising again, and feeling more like herself. Her mood was more stable, her joint discomfort had improved, and she had the energy to enjoy life again. She smiled and said, “I finally feel like myself again.” Looking back, Lisa said her biggest regret was waiting so long to seek help. She had spent years trying to manage her symptoms naturally because she was hesitant about hormone therapy. She wished she had known sooner that hormone therapy could be safely combined with healthy lifestyle habits as part of a personalized treatment plan. Today, she continues to prioritize nutrition, exercise, stress management, and sleep while feeling like the best version of herself again. > "I Just Didn’t Feel Like Myself." - LISA Painful intimacy ### Painful Intimacy #### “I wish someone had told me years ago that I didn’t have to live like this." - Linda #### When She First Came to SPOKEmed Linda, 70, admitted she had been avoiding intimacy because intercourse had become painful. She was also experiencing vaginal dryness, irritation, and several urinary tract infections over the previous year. She felt embarrassed discussing these symptoms and assumed they were simply part of getting older. Linda had previously been told she was not a candidate for systemic hormone replacement therapy, but no one had discussed local vaginal estrogen or explained that it was different from systemic hormone therapy. #### What We Did Together We explained Genitourinary Syndrome of Menopause (GSM) and reassured Linda that her symptoms were common, highly treatable, and not something she simply had to live with. We also explained that low-dose vaginal estrogen works primarily in the vaginal and urinary tissues with minimal absorption into the bloodstream. Together, we created a personalized treatment plan that included local vaginal hormone therapy, education about vaginal and urinary health, and ongoing follow-up. We also helped her make nutritional and lifestyle changes that allowed her to lose a few pounds and feel healthier overall. After About 3 Weeks Linda noticed less dryness and irritation. Walking and exercising became more comfortable, and she was beginning to feel more confident and less anxious about intimacy. After 2–3 Months Intercourse was comfortable again, and her urinary symptoms became much less frequent. A few months later, Linda celebrated her 70th birthday feeling healthier, more confident, and full of joy. She even shared photos from her birthday celebration with us because she was so excited about how she looked and felt after losing fat, regaining her confidence, and finally enjoying life without the discomfort she had silently accepted for years. Linda also learned that not being a candidate for systemic hormone therapy does not necessarily mean vaginal hormone therapy isn’t an option. For many women, including some with a history of breast cancer, low-dose vaginal estrogen may still be considered after an individualized discussion with their healthcare team. > "I Thought Painful Sex Was Just Part of Getting Older." - LINDA ## Perimenopausal And Postmenopausal Conditions We Commonly Treat ### Primarily Perimenopause - Mood swings - Irritability - Anxiety - Feeling overwhelmed - Feeling like "I'm just not myself" - Brain fog and difficulty concentrating - Memory changes and forgetfulness - Heart palpitations - Headaches or migraines ### Both Perimenopause & Menopause - Hot flashes - Night sweats - Fatigue and low energy - Poor sleep and insomnia - Low motivation - Low libido - Joint aches and stiffness - Muscle aches - Weight gain, especially around the abdomen - Difficulty losing weight - Increased body fat ### Primarily Menopause / Post-Menopause - Vaginal dryness - Painful intercourse - Genitourinary Syndrome of Menopause (GSM) - Recurrent urinary tract infections - Urinary urgency and frequency - Difficulty building or maintaining muscle - Loss of muscle mass - Hair thinning or hair loss - Dry or itchy skin - Dry eyes ### Women's Health Concerns - Perimenopause - Menopause - Early menopause - Premature menopause - Surgical menopause - Sexual wellness - Vaginal health - Healthy aging after menopause ### We Also Help Women Who… - Have been told their hormone levels are "normal" but still don't feel well. - Want a personalized, evidence-based approach to hormone therapy. - Want to optimize their energy, metabolism, body composition, brain health, and longevity. - Want to feel like themselves again. ### Hormonal & Metabolic Health - Estrogen deficiency - Progesterone deficiency - Testosterone deficiency - Insulin resistance - Prediabetes and elevated A1C - Difficulty managing blood sugar - Elevated cholesterol - Increased cardiovascular risk after menopause - Elevated blood pressure - Menopause-related metabolic changes - Increased visceral fat - Bone loss and osteopenia prevention - Increased stress response associated with menopause - Healthy aging and longevity optimization ## Advanced Testing for a More Personalized Approach While many women can be successfully treated based on their symptoms and medical history alone, some benefit from advanced testing to uncover additional factors contributing to their symptoms. At SPOKEmed, we offer comprehensive testing when clinically appropriate to create a truly personalized treatment plan. - [DUTCH Test ](javascript:void(0);) - [3X4 Genetics ](javascript:void(0);) - [GI MAP Comprehensive Stool Analysis ](javascript:void(0);) DUTCH Test ### DUTCH Test (Dried Urine Test for Comprehensive Hormones) The DUTCH Test provides a deeper look at hormone balance than standard blood work by evaluating hormone production, metabolism, and adrenal function. It may help identify: - Estrogen metabolism patterns - Low progesterone or testosterone - Cortisol patterns related to stress and fatigue - Sleep disturbances - Persistent fatigue - Mood changes, anxiety, and brain fog - Low libido - Hormonal imbalances that may contribute to weight gain - Whether hormones are being metabolized efficiently Why It Matters Two women can have similar hormone levels but experience very different symptoms. The DUTCH Test helps us understand how your body produces and metabolizes hormones, including estrogen metabolism pathways that may influence symptoms, inflammation, and hormone balance. While most women can begin hormone therapy based on their symptoms and medical history alone, this test can be especially helpful when symptoms are complex, persistent, or not responding as expected, allowing us to further personalize your treatment plan. 3X4 Genetics ### 3X4 Genetics Your genes don’t determine your future, but they can help explain why you respond differently to hormones, nutrition, exercise, and stress. Our 3X4 Genetics assessment may provide insights into: - Hormone metabolism - Detoxification pathways - Inflammation - Oxidative stress - Insulin resistance and metabolic health - Cardiovascular risk - Bone health - Brain health and cognitive aging - Nutrient needs - Response to exercise - Healthy aging and longevity strategies Why It Matters Menopause often brings increased inflammation, insulin resistance, changes in body composition, and a decline in muscle mass, making it harder to lose weight and maintain energy. Your genetic blueprint helps us personalize nutrition, exercise, supplements, and lifestyle recommendations based on how your body is designed to function, allowing for a more targeted approach to metabolic health, healthy aging, and sustainable weight management. GI MAP Comprehensive Stool Analysis ### GI MAP Comprehensive Stool Analysis The health of your gut plays a significant role in hormone balance, inflammation, metabolism, and overall well-being. GI MAP testing may help identify: - Gut bacteria imbalances (dysbiosis) - Intestinal inflammation - Digestive dysfunction - H. pylori - Intestinal infections and parasites - Yeast overgrowth - Gut barrier dysfunction (“leaky gut”) - Causes of bloating, constipation, or diarrhea - Factors that may contribute to autoimmune conditions and chronic inflammation - Gut health issues that can influence estrogen metabolism through the estrobolome Why It Matters Your gut contains a collection of bacteria known as the **estrobolome**, which helps regulate how estrogen is metabolized and eliminated. When the estrobolome is out of balance, it may contribute to persistent menopausal symptoms, inflammation, and difficulty achieving optimal results with hormone therapy. Improving gut health can support healthy estrogen metabolism, reduce inflammation, improve nutrient absorption, and enhance your response to treatment. ## How It Works - ### STEP 1 : Initial Consultation Comprehensive evaluation of your symptoms, medical history, current medications, lifestyle factors, and health goals. We will discuss whether hormone therapy may be appropriate for you and order any necessary laboratory testing to help guide personalized treatment recommendations. - ### STEP 2 : Targeted Testing Lab work is used to evaluate hormone levels, metabolic markers, and other key imbalances. If you complete a DUTCH test, we can also assess how your body is metabolizing hormones, along with your cortisol rhythm and cortisol awakening response. - ### STEP 3 : Personalized Treatment Plan A customized treatment plan is developed based on your symptoms, goals, laboratory findings, lifestyle, and personal preferences. Recommendations may include hormone therapy, nutrition and lifestyle interventions, targeted supplementation, peptides, weight management strategies, or additional testing to address the root causes of your symptoms and optimize long term health. - ### STEP 4 : Ongoing Monitoring Regular follow up appointments are used to assess your response to treatment, review progress, and make any necessary adjustments to your plan. We also focus on implementing sustainable nutrition, movement, sleep, stress management, and lifestyle habits to support long term success, symptom improvement, and optimal health outcomes. ## Why Choose SPOKEmed for Bioidentical Hormone Therapy At SPOKEmed, we offer several FDA-approved delivery methods for bioidentical hormones: ### Medical Expertise Michelle Middleton, PA-C, MSCP (Menopause Society Certified Practitioner), brings extensive clinical experience and specialized training in hormone optimization, menopause management, metabolic health, and precision medicine. Treatment recommendations are guided by evidence based medicine, comprehensive testing, and an individualized approach to care. ### Evidence-Based Approach Treatment recommendations are guided by current clinical data and evidence based guidelines from The Menopause Society, while considering each patient's unique symptoms, medical history, risk factors, and personal goals. ### No Pellet Therapy Avoided due to inconsistent delivery and inability to adjust dosing. ### Comprehensive Care Addressing lifestyle factors including nutrition, stress, exercise, mindset, and sleep. ### Direct Access Direct communication with Michelle between appointments. For optimal results, we recommend you retest after 4-6 months to track improvements and make necessary adjustments to your plan. ## Real Patients. Real Hormone Balance. Real Life Improvements. Through personalized hormone replacement therapy and bioidentical hormone therapy programs, patients often share how treatment has helped restore balance,improve energy, support healthy weight management, and enhance overall quality of life. - ![Google](https://cdn.trustindex.io/assets/platform/Google/logo.svg) Excellent![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)5.037 reviews 5.0![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg) Excellent37 reviews [Write a review](https://admin.trustindex.io/api/googleWriteReview?place-id=ChIJN5Vn_DmOwY4REP26eg_W55Y) Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Katrina Eggertsson profile picture](https://lh3.googleusercontent.com/a/ACg8ocK4onm_j8dBS8I19w9J0KjU87kG7thB0CJNAoHwwNHjAO0eeg=w40-h40-c-rp-mo-br100) Katrina Eggertsson 10 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is amazing! Super knowledgeable and helpful! If you’re looking for help to a healthy lifestyle she is the one you want help from. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Greta Lambert profile picture](https://lh3.googleusercontent.com/a-/ALV-UjVu5E4xW8J4Fo-Ej2d0pdp_tSPhBU87qMAGdmxBxQvWUlJfw8Gf=w40-h40-c-rp-mo-br100) Greta Lambert 26 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Dr. Michelle Middleton has been such a blessing in my life. She has helped me learn good habits not only for meals, but for living a happy, life of joy. I am so grateful for her guidance and tips. She is amazing! Her guidance has helped me emotionally and physically. She has helped me lose weight and to love myself again! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Michelle Chavers profile picture](https://lh3.googleusercontent.com/a-/ALV-UjVCIAjQY6x609KRkBUl1xUpjKCNEYtdnYhYvoCWh3649VyrwPKr=w40-h40-c-rp-mo-ba12-br100) Michelle Chavers 26 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle helped me with my crazy hormones when others told me I just needed to ride the perimenopause rollercoaster. That answer wasn’t good enough for me. I wanted to feel better. When I found Michelle she got me on the correct HRT and supplements I needed to feel better. It’s made a big difference in my mood and daily routine. I would highly recommend her as a woman trying to understand our complex body in midlife! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Celeste Mikes profile picture](https://lh3.googleusercontent.com/a/ACg8ocIIWiJyiqKM-L2izgfLvaL_-QzUK2ApJt7zYmjsIJhTw-evnA=w40-h40-c-rp-mo-br100) Celeste Mikes 64 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. SPOKEmed is a very knowledgeable with weight loss. They take the time to speak with you directly and walk you through the process. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![danielle cruz profile picture](https://lh3.googleusercontent.com/a/ACg8ocIHngxkakx0pqI4aU2mTq-tKJRsnMB0MintnwAwyIYwwUJgNA=w40-h40-c-rp-mo-br100) danielle cruz 166 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is a wealth of knowledge and has done so much to help me dig into root causes - both physiologically as well as mentally. I appreciate her comprehensive approach to wellness, her patience and her ongoing coaching! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Lisa B profile picture](https://lh3.googleusercontent.com/a/ACg8ocK-avI7EjVEl84cdA3oUvuyVNCb48PaPZPhSkn5Sx3_5FyfnA=w40-h40-c-rp-mo-br100) Lisa B 180 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is lovely to work with. She takes adequate time to listen and has useful and practical solutions. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Judith Rosbrook profile picture](https://lh3.googleusercontent.com/a/ACg8ocKNHtp9r_gSjNJgzNzO9K28W_976iMCfsFjtO0bRYVsqYlm9jY9=w40-h40-c-rp-mo-br100) Judith Rosbrook 182 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. I’ve been counseling with Michelle for almost a year. She has your best interest at heart! She’s very knowledgeable and recommends what’s best for your health! Thank you for everything Michelle!!! JR Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![ilissa siegel profile picture](https://lh3.googleusercontent.com/a/ACg8ocK5dWnwzpOjxekqARA3AZqXr8HkzCn0ushVtNNZ8kXv7Z_4gQ=w40-h40-c-rp-mo-br100) ilissa siegel 187 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. SpokeMED/Michelle is very knowledgeable and always accessible/helpful. She looks at your health and wellbeing holistically and has helped me feel like the best version of myself. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Ali Loomis profile picture](https://lh3.googleusercontent.com/a-/ALV-UjVadlfLKD_3KVNbCtIl6sbCccUAv0EdxIm5-gniAbSliZzjnDqy8g=w40-h40-c-rp-mo-br100) Ali Loomis 189 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Working with Michelle has been wonderful! She is clear, informative, and makes sure all of my questions have been answered. She is personable, supportive, and easy to talk to. I highly recommend her! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Nancy Hortman profile picture](https://lh3.googleusercontent.com/a-/ALV-UjVdQHAtZIW_IRHH8YHLorZWvBEJUewwbL5sMS5s69GNV1HiKeOZ=w40-h40-c-rp-mo-br100) Nancy Hortman 189 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle, is absolutely wonderful! She is beyond helpful and wise and cares woud recommend !! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Joni House profile picture](https://lh3.googleusercontent.com/a/ACg8ocLVDKzhUwtJeA4QQWUobtUvYH_mHOrB6t6D-TtX8PlPvvgScQ=w40-h40-c-rp-mo-br100) Joni House 195 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Working with SPOKEmed has truly transformed my health and focus. The guidance, accountability, and encouragement is helping me build better habits and gain clarity. I am thankful for the positive impact they have had on my life. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Rhina Mendoza profile picture](https://lh3.googleusercontent.com/a/ACg8ocIarboXuU40fVYqx2cT-foizPKwFVBnxwuJr80pZghSnhqAVg=w40-h40-c-rp-mo-br100) Rhina Mendoza 196 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. I have nothing but excellent reviews with this service, very friendly and knowledgeable people, love it , thanks Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Rolanda Montenegro profile picture](https://lh3.googleusercontent.com/a/ACg8ocIr8zAMax6UK_9_3b5ICSetsF_r4l8oKlQ293HceqvQia_o4tA=w40-h40-c-rp-mo-br100) Rolanda Montenegro 197 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Love working with Michelle! She answers all my questions and shows extreme understanding and care with her clients. I felt very good knowing she was there to walk me through this process. Highly recommend her services! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Katie Norman profile picture](https://lh3.googleusercontent.com/a/ACg8ocJdsPhHVM7qTrBi8EIQSY9MZPPALAePOdwgvA3Bw6cb_qOg3g=w40-h40-c-rp-mo-br100) Katie Norman 201 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is wonderful! Michelle is so supportive, responsive and encouraging. She truly listens to your concerns and provides sound solutions and guidance. She truly cares for her patients. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Pawfessional Mobile Vet profile picture](https://lh3.googleusercontent.com/a-/ALV-UjVJdSyTonlQEBgN4fMHeSJjTsikGO-1XGNzCPSaUqV_Ww5IORU=w40-h40-c-rp-mo-br100) Pawfessional Mobile Vet 206 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is wonderful to work with and provides exceptional advice! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Tim Ellenburg profile picture](https://lh3.googleusercontent.com/a-/ALV-UjWZ1BD9d59ygmx60wXUmxZnL9WQrHJaVs_OtxakTQ1C3Td7dQ=w40-h40-c-rp-mo-br100) Tim Ellenburg 210 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Close attention to detail, thorough coverage of information Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![L.S.C profile picture](https://lh3.googleusercontent.com/a/ACg8ocKp9Vig2UnPV8px5eAKrm1RolcQe4hFadf72jpGJj0T37IMbQ=w40-h40-c-rp-mo-br100) L.S.C 216 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Kas profile picture](https://lh3.googleusercontent.com/a/ACg8ocIz5Ny2uMee0QlzplHhxKdiNHFkQ1UBbnvVrc-PFLVvoOv8rQ=w40-h40-c-rp-mo-br100) Kas 224 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is very knowledagble, kind and is always willing to help if I have a question about something. She makes sure she gives enough info on the glp1 shot for her clients to be successful. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Katie Sefton profile picture](https://lh3.googleusercontent.com/a/ACg8ocIOsLFz-uv4vXVxQOhawxVr9en_Rs8juxBgsm0YSJ_9pauSAQ=w40-h40-c-rp-mo-br100) Katie Sefton 230 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. I’ve been working with Michelle for several months and have lost over 50 lbs at a healthy pace. It is easy to arrange appointments and she is flexible with the need to reschedule. She listens well and offers on point advice without judgement. She seems to love helping people on their journey to better health and is very knowledgeable about current best practices. I highly recommend SPOKEmed. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Jenna profile picture](https://lh3.googleusercontent.com/a/ACg8ocL9vB8PKIWsqv5jlcuNcQbQxo8cMKNuNM5UPT7qGX6rEp8AoQ=w40-h40-c-rp-mo-br100) Jenna 490 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. I can’t say enough positive things about working with Michelle! She has been instrumental in my weight loss journey with GLP-1 and Lipomino injections. She is so supportive, incredibly knowledgeable, and always willing to answer my questions. She truly listens and takes the time to understand my needs and goals. Her availability and accommodating nature have made this process smooth and reassuring. I’m so grateful to have her guidance and expertise! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Sumner Lane profile picture](https://lh3.googleusercontent.com/a-/ALV-UjUWqXjqQJt7jnI0tQ324-62YkMRJntAl1fmbLeteB9X38huMNxn=w40-h40-c-rp-mo-br100) Sumner Lane 493 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is knowledgeable, attentive, and takes the time to explain her treatments clearly, making me feel comfortable and informed. I appreciate how easy it is to communicate with her and efficiency of visits. She truly cares for her clients and their health. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Natalie Crain profile picture](https://lh3.googleusercontent.com/a-/ALV-UjX3GI7AjdRZjEf-f5E35LWgigCcEM8bLny1wOGThna7Qo-X_Zp8Eg=w40-h40-c-rp-mo-br100) Natalie Crain 515 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Very engaging, cares about my progress, extremely knowledgeable and supportive of my journey. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Franklin E Corvaia II profile picture](https://lh3.googleusercontent.com/a/ACg8ocJ8ncw6_59-H0rltZT7Fjmtm7yZ-PU6eir6zWufvASnhBKqN-Q=w40-h40-c-rp-mo-br100) Franklin E Corvaia II 538 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Thank you for your health education and expertise on my weight loss journey. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Michele Sabin profile picture](https://lh3.googleusercontent.com/a-/ALV-UjW4b1hLM9J5tkc-GCYtyPp-wtrcnX9jrd8VaeT5qxGFc9d1Np88pw=w40-h40-c-rp-mo-br100) Michele Sabin 539 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. I have really enjoyed working with Michelle Middleton. She is helping me reach my optimal health goals with proven solutions, great advice and expertise. She’s incredible!! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Colleen McKenzie profile picture](https://lh3.googleusercontent.com/a/ACg8ocJSM2uLoX6T3JERFlmIiH6hLirwilLKjpkvQ7kClsPQwEqfvg=w40-h40-c-rp-mo-br100) Colleen McKenzie 613 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. I’ve lost 11 lbs in less than 3 weeks. A genuine caring person. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Melissa Staelens profile picture](https://lh3.googleusercontent.com/a-/ALV-UjVJALUJ2Ik5OLOXVcoXlEiPEMVEKM1HCQKmIgbaA9q7McW60IM4yg=w40-h40-c-rp-mo-br100) Melissa Staelens 627 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle has provided amazing support as I continue in my journey towards better health. She helps provide tools that make getting healthy easier and attainable! So thankful to have found her! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![MM profile picture](https://lh3.googleusercontent.com/a/ACg8ocIGumFMquwXvOnTlle3w27YRqMW3of5PTgxM3SE6CYbFuOfoQ=w40-h40-c-rp-mo-br100) MM 630 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is just amazing! From our very first conversation she listens to what I am looking for, addresses all my concerns and she patiently answers all my questions. She is also an incredible positive force and a fantastic cheerleader as I continue my journey of growing and learning in regards to my health and happiness! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Arden Ellis profile picture](https://lh3.googleusercontent.com/a-/ALV-UjVTGTIpa9WI83B_e9PuWRmZj5AcQGtkN-cgfiN9Hf_QeDfu1QL5=w40-h40-c-rp-mo-br100) Arden Ellis 634 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is just the best. She helps you look at the WHOLE picture not just one aspect of your health. It's so important to take the time to really understand each patient's specific needs, issues our health goals, and Michelle does this like no one I've ever met. I am so grateful for her expertise and commitment to her patients. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Susan Martin profile picture](https://lh3.googleusercontent.com/a/ACg8ocJrDtGeQrWhzCW3L6pky-s0H7EkFTgwWgLBQLG6OvGyX2wqIA=w40-h40-c-rp-mo-br100) Susan Martin 653 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. When one comes across something or someone of exceptional quality, you want to share it. That is what I would like to do w/ Michele Middleton. Michelle reached out to me with a suggestion of treatment and course of action to repair and restore my destructive behavior and thinking the program she believes in is good very good but her skills in repairing and Restoration are exceptional. Never judgmental always viewing it from let’s redirect it. Bottom line always with love the heart of hers is full and giving all the time I find her a gift from above Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Jennifer Riggs profile picture](https://lh3.googleusercontent.com/a/ACg8ocLgcAVzsxC25OqyUaqGjyPTtGCj28QiFs6eiuO0PeaWd-ryYg=w40-h40-c-rp-mo-br100) Jennifer Riggs 655 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. ![](https://lh3.googleusercontent.com/grass-cs/ACvplmOL3AsBXx9gSSrI-nIYAgohwhCDMv0UXX9XRO952p3wixcRKWujsMjLZUFeOSIJw_laKf8f1aVNywq1T2PznxXxSx7rgdYlTcvl5EszVi3vKarT-TW5xFnymqWatxYbdJekgeroxQ=k-no)+0Michelle- has been there for my health journey every step of the way. She turns a negative into a positive and at times when I wanted to give in, she was right there for me. She is a big part of my success and continues to support me. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Shannon Perry profile picture](https://lh3.googleusercontent.com/a-/ALV-UjWQ6GLRraLR5k8_WhyBSMddes0A5IXGWonMVxs-ZVdR7VW6X2Fy=w40-h40-c-rp-mo-br100) Shannon Perry 656 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle Middleton, P.A. Is one of the most caring & careful health care professionals I’ve ever encountered! The world needs more Michelle’s! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Enid Roper profile picture](https://lh3.googleusercontent.com/a/ACg8ocIEufsAEKjF77xDpa7L7GnqA2nrvl6T1V5rka_FEEOoCuRr4Q=w40-h40-c-rp-mo-br100) Enid Roper 679 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is wonderful. Knowledgable, professional, and really explains things well. Made the process so easy. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Troy M profile picture](https://lh3.googleusercontent.com/a-/ALV-UjX2R7kdniVS7rTuhuEVuNfjhc2lvUcVlb3xA1hFtxjhlXZnu_c=w40-h40-c-rp-mo-ba12-br100) Troy M 685 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle has been absolutely amazing. She is thorough, professional and takes the time to not just listen to my health concerns, but addresses them in a way that is easy to understand. Very pleased with the journey so far and am looking forward to continue my health journey with her. Crystal F. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Karla McCoy profile picture](https://lh3.googleusercontent.com/a/ACg8ocKx4gMNm4-nrXyZVWWwJT4WyBsgVqoGXd3eI37CUtQ_natUKA=w40-h40-c-rp-mo-br100) Karla McCoy 685 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle has been an essential part of my health journey. She is knowledgeable, always available to answer my questions when needed, and always ready to help and encourage me. I highly recommend her to anyone ready to start their health journey. Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Marty McCravy profile picture](https://lh3.googleusercontent.com/a-/ALV-UjWmkIraR5igtLl9-73vGDyhthcLHxwe0gQPoU-jAC89wPUTkcc=w40-h40-c-rp-mo-br100) Marty McCravy 685 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is a fantastic coach. She is so knowledgeable and helpful. I highly recommend Michelle for your weight loss journey Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Charlin Burdick profile picture](https://lh3.googleusercontent.com/a-/ALV-UjUuV5ICf0poI_XH20s-rL8JT-3-tvaN-m3yEq7pMHUuyHQugvA=w40-h40-c-rp-mo-br100) Charlin Burdick 692 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. Michelle is absolutely amazing!!! She is beyond professional and listens to her patients needs and concerns. She has been my guide in this journey answering questions, addressing concerns and helping me bridge the gap in achieving my health & nutrition goals. She is incredibly intelligent & respectful and so easy to connect with as well! Do yourself a favor and schedule a consultation and see for yourself. You’ll thank me later!! Posted on Google ![Google](https://cdn.trustindex.io/assets/platform/Google/icon.svg) ![Gerry Gerrard profile picture](https://lh3.googleusercontent.com/a-/ALV-UjXzunBEBe868bD1UuTOYDB_zUZzJXfVGfuj6PbzoDCynegnw4E=w40-h40-c-rp-mo-ba12-br100) Gerry Gerrard 732 days ago ![Google star 1](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 2](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 3](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 4](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)![Google star 5](https://cdn.trustindex.io/assets/platform/Google/star/f.svg)Trustindex verifies that the original source of the review is Google. My friend lost 8 pounds in 2 weeks through this program of a healthy lifestyle and healthy eating. She stopped drinking alcohol (which is miraculous) and eats regularly but healthy all day long and feels GREAT! shes in it to win it and can't wait to get to her ideal weight! Verified by Trustindex Trustindex verified badge is the Universal Symbol of Trust. Only the greatest companies can get the verified badge who has a review score above 4.5, based on customer reviews over the past 12 months. [Read more](https://www.trustindex.io/?a=sys&c=verified-badge&url=/the-trustindex-verified-badge/) ## Traditional Hormone Therapy vs. Bioidentical Hormones Many women wonder about the difference between traditional hormone therapy and bioidentical hormone replacement therapy. Here's a simple comparison: | FEATURE | TRADITIONAL HRT | BIODENTICAL HRT (BHRT) | | ------- | --------------- | ---------------------- | | SOURCE | Synthetic or animal-derived hormones | Usually plant-derived and processed to be structurally identical to human hormones. | | COMMON FORM | Oral tablet/pills, patches, creams, gels, troches, rings, injections, pellets | Creams, gels, troches, tablets/pills, injections, pellets | | FDA APPROVAL | Many forms FDA-approved | Many FDA-approved; compounded versions are not FDA approved | | HORMONE USED | May include conjugated estrogens, medroxyprogesterone | Estradiol, micronized progesterone, testosterone | | MONITORING | Varies by provider | Varies by provider | At SPOKEmed, we focus on FDA-approved bioidentical options that provide the benefits of molecular matching with the safety assurance of regulatory oversight. ## BHRT Frequently Asked Questions ### What are bioidentical hormones? Are they natural hormones? Bioidentical hormones are hormones that are structurally identical to the hormones the human body produces. They are often derived from plant sources, but they are processed in a lab to match human hormones. Examples include estradiol, progesterone, and sometimes testosterone. ### How do I know if my hormones or hormone levels are out of balance? Common signs include: Hot flashes or night sweats - Mood changes: irritability, anxiety, or depression - Dry, itchy skin - Sleep disturbances or insomnia - Vaginal dryness or recurring urinary tract infections - Low libido or changes in sexual function - Fatigue or low energy - Brain fog or difficulty concentrating - Unexplained weight gain or weight changes - Increased inflammation, joint pain ### Is compounded bioidentical hormone therapy better than FDA-approved options? While compounded bioidentical menopausal hormone therapy is often marketed as superior, the safety of compounded bioidentical hormones has not been as thoroughly studied as FDA-approved options. We primarily recommend FDA-approved bioidentical hormone therapies that provide the benefits of bioidentical hormones with the safety assurance of regulatory oversight. ### How long does it take to see results when using bioidentical hormones? Many women notice improvement in symptoms like hot flashes and night sweats within 2-3 weeks of starting therapy. Other benefits, such as improved sleep and mood, may follow shortly after. Some effects, like changes to skin texture and bone density, develop more gradually over months of treatment. ### What is the difference between compounded bioidentical hormones and FDA-approved bioidentical hormones? FDA-approved bioidentical hormones undergo rigorous testing for safety, efficacy, and consistent dosing. Compounded bioidentical hormone therapy is custom-made by specialty pharmacies and hasn't undergone the same level of testing. While compounded preparations offer customization, they may lack consistency in quality and potency. ### Do you use hormone pellets at SPOKEmed? No, we do not use pellet therapy at SPOKEmed. While some providers offer hormone pellets as a delivery method, we have concerns about: - The inability to adjust hormone dosing once the pellet is inserted - Inconsistent hormone levels over time - The inability to remove the pellet if side effects occur Because hormone balance is complex, especially when multiple hormones are involved. We prioritize delivery methods that allow precise, flexible dosing and easy adjustments to ensure your safety and optimal results. ### How does the U.S. Food and Drug Administration view bioidentical hormone replacement therapy products? - The U.S. FDA has approved several **bioidentical hormone therapy products** for treating menopausal symptoms. These products have undergone **rigorous clinical trials** confirming their safety and effectiveness. - However, the FDA has expressed **concerns about custom-compounded bioidentical hormones**, as these preparations **have not undergone the same level of testing or regulation.** - Despite marketing claims that bioidentical hormones are more effective than synthetic hormones, the **National Academies of Sciences states that all hormones; bioidentical or conventional, carry similar benefits and risks.** - When considering hormone therapy, it's important to **choose FDA-approved products whenever possible to ensure safety and quality.** ### What possible side effects should I be aware of when taking bioidentical hormones? While bioidentical hormones can effectively manage menopausal symptoms, it's important to be aware that they may cause side effects similar to traditional hormone therapy: - **Common side effects:** Breast tenderness - Spotting or irregular bleeding - Headaches - Mood changes - **Rare but serious risks:** Increased risk of certain hormone-sensitive cancers in women - Blood clots - Cardiovascular issues Bioidentical hormones come in various delivery methods; such as creams, patches, and pills, each carrying its own side effect profile. - **During your consultation, we will:** Review your medical history - Discuss how different hormone products affect your body - Determine the safest and most effective estrogen replacement therapy plan tailored to your needs ## Learn More About Our Services [ View All Our Services ](https://spokemed.com/clinical-services/) ### Weight Loss & Weight Management Hormonal changes can affect metabolism and weight; address both for optimal results [Learn More](https://spokemed.com/clinical-services/medical-weight-loss-management/) ### Health Coaching Get the accountability coach and support you need for lasting change [Learn More](https://spokemed.com/clinical-services/health-coaching/) ### Gut Health & Microbiome Testing Identify gut imbalances and get personalized solutions for your overall health and wellness. [Learn More](https://spokemed.com/clinical-services/gut-health-microbiome-testing/) ### Peptides Addressing where your body needs help in a targeted way [Learn More](https://spokemed.com/clinical-services/targeted-peptide-support/) Let's be friends [ @SPOKEmed Instagram ](https://www.instagram.com/spokemed) @ [ @SPOKEmed Facebook ](https://www.facebook.com/profile.php?id=61564399674406) ![SPOKEmed Instagram post sharing menopause facts for women in midlife](https://spokemed.com/wp-content/uploads/2026/02/menopause-facts.jpg) ![SPOKEmed Instagram post on low libido and hormone imbalance in women](https://spokemed.com/wp-content/uploads/2026/02/low-libido.jpg) ![SPOKEmed Instagram: why midlife muscle health matters for women's metabolism](https://spokemed.com/wp-content/uploads/2026/02/midlife-muscles-matter.jpg) ![SPOKEmed Instagram post: the role of cortisol in weight gain and hormonal health](https://spokemed.com/wp-content/uploads/2026/02/lets-talk-about-cortisol.jpg) **REFERRAL PROGRAM** --- Join Our Referral Program and Get Rewarded for Spreading Wellness [Learn About Our Referral Program](https://spokemed.com/referral/) **BEFORE & AFTER** --- Explore Real Before-and-After Success Stories [See Success Stories](https://spokemed.com/results/) ## Business Facts:SPOKEmed - **Bioidentical hormone** replacement therapy is provided when clinically appropriate - **Services** include hormone evaluation, laboratory review, and treatment planning - **Prescription management** is included if clinically indicated - **Ongoing monitoring** and dosage adjustments are part of care delivery - **Services** are provided via telemedicine to eligible patients - **Care** is delivered by a board-certified Physician Assistant - **Availability** is limited to states where providers are licensed [Read all Business Facts about SPOKEmed](https://spokemed.com/facts/)