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Hormone health and intimate wellness for women and men
Perimenopause and menopause care, FDA-approved bioidentical hormone therapy, testosterone therapy, and intimate wellness, from a physician who takes the time to find out what is actually going on. Salinas, Carmel, and telehealth across California.
Perimenopause and menopause care
Hot flashes and night sweats are the symptoms everyone knows. The ones that bring most women in are the others: sleep that falls apart, brain fog, anxiety that appeared out of nowhere, joint aches, weight that shifts to the middle, dryness, and a libido that quietly left. Perimenopause can start in your late thirties or forties, and too many women are told it's just stress.
Hormone therapy, when it's appropriate, uses the same estradiol and progesterone your body made, in FDA-approved forms: patches, gels, and capsules, adjusted to you over time. That is what bioidentical means here. Pellets are not the only bioidentical option, whatever a decade of very effective marketing has suggested: FDA-approved patches, gels, and capsules are bioidentical too, and they are what the Menopause Society recommends over compounded mixtures and pellets. We don't favor pellets, because a dose that can't be adjusted for months makes fine-tuning hard, but if pellets turn out to be the right fit for you after we talk it through, we can place them. For healthy women who start within about ten years of menopause, the benefits often outweigh the risks, and the risks are far smaller than the headlines of twenty years ago suggested. We'll go through your history carefully, explain the evidence in plain language, and decide together.
What we help with:
Testosterone therapy, for women and men
Coming soon Testosterone therapy for men opens later this fall; testosterone for women is part of menopause care now.
Testosterone isn't only a men's hormone. In women, low levels can show up as low desire, fatigue, and a harder time keeping muscle, and testosterone can be part of care in select cases. In men, low energy, low drive, more belly fat, low mood, and poor sleep can all point to low testosterone. In either case, what evaluation makes sense and whether therapy is right for you is decided at your consultation, based on your history, your symptoms, and labs as needed. If we treat, we use FDA-approved options, adjust as needed, and keep working with you toward feeling like your best self in this stage of life. More for men.
Intimate wellness
Desire, arousal, comfort, and satisfaction are tied to hormones more often than most people are told, which is why Dr. Monarrez treats hormone health and sexual health together. Low desire, dryness or pain, orgasm concerns, and erectile or performance concerns all have real options, discussed at your visit, including the O-Shot, which launches later this fall.
What a first visit looks like
Plan on a long conversation. We review your symptoms, cycle or hormone history, sleep, mood, sexual health, medications, and family history, with labs as needed to guide decisions. Most patients leave the first visit with a plan and a follow-up date. Concierge patients can meet with Dr. Monarrez as often as needed, by appointment with priority booking. From there we adjust as needed and continue the journey with you, toward feeling like your best self in this new stage of life.
Some treatments may involve compounded medications, complementary approaches, or medically appropriate off-label uses of FDA-approved therapies. When applicable, we explain the regulatory status of the treatment, the strength and limitations of the available evidence, and its potential benefits, risks, and alternatives. Recommendations are individualized following an appropriate medical evaluation. No treatment or result is guaranteed.
Hormone questions, answered plainly
What patients ask before they book.
Is hormone replacement therapy safe?
For most healthy women who begin within about ten years of menopause or before age 60, current evidence shows the benefits of hormone therapy generally outweigh the risks. It isn't right for everyone, and a careful history, including breast cancer, clotting, and cardiovascular history, comes before any prescription. We'll walk through the evidence with you in plain language.
Do you test hormone levels?
When it will help guide the plan. For perimenopause, symptoms often tell us more than a single lab value because levels swing day to day. What testing makes sense for you is decided at your consultation.
Can hormone care be done by telehealth?
Yes. Consultations and follow-ups can be done by secure video anywhere in California, with labs drawn at a Quest or LabCorp location near you. Procedures such as the O-Shot are performed in the office.
Can I use FSA or HSA funds for hormone care?
Qualifying medical appointments, diagnostic testing, and treatment may be paid for or reimbursed with FSA or HSA funds. Ask about an itemized receipt, and confirm any documentation requirements with your plan administrator. Not every treatment or supplement qualifies, so keep medical and cosmetic charges separate and ask us for the receipt you need.
What is the O-Shot, and does it work?
The O-Shot is an injection of your own platelet-rich plasma into the tissue around the clitoris and vaginal wall, done with numbing cream in about 30 minutes. Many women report improved sensitivity, arousal, and lubrication. We'll talk through whether it's a good fit for you. More on the sexual health page.
Do you treat men?
Yes. Testosterone evaluation and therapy, erectile and performance concerns, and general hormone health for men are all part of the practice.
You don't have to figure this out alone
Book a consultation in Salinas, Carmel, or by video. If you're not sure where to start, text us and we'll point you in the right direction.