Treatment planning

Topics to discuss

• Perimenopause and menopause symptoms, with hormonal and non-hormone options
• Irregular cycles and PCOS (polycystic ovary syndrome) follow-up
• Confirmed low testosterone, after a guideline-based evaluation, including whether testosterone replacement therapy (TRT) is appropriate
• Straightforward underactive thyroid (hypothyroidism)
• The hormonal side of weight, insulin resistance and prediabetes

When we refer

Viva Hormone Clinic is primary care. Your clinician coordinates endocrinology for an overactive thyroid, thyroid nodules or goiter, thyroid problems in pregnancy, suspected pituitary or adrenal causes, or premature ovarian insufficiency; urology for a prostate nodule or high PSA before any testosterone decision; and gynecology for abnormal bleeding or any bleeding after menopause.

Prepare for your visit

Bring a list of your medicines, vitamins, and supplements, including how often you take each one. Include allergies and any past reactions. If you have recent test results, discharge papers, or notes from another care team, bring them or ask how to share them before the visit. You do not need to order your own tests to prepare.

Write down your main questions and what has changed since your last visit. Note when symptoms began, how they affect your daily activities, and what you have already tried. If you track readings or symptoms at home, bring that record. Tell the team if you need help with language, transportation, or getting records so those needs can be discussed.

Decide on a plan together

Your provider starts with your priorities and reviews the history and information available. An examination may be needed before deciding on the next step. The lists on this page describe the program's general scope; they are not a promise that every test or treatment is needed or available for your situation. Ask what each proposed step is meant to answer.

When an option is discussed, ask about its possible benefits, risks, alternatives, and practical demands. Mention cost or coverage concerns before scheduling a test or referral. Some care is coordinated with an outside center, and availability must be confirmed. Do not stop or change a medicine based only on this page. Your plan should fit your health history and preferences.

Results and follow-up

Before you leave, ask how results will reach you and who will review them. Confirm the next appointment or the reason to return sooner. A referral request does not mean an appointment has been scheduled. Ask whom to contact if you have not heard back, and keep copies of outside results when possible so your care team can review them.

The follow-up schedule depends on what is found, any care started, and whether symptoms change. Ask for the next steps in a form you can use at home. Telehealth may suit some conversations when the program allows it, but an in-person examination may still be needed. For sudden or severe symptoms, use the urgent guidance rather than waiting for a routine follow-up.

Sources

• Hormonal Imbalance: Causes, Symptoms & Treatment — Cleveland Clinic
• Hypothyroidism (Underactive Thyroid) — NIDDK (NIH)
• Thyroid Function Tests — American Thyroid Association
• Insulin Resistance & Prediabetes — NIDDK (NIH)
• The 2022 hormone therapy position statement of The North American Menopause Society — The Menopause Society (formerly NAMS)
• Hormone Therapy for Menopause (FAQ) — American College of Obstetricians and Gynecologists
• Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline — Endocrine Society
• 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome — ESHRE/ASRM/Monash-led international guideline