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Menopause & Hormone Therapy  ·  Winter Garden, FL

Hormone therapy,
done carefully.

Individualized hormone therapy for perimenopause and menopause from Dr. Megan Luciano, a Menopause Society Certified Practitioner (MSCP), at our Winter Garden office. In network with Aetna, Cigna, and Humana, Traditional Medicare accepted, and transparent self-pay pricing.

Woman relaxing with a cup of coffee at home

The symptoms hormone therapy
can treat.

Hormone therapy is the most effective treatment for hot flashes and night sweats, and it can help with several other symptoms of the menopause transition. Whether it fits you depends on your symptoms, your age and time since your last period, and your health history.

Hot flashes & night sweats
The symptoms hormone therapy treats best, including the night sweats that break up sleep.
Sleep disruption
When night sweats are what wakes you, treating them is often the most effective thing you can do for sleep.
Mood, anxiety & brain fog
Emotional and cognitive changes of the transition, weighed alongside nonhormonal options.
Vaginal dryness, painful sex & urinary symptoms
Treated with low-dose vaginal estrogen, on its own or alongside systemic therapy, at any age.
Symptoms during perimenopause
You do not have to wait until your periods stop. Bothersome symptoms while still cycling can be treated.
Bone protection
Estrogen helps prevent the bone loss that speeds up after menopause, part of the conversation for women at higher fracture risk.

FDA-approved options,
chosen for you.

Dr. Luciano prescribes FDA-approved hormone therapy, including bioidentical estradiol and micronized progesterone, rather than compounded preparations or pellets. The form and dose are chosen around your symptoms, your health history, and what fits your life.

Estrogen
Patch, pill, gel, or spray
Estrogen is what relieves hot flashes, night sweats, and most other symptoms. Skin-delivered forms bypass the liver and are linked to a lower risk of blood clots in observational studies, so they are the usual choice for women with clot risk factors.
Progesterone
Protecting the uterus
If you have a uterus, a progestogen is added to protect the uterine lining. Micronized progesterone, taken at bedtime, is the usual choice. In perimenopause a hormonal IUD is sometimes used for the same purpose.
Vaginal estrogen
Low-dose, local treatment
For dryness, painful sex, and recurrent urinary infections, low-dose vaginal estrogen works where the symptoms are and does not require a progestogen. It can be used at any age and for as long as needed.
Nonhormonal options
When hormones are not the right fit
FDA-approved nonhormonal medications for hot flashes, and treatments for sleep and mood, for women who cannot or prefer not to use hormone therapy.

A decision made
individually.

Safety is assessed person by person, not as a blanket yes or no. For many healthy women who start within 10 years of their last period or before age 60, the potential benefits outweigh the risks. Starting later, or with certain personal or family history, shifts the balance, and some women should not use estrogen at all.

You do not need to wait until your periods stop, and you do not need a hormone test first. Perimenopause and menopause are diagnosed from your symptoms, age, and cycle pattern, and the regimen is chosen differently while you are still cycling.

Schedule a Consultation
Hormonal and nonhormonal options
Both are on the table at every consultation, so the plan fits you rather than a protocol.
No hormone test required to start
Testing is reserved for specific situations, such as symptoms well before age 40 or ruling out thyroid disease.
Reviewed every year
There is no fixed time limit. The dose, the form, and whether to continue are revisited at least yearly as your health changes.

What a consultation
involves.

01
Your story first
Your symptoms, your history, and what matters most to you, with real time to talk. Bring your questions and any records of past treatment.
02
A plan you decide on together
Hormonal and nonhormonal options, the benefits and risks for you specifically, and whether now is the right time to start.
03
Follow-up and adjustment
A check-in after you start, to adjust the dose or the form if needed, then yearly review. Established patients can often follow up by telehealth.

Straightforward visits,
transparent pricing.

Hormone therapy evaluation and follow-ups can be billed to Aetna, Cigna, Humana, or Traditional Medicare, or are available at transparent self-pay prices. No enrollment and no membership.

Your First Visit
Comprehensive menopause consultation
A thorough perimenopause or menopause consultation with Dr. Luciano: your history, your symptoms, and a treatment plan tailored to you, including hormone therapy when appropriate.
Self-pay: $350 Aetna, Cigna, Humana & Traditional Medicare: billed per plan benefits
Book a Visit →
Ongoing Care
Follow-ups & between-visit support
Follow-up visits and lab reviews to refine your plan as your needs change, plus telehealth and phone support when questions come up between appointments.
Self-pay: $150 Follow-up and lab-review visits  ·  Aetna, Cigna, Humana & Traditional Medicare: billed per plan benefits
Book a Visit →

For covered services billed through participating insurance plans, your financial responsibility is determined by your plan's applicable copay, deductible, coinsurance, and other cost-sharing requirements. Self-pay rates do not apply to those visits. Full details are on our Insurance & Payment page.

Menopause care from a
certified specialist.

Menopause Society Certified Practitioner
A credential earned by passing a competency examination in menopause medicine and maintained with ongoing menopause-specific education.
Board-certified gynecologist
Diplomate of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists, practicing gynecology and menopause care at Sparrow.
One physician, every visit
You see Dr. Luciano herself each time, in the office or by telehealth once established, so your plan is adjusted by the doctor who knows your history.

Common
questions.

Is hormone therapy safe?+
It depends on the person. Hormone therapy is FDA-approved and, for many healthy women who start it before age 60 or within 10 years of their last period, the potential benefits can outweigh the risks. For women who start later, or who have certain personal or family health history, the balance can shift. Safety is assessed individually, not as a blanket yes or no.
Do I need a hormone test before starting?+
Usually not. Perimenopause and menopause are diagnosed from your symptoms, age, and cycle pattern, and hormone levels swing too widely in perimenopause for a single test to be reliable. Testing is reserved for specific situations, such as symptoms well before age 40 or ruling out thyroid disease.
Can I start hormone therapy while I am still having periods?+
Yes. Bothersome hot flashes, night sweats, sleep disruption, or mood symptoms during perimenopause can be treated. The regimen is chosen differently while you are still cycling, and menopausal hormone therapy does not prevent pregnancy, so contraception is a separate decision.
How long can I stay on hormone therapy?+
There is no universal time limit, and no rule that it must stop at 65. The Menopause Society and ACOG do not recommend stopping at a set age. Continued use is reasonable for persistent symptoms, bone protection, or vaginal symptoms, with a yearly review of benefits, risks, and any changes in your health.
Are bioidentical or compounded hormones better?+
FDA-approved bioidentical options already exist, including estradiol patches and micronized progesterone. Compounded hormones and pellets are not FDA-approved, are not tested for safety or effectiveness, and vary in strength, so major medical societies recommend approved products. Dr. Luciano prescribes FDA-approved hormone therapy.
Can follow-up visits be done by telehealth?+
Yes, for established patients. Your first visit is in person at our Winter Garden office. Follow-up visits and lab reviews can often be done by telehealth, with phone and secure messaging support when questions come up between appointments.
What does a hormone therapy consultation cost?+
If you are with Aetna, Cigna, Humana, or Traditional Medicare, your visits are billed to your plan according to your individual benefits. For other plans and self-pay patients, the comprehensive menopause consultation is $350 and follow-ups are $150, with a detailed superbill available on request for possible out-of-network reimbursement, which is determined by your plan and not guaranteed.

Hormone therapy,
explained in depth.

Guides from our menopause library, medically reviewed by Dr. Luciano.

Benefits & risks
How the decision is weighed
Why age, timing, and health history change the balance of benefits and risks, individually.
Read more →
Options
Estrogen, progesterone, patch or pill
Why progesterone is added, how patches differ from pills, and why FDA-approved bioidentical hormones are recommended over compounded ones.
Read more →
Perimenopause
Starting while still having periods
How the options differ while you are still cycling, and why contraception still matters.
Read more →
Vaginal estrogen
Is vaginal estrogen safe?
What low-dose vaginal estrogen treats, how it differs from systemic therapy, and what is known about long-term use.
Read more →
Nonhormonal
Options without hormones
FDA-approved medications and other approaches for hot flashes if hormone therapy is not right for you.
Read more →
Diagnosis
Is hormone testing needed?
Why menopause is usually diagnosed by symptoms and history, not a blood test, and when testing actually helps.
Read more →

Ready for healthcare
that's actually for you?

Schedule your first visit with Dr. Luciano today — unhurried appointments, direct answers, and care built around you from day one.

New patients are welcome, and every appointment is built so you receive the time and attention you deserve.