Hormone care

Hormone care.

Changes in how you feel deserve to be taken seriously. Lili starts with your symptoms, history, and goals, uses appropriate testing, and stays with you through follow-up and adjustments.

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A thoughtful evaluation

How hormone care is guided.

  • Your symptoms

    What you are feeling, how long, and how it affects daily life. Symptoms point the way but do not prove a deficiency on their own.

  • Your history

    Medical and family history, medications, and risk factors shape which options are safe and sensible.

  • Appropriate testing

    Labs answer specific questions. A normal result does not automatically mean treatment is needed, and an abnormal one is read in context.

  • Your goals

    What you want to feel and do again guides the plan, including whether treatment makes sense at all.

  • Follow-up

    Monitoring, direct messaging, and adjustments keep your plan matched to how you respond.

What hormone care can help with

Matched to the right therapy and the right person.

AreaWomenMen
Sexual healthTestosterone has the strongest evidence for improving desire and function in appropriately selected women, particularly after menopause. Vaginal estrogen helps dryness and painful sex.In men with confirmed deficiency, testosterone modestly improves desire and erectile function.
SleepEasing night sweats with estradiol often improves sleep; some women sleep better on bedtime progesterone.Sleep problems get their own evaluation; testosterone is not an established sleep treatment.
MoodDuring perimenopause, estrogen may improve depressive symptoms for some women.Some men with confirmed deficiency see modest improvements in mood.
Body composition and muscleHormone therapy is not a weight-loss treatment; metabolic care and strength training address body composition directly.Treating confirmed deficiency increases lean mass and reduces fat mass.
BoneEstrogen therapy prevents bone loss after menopause and is considered when appropriate.Testosterone increased bone density in men with low testosterone in the Testosterone Trials.

About “bioidentical.” Bioidentical means a hormone has the same chemical structure as the one your body makes. FDA-approved estradiol and micronized progesterone are bioidentical. The word does not mean a product is compounded, safer, or better.

Common questions

Hormone care, answered.

Does Viva offer testosterone care for women?

Yes, for appropriately evaluated women. Testosterone plays a role in women's health as well as men's. Its strongest clinical evidence is for improving sexual desire and function in appropriately selected women, particularly after menopause. Research on other outcomes is more limited, and benefits demonstrated in men cannot automatically be assumed in women. Evaluation considers your symptoms, health history, goals, and monitoring needs. Women are prescribed a small fraction of a typical male dose, with labs to keep levels in the normal female range. No testosterone product is FDA-approved for women in the US, so treatment is off-label.

What does bioidentical mean?

Bioidentical means a hormone has the same chemical structure as the one your body makes. FDA-approved estradiol and micronized progesterone are bioidentical and available at retail pharmacies. The word does not mean a product is compounded, natural, safer, or better; those depend on the specific product, dose, and route.

Can estradiol or progesterone go through my retail pharmacy?

Estradiol and progesterone can be prescribed through your retail pharmacy when appropriate. Medication costs are separate, and insurance may help cover eligible prescriptions. Compounded preparations, when prescribed, are available at an additional cost.

Can I combine metabolic, hormone, and peptide care?

Yes. Hormone management requires an additional membership if you're enrolled in a metabolic program. Peptide management is included with all active memberships, with peptide therapy costs separate.

Can I discuss hormone therapy if I have a history of breast cancer?

Yes. You can book a symptom and quality-of-life evaluation, with decisions made case by case alongside your oncology team. Systemic menopausal hormone therapy is generally not recommended after breast cancer. Nonhormonal options are considered first for vaginal and urinary symptoms; selected patients may consider low-dose vaginal estrogen after a shared risk-benefit discussion. This is different from systemic hormone therapy. Anyone taking an aromatase inhibitor needs shared decision-making with their oncologist.

Hormone memberships

TRT All-Inclusive, $199/month: testosterone care for appropriately evaluated men and women, with medication, supplies, home delivery, and listed labs. Viva Concierge Access, $99/month: ongoing provider access with medication and labs separate, including estradiol and progesterone through your retail pharmacy.

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Included with every membership

Concierge care at your fingertips.

Your membership includes ongoing provider support, direct messaging with prompt responses, and one complimentary acute/sick visit per month for an appropriate minor illness, because life happens between follow-ups.

Medication or testing prescribed during that visit may cost extra. Not for emergencies.

See membership benefits

Your care, step by step

How care works at Viva.

Labs are ordered during your initial consultation after a review of your medical history and goals. You may provide recent lab results for your provider to review, and additional testing will be recommended when needed.

How it works
  1. Book a Consult

    Schedule your initial consultation with Lili. It is a private video visit focused on your concerns and goals.

  2. Medical review and labs

    Lili reviews your history and any recent results, then orders appropriate labs when they are needed.

  3. Your individualized plan

    Once the needed information is available, you and Lili build a plan that fits your goals, health history, and life.

  4. Monitoring, support, and adjustments

    Follow-ups, direct messaging, and adjustments keep your care moving as you progress and as life changes.