Bioidentical hormone therapy in Charleston, run from your home

Labs drawn at your kitchen table. A nurse practitioner reads them. You go into an office once, if at all.

BHRT is bioidentical hormone replacement therapy, hormones molecularly identical to the ones your body already makes. Holy City Healthcare Consultants provides it across Charleston for women in perimenopause and menopause and for men with low testosterone, using EvexiPEL pellet therapy, injections, creams and patches depending on what your labs and your life call for.

Most of the work happens before you ever meet us in person. We draw your labs at home, you complete intake electronically, and a licensed nurse practitioner reviews the results with you by telehealth. The in-person visit is for starting treatment, not for paperwork.

5.0 on Google across 133 reviews. Hormone therapy is prescribed and monitored by South Carolina licensed nurse practitioners.

Couple in Charleston, SC after starting bioidentical hormone replacement therapy at home

What hormone decline actually feels like

Most people arrive here after a year or two of being told their labs are normal. Hormone decline is gradual, and the symptoms get blamed on stress, age or work. These are the patterns we treat.

Women, perimenopause and menopause

Usually somewhere between 40 and 58, sometimes earlier.

Hot flashes and night sweats
Sleep that breaks up at 2 or 3 in the morning
Brain fog, or losing words mid sentence
Mood swings, irritability or new anxiety
Weight gain around the middle that diet does not touch
Low libido and vaginal dryness
Periods that have become unpredictable

Men, low testosterone

Testosterone falls about 1% a year after 30. It adds up quietly.

Fatigue that rest does not fix
Losing muscle while gaining fat
Low libido or erectile changes
Low motivation and flat mood
Trouble concentrating at work
Poor sleep quality
Strength dropping off in the gym

How hormone therapy works here

Four steps. Most of it happens before you meet anyone in person.

Nothing gets prescribed off a symptom questionnaire. Every plan starts with a real hormone panel and a provider who reads it.

An EvexiPEL bioidentical hormone pellet used in hormone therapy in Charleston, SC
1Intake and labs at homeNo lab waiting roomYou complete a secure electronic intake, then a nurse draws your labs at your house. Nobody sits in a Quest waiting room for a hormone panel.
2Nurse practitioner reviewTelehealth, with your results in front of youA licensed nurse practitioner goes through your panel, your symptoms and your history, and tells you whether hormone therapy is appropriate. Sometimes the answer is that something else is driving it.
3Starting treatmentOne in-person visitIf BHRT is right for you, the provider prescribes the method and the dose. Pellet insertion is a short in-office procedure. Injections, creams and patches start at home.
4Monitoring and adjustmentLabs and symptoms, over timeDoses are raised conservatively and re-checked. Hormone therapy that is never re-measured is guesswork, so reassessment is built into the plan rather than left to you to request.

Four ways it can be delivered, chosen clinically

There is no single best route. The provider picks based on your labs, your tolerance and how much daily maintenance you actually want.

EvexiPEL pellets

FDA-registered pellets placed under the skin, releasing a steady dose over several months. Suits people who do not want a daily or weekly task, and who dislike the peaks and troughs of creams and pills.

Injections

Weekly or twice-weekly, done at home. Precise, easy to adjust quickly, and the least expensive to start.

Creams and gels

Applied daily. Simple to stop or change, useful when a provider wants fine control early on.

Patches

Transdermal, changed on a schedule. A steady option for patients who cannot tolerate other routes.

Why we use the EvexiPEL method

Steady levels instead of a daily spike and crash.

A cream or a pill puts a dose in and lets it fall away before the next one. Patients feel that as a good morning and a rough afternoon. EvexiPEL pellets sit under the skin and release continuously for several months, so levels stay in range instead of sawtoothing.

EvexiPEL is also a protocol, not just a pellet. It asks what is driving the imbalance in the first place, including thyroid, gut health, stress load, sleep and nutrition, rather than treating a low number as the whole story. Our providers are trained in that method and monitor accordingly.

Patients most often report better sleep first, then steadier mood and clearer thinking, then changes in body composition and libido over a longer stretch. Response varies, and dosing is adjusted to what your labs and your symptoms actually show.

Prescribed by a nurse practitionerEvery plan is provider directed. No treatment is dispensed on a questionnaire alone.
Labs drawn in your homeIncluding the follow up panels, which is where most hormone programs quietly stop bothering.
Adjusted, not set and forgottenDoses move based on measured response. Reassessment is scheduled, not left for you to chase.
Men and women, same standardPerimenopause, menopause and low testosterone are all managed under the same clinical process.
Part of a whole pictureHormones are checked alongside metabolic and nutritional markers, so a thyroid problem does not get treated as a testosterone problem.

Hormone therapy questions, answered

Still have a question? Call or text 843.730.2790 and a clinical concierge will get back to you.

Charleston couple feeling like themselves again after bioidentical hormone therapy

What is BHRT, and how is it different from traditional hormone therapy?

BHRT uses hormones that are molecularly identical to the ones your body produces. Older conventional hormone therapy often used synthetic or animal-derived versions with a different structure. Both are prescription medicine and both need provider oversight. The practical difference patients notice more is delivery: a pellet holding a steady level behaves very differently from a daily pill.

Usually once, and only to start. Intake, labs and the provider consultation all happen at your home or by telehealth. Pellet insertion is a short in-office procedure. Injections, creams and patches are started at home, so some patients never come in at all.

You do not, until the labs come back. That is the point of the panel. Plenty of people arrive convinced their hormones are the problem and turn out to have a thyroid, sleep or nutritional issue instead. Our providers will tell you when hormone therapy is not the answer.

No. Roughly half of hormone therapy patients are men being treated for low testosterone. Testosterone declines about 1% a year after 30, and the symptoms, fatigue, lost muscle, low motivation, poor sleep, get written off as ordinary aging for years before anyone measures it.

Sleep and mood tend to move first, often within a few weeks. Body composition and libido take longer, usually two to three months, and depend on dose and on what else is going on. Anyone who promises a specific timeline before seeing your labs is guessing.

Hormone therapy is quoted before anything is scheduled, once the provider knows which method and what monitoring your case needs. You will not be scheduled without knowing the number first. Call 843.730.2790 and we will walk you through it.

Ask us when you call and we will tell you plainly what applies to your situation rather than guessing here.

South Carolina licensed nurse practitioners, with the practice founded and led by Ralph Fontanez, BSN, RN. Your labs are read by a clinician, not scored by software.

Ralph Fontanez, BSN, RN, founder of Holy City Healthcare Consultants in Charleston, SC

Medically reviewed by

Ralph Fontanez, BSN, RN

Founder, Holy City Healthcare Consultants

Ralph spent nearly eight years as a US Army medic with the 173rd and 82nd Airborne, including a deployment to Afghanistan, before moving into nursing. His clinical background is in critical care, hematology and oncology, and infusion therapy. He founded Holy City Healthcare Consultants to bring that standard of care into patients’ homes across the Charleston metro.

Last reviewed September 2026. This page is for general information and is not a substitute for a consultation with a licensed provider.

Book a hormone consultation

Start with the labs. We will tell you what they say before anyone talks about treatment.

843.730.2790

7 days a week, 8:00 AM to 8:00 PM

24/7 for Whole Health Management members

clientservices@holycityhc.com

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