Hormone Replacement Therapy in New York City, NY

Medically reviewed by Dr. David Borenstein, MD. Last reviewed November 2026.

In short: Dr. David Borenstein provides hormone replacement therapy (HRT) for women and men at his Manhattan office. He tests estrogen, progesterone, testosterone, DHEA, cortisol and thyroid, then prescribes bioidentical hormones at doses matched to your labs and symptoms. He has treated hormone imbalance in New York for over 20 years.

Hot flashes at your desk. Waking at 3 a.m. Brain fog in meetings. A body that stores fat no matter how carefully you eat. Low drive, low mood, and the sense that you’re not yourself anymore.

These are often hormones, and they are treatable. Hormone replacement therapy restores hormones your body is no longer making in adequate amounts, most often estrogen and progesterone in women and testosterone in men.

Call (212) 262-2412 or request a consultation.

What changed with HRT safety in 2025

On November 10, 2025, the FDA announced it would remove most of the “black box” warning from menopausal hormone therapy. The warning dated to the 2002 Women’s Health Initiative study. Updated labels drop the boxed language on cardiovascular disease, breast cancer and probable dementia, and no longer tell doctors to use “the lowest dose for the shortest time.” The first relabeled products were approved in February 2026.

What this means for you: for women who start HRT before age 60 or within 10 years of menopause, the FDA now considers the benefit-risk balance more favorable than the old label suggested. Risks still exist: the endometrial cancer warning remains for estrogen-only products in women with a uterus, and the decision is still individual.

HRT for women

For perimenopause and menopause: hot flashes, night sweats, poor sleep, mood changes, brain fog, vaginal dryness, low libido, weight gain and bone loss. Dr. Borenstein may prescribe estradiol, progesterone, testosterone and DHEA, and treats vaginal dryness and recurrent yeast infections with vaginal estrogen. He also treats hormone imbalance from PCOS.

Read more: HRT for Women →

HRT for men

For low testosterone and andropause: fatigue, low libido, erectile changes, loss of muscle, belly fat, low mood and poor focus. Diagnosis requires symptoms plus low testosterone on at least two early-morning blood tests. Treatment options include testosterone creams, gels or injections.

Read more: Testosterone Replacement for Men →

Thyroid: the hormone often missed

Many patients referred for “hormones” have an underactive thyroid that standard TSH testing missed. Dr. Borenstein checks free T4, free T3, reverse T3 and thyroid antibodies. Holistic thyroid treatment →

Bioidentical vs. synthetic vs. compounded

Type	What it is	Examples	FDA-approved?
FDA-approved bioidentical	Same molecular structure as your hormones, standard doses	Estradiol patch, gel or pill; micronized progesterone; testosterone gel	Yes
Synthetic / non-bioidentical	Similar but not identical structure	Conjugated equine estrogens; medroxyprogesterone	Yes
Compounded bioidentical	Bioidentical hormones mixed by a compounding pharmacy at a custom dose or form	Custom estradiol/estriol creams, troches	No; not reviewed by FDA for safety or effectiveness

Dr. Borenstein uses FDA-approved bioidentical products when they fit, and compounded preparations when a patient needs a dose or form that isn’t commercially available. He explains the difference before you choose.

How Dr. Borenstein tests your hormones

Test	What it measures	Why
Blood	Estradiol, progesterone, total and free testosterone, SHBG, DHEA-S, thyroid panel, cortisol	Baseline and dose monitoring
Saliva	Free (bioavailable) hormones; cortisol rhythm across the day	Shows the daily stress-hormone pattern
Urine	Estrogen metabolites, hormone breakdown pathways	How your body processes estrogen
Safety labs	CBC/hematocrit, PSA (men), lipids, mammogram history (women)	Monitoring during treatment

Delivery options

• Transdermal creams, gels and patches: absorbed through skin; avoid first-pass liver metabolism of oral estrogen, which may lower clot risk
• Oral capsules: commonly used for progesterone, which can help sleep
• Vaginal estrogen: low-dose local treatment for dryness and urinary symptoms
• Injections: an option for testosterone

Risks and monitoring

For women: estrogen without progesterone raises endometrial cancer risk in women with a uterus, and oral estrogen carries a small clot risk. For men: testosterone can raise red blood cell counts, suppress sperm production and affect PSA. Dr. Borenstein schedules follow-up labs and adjusts your dose.

HRT may not be right if you have a history of breast or uterine cancer, blood clots, stroke, active liver disease, or (for men) untreated prostate cancer or plans to conceive soon.

Frequently asked questions

Is hormone replacement therapy safe?

For most healthy women under 60 or within 10 years of menopause, the FDA now considers HRT’s benefits to generally outweigh its risks for treating symptoms. Safety depends on your history, the hormones used and how they’re delivered, which is why Dr. Borenstein tests and monitors.

What is bioidentical hormone replacement therapy (BHRT)?

BHRT uses hormones with the same molecular structure as those your body makes, such as estradiol, progesterone and testosterone. Many are FDA-approved; compounded versions are not.

At what age should a woman start HRT?

Usually when symptoms start in perimenopause or menopause, ideally before 60 or within 10 years of the last period. Older women can sometimes start, with closer evaluation.

How do I know if I have low testosterone?

Common signs are low libido, fatigue, loss of muscle and low mood. Diagnosis needs those symptoms plus low levels on two separate morning blood tests.

How long until HRT works?

Hot flashes and sleep often improve in 2–4 weeks. Energy, mood, libido and body composition usually take 2–3 months.

Does insurance cover HRT in NYC?

The practice does not accept insurance for visits. Prescriptions for FDA-approved hormones are often covered by pharmacy benefits; compounded hormones usually are not.

Can HRT help with weight gain?

Correcting estrogen, progesterone, testosterone and thyroid imbalances can make weight loss possible again. See the Manhattan Metabolism weight loss program.

Reserve your appointment

Call Dr. Borenstein at (212) 262-2412 or contact us here. Manhattan office at 308 Fifth Avenue; telemedicine follow-ups available. Hormone therapy is often part of a broader longevity plan.

Serving patients across New York City: Manhattan (Midtown, NoMad, Flatiron, Chelsea, Murray Hill, Gramercy, the Upper East Side and the Upper West Side), Brooklyn, Queens, the Bronx and Staten Island, plus Long Island, Westchester and the greater New York metro area.