Midlife symptom clusters
Night waking, hot flashes, night sweats, fatigue, anxiety, brain fog, libido shifts, and body changes often travel together, even when one symptom gets your attention first.
Perimenopause + Hormones
If something has shifted, you aren't imagining it.
Sleep changes, mood shifts, heat, cycle changes, libido changes, and weight changes can show up together. This physician-led evaluation looks at midlife symptom clusters, BHRT when appropriate, and functional-medicine-informed next steps.
Sleep that won't hold
Mood, focus, and heat changes
Cycle and libido shifts
BHRT planning
These midlife changes often show up in clusters, even when they start one by one.
Many women do not need a headline diagnosis. They need a serious look at symptom clusters and whether BHRT, testing, or another next step makes sense.
Functional-medicine-informed evaluation
The visit can include a broader physician review of history, labs, patterns, and contributing factors so the plan stays grounded in how you actually feel and function.
BHRT and physician-led planning
When bioidentical hormone replacement therapy belongs in the conversation, it is discussed as part of a real medical plan with follow-up, not as a one-note promise.
Your first visit
What a first consultation includes.
Every first visit at PURR is 45 to 60 minutes with Dr. Gomez-Ratush — enough time to actually get to the point.
- 45 to 60 minutes with Dr. Gomez-Ratush
- A full conversation about your history, symptoms, and goals
- A consent-led, trauma-informed exam when appropriate
- Targeted lab work ordered at the visit if clinically useful
- A written, prioritized plan before you leave
- Clear pricing for anything recommended next
Concierge scheduling. Private Hamilton Park office. Cash-pay with HSA/FSA accepted.
How care is framed
Start with your story, then build a plan that makes sense.
The visit moves from symptoms and history to targeted next steps, rather than forcing every woman into the same script.
A hormone conversation that stays medical and specific.
Your first visit can include symptom timing, cycle changes, prior treatment experiences, lab review, and day-to-day impact.
Written follow-through, not a vague suggestion.
If testing, BHRT, or another next step is useful, it is folded into a practical plan you can return to.
Clear pricing belongs in the conversation.
PURR is a private cash-pay practice. We accept HSA and FSA, and we provide detailed superbills for out-of-network reimbursement where your plan allows.
Most treatments at PURR are part of a small, personalized plan — we'll give you the full investment before anything begins, and we never recommend what you don't need.
Private, physician-led care from the first visit.
PURR is built for women who want time, discretion, and a clear plan.
A calm, discreet setting
Visits are designed to feel personal, private, and medically grounded.
Time to talk it through
Questions, symptoms, and treatment options are discussed without rushing the conversation.
A plan you can follow
Each visit is built around clarity, follow-through, and next steps that make sense for you.
FAQ
Quick answers before you book.
The first step should feel clear even if you are not sure what to call your symptoms yet.
Do I need labs before I book a hormone consultation?
No. If lab work is clinically useful, it can be ordered at the visit and reviewed as part of your plan.
Do you offer BHRT?
Yes. When bioidentical hormone replacement therapy is clinically appropriate, it is discussed as part of a physician-led evaluation and follow-up plan.
Do you take insurance?
PURR is a private cash-pay practice. We accept HSA and FSA, and we provide detailed superbills for out-of-network reimbursement where your plan allows.
What happens after I submit?
You will see a thank-you page confirming your request, and the team can follow up about next steps from there.
Book a Hormone Consultation
Start with a visit long enough to be useful.
Private, physician-led care in Hamilton Park for symptoms that deserve more than a rushed reassurance.