Wellness & HRT in Houston

Overview

Wellness and hormone therapy

Wellness and hormone therapy is a category, not a single procedure. A woman searching “hormone therapy” may need FDA-approved estradiol and progesterone, vaginal estrogen, a thyroid workup, or a GLP-1 drug for weight. This page is organized by concern so you can work out which conversation to have with a clinician.

Women’s hormone therapy, men’s testosterone therapy and GLP-1 weight-loss drugs get the most coverage. Peptides, IV therapy and thyroid treatment get short sections. Texas rules on delegated cosmetic procedures took effect January 9, 2025 (Texas Medical Board), and Texas HB 3749 on elective IV therapy took effect September 1, 2025 (Texas Legislature).

Categories

What this category covers

Perimenopause and menopause. Hot flashes, night sweats, sleep problems, vaginal dryness and painful sex. FDA-approved treatment is systemic estrogen (with a progestogen if you have a uterus) or low-dose vaginal estrogen for genitourinary symptoms (The Menopause Society, 2022).

Low testosterone in men. The Endocrine Society recommends diagnosing it only in men with symptoms and signs of deficiency and consistently low levels, confirmed by repeating a morning fasting total testosterone test (Endocrine Society guideline, 2018).

Weight and metabolism. Semaglutide (Ozempic for type 2 diabetes, Wegovy for weight) and tirzepatide (Mounjaro for type 2 diabetes, Zepbound for weight) (Ozempic label; Mounjaro label; Wegovy label; Zepbound label). FDA declared the shortages of both drugs resolved in 2024 and 2025, which limits what compounding pharmacies may make (FDA).

Peptides, IV drips and NAD+. Several peptides sold by wellness clinics were previously in FDA’s Category 2 for compounding, the group for substances that may present significant safety risks (FDA).

Thyroid. Hypothyroidism is treated with levothyroxine. Thyroid hormone labels carry a boxed warning against use for obesity or weight loss (Synthroid label).

The first question is which concern you have. Ask the clinic to explain which condition it is treating and what tests support that diagnosis before it prescribes.

Decision

Understanding what you need

A starting point for the first conversation:

Several concerns can exist at the same time. Ask the clinic which one it plans to treat first and why.

Women

Hormone therapy for women

What the WHI found

The 2002 Women’s Health Initiative trial gave women aged 50 to 79 conjugated equine estrogens plus medroxyprogesterone acetate or a placebo. It reported higher rates of invasive breast cancer, coronary heart disease, stroke and pulmonary embolism, and lower rates of colorectal cancer and hip fracture, in the hormone group (Rossouw et al., JAMA 2002). An 18-year follow-up of the WHI trials found hormone therapy was not associated with higher all-cause, cardiovascular or cancer death rates (Manson et al., JAMA 2017).

The Menopause Society’s 2022 position statement says that for women younger than 60 or within 10 years of menopause onset, with no contraindications, the benefit-risk ratio is favorable for bothersome hot flashes and night sweats and for preventing bone loss. For women who start more than 10 years after menopause onset or after age 60, it says the benefit-risk ratio appears less favorable because of greater absolute risks of coronary heart disease, stroke, venous thromboembolism and dementia (The Menopause Society, 2022).

In November 2025, FDA began removing boxed-warning language about cardiovascular disease, breast cancer and probable dementia from menopausal hormone therapy labels. The boxed warning about endometrial cancer for systemic estrogen-alone products stays (FDA).

FDA-approved hormone therapy

• Systemic estradiol: for example patches (Vivelle-Dot, Climara, Minivelle), gels (Divigel, Estrogel) and spray (Evamist). The Menopause Society says hormone therapy risks differ by type, dose, duration, route, timing of initiation and whether a progestogen is used (The Menopause Society, 2022).
• Micronized progesterone: Prometrium’s label dose for preventing endometrial hyperplasia is 200 mg at bedtime for 12 days of each 28-day cycle in a postmenopausal woman with a uterus taking estrogen (Prometrium label). Estrogen labeling states that adding a progestogen reduces the risk of endometrial hyperplasia, which may be a precursor to endometrial cancer (Vivelle-Dot label).
• Vaginal estrogen for genitourinary syndrome of menopause: for example Vagifem, Imvexxy, Estring and Estrace cream. For bothersome symptoms not relieved by over-the-counter products, The Menopause Society recommends low-dose vaginal estrogen or other therapies such as vaginal DHEA or oral ospemifene (The Menopause Society, 2022).
• Combination products: for example Bijuva (estradiol and progesterone) and CombiPatch (estradiol and norethindrone acetate).

Estrogen should not be used by women with undiagnosed abnormal genital bleeding, breast cancer or a history of it, estrogen-dependent cancer, active or past blood clots, active or past stroke or heart attack, or liver impairment or disease (Vivelle-Dot label).

Compounded bioidentical hormone therapy

“Bioidentical” means chemically identical to a hormone the body makes, and some FDA-approved products fit that description: Prometrium’s label describes its progesterone as chemically identical to progesterone of human ovarian origin (Prometrium label). The useful distinction is FDA-approved vs. compounded. A 2020 National Academies review of compounded bioidentical hormone therapy found a lack of rigorous evidence of its safety and effectiveness from well-designed clinical studies (FDA summary of the NASEM report). If a clinic recommends a compounded product, ask why an FDA-approved product will not work for you.

Pellet therapy

Pellets are implanted under the skin and release hormone over months. Testopel is an FDA-approved testosterone pellet for men; its label dose is 150 mg to 450 mg every 3 to 6 months (Testopel label). Testopel’s labeling covers males only; ask whether any pellet offered to a woman is an FDA-approved product.

The 2019 Global Consensus Position Statement on testosterone for women says the only evidence-based use is for postmenopausal women diagnosed with hypoactive sexual desire disorder after formal assessment. It says any testosterone preparation that produces above-normal (supraphysiologic) levels, including pellets and injections, is not recommended, and that compounded “bioidentical” testosterone cannot be recommended for low sexual desire (Global Consensus Position Statement, JCEM 2019). A 2020 National Academies review recommended that FDA’s compounding advisory committee consider all compounded bioidentical hormone pellets for its list of drugs that are difficult to compound (National Academies, 2020).

If a clinic recommends pellets, ask why it prefers them over FDA-approved patches, gels or pills, which hormone levels it will check, what happens if the dose is too high, and how the dose can be lowered once a pellet is implanted.

Men

Testosterone replacement therapy for men

Who qualifies

The Endocrine Society’s 2018 guideline recommends (Endocrine Society guideline, 2018):

1. Diagnosing low testosterone only in men with symptoms and signs of deficiency and consistently low levels
2. A morning fasting total testosterone test, repeated to confirm
3. A free testosterone measurement when total testosterone is near the low end of normal
4. An evaluation of the cause once deficiency is confirmed

The guideline does not set a single 300 ng/dL cutoff. It cites 264 ng/dL as the lower limit of normal in healthy nonobese young men for standardized assays (Endocrine Society guideline, full text). The Testopel label likewise says to confirm the diagnosis with morning testosterone measured on at least two separate days (Testopel label). Ask whether the clinic repeats the test and looks for a cause before prescribing.

The guideline recommends against starting testosterone in men planning fertility soon, or who have breast or prostate cancer, a palpable prostate nodule, a PSA above 4 ng/mL (above 3 ng/mL in men at higher risk) without urologic evaluation, an elevated hematocrit, untreated severe sleep apnea, severe lower urinary tract symptoms, uncontrolled heart failure, a heart attack or stroke in the last 6 months, or thrombophilia (Endocrine Society guideline, 2018). It also suggests against routinely prescribing testosterone to all men 65 or older (Endocrine Society guideline, full text).

The TRAVERSE trial

TRAVERSE enrolled 5,246 men aged 45 to 80 with heart disease or high heart risk, symptoms of hypogonadism and two fasting testosterone levels below 300 ng/dL. They received daily 1.62% testosterone gel or a placebo gel. Mean treatment lasted 21.7 months (Lincoff et al., NEJM 2023).

• A major cardiac event (cardiovascular death, nonfatal heart attack or nonfatal stroke) occurred in 7.0% of the testosterone group and 7.3% of the placebo group; testosterone was noninferior to placebo.
• Atrial fibrillation, acute kidney injury and pulmonary embolism occurred more often in the testosterone group.

In February 2025, FDA recommended adding the TRAVERSE results to all testosterone labels and removing boxed-warning language about increased cardiovascular risk, and required blood pressure warnings (FDA). In June 2026, FDA requested further label updates, including removing the limitation of use on age-related hypogonadism (FDA).

FDA-approved testosterone forms

• Injections: testosterone cypionate or enanthate; Xyosted (weekly injection under the skin) (Xyosted label); Aveed (long-acting injection available only through a restricted REMS program because of the risk of pulmonary oil microembolism reactions) (Aveed label)
• Gels: for example AndroGel
• Oral capsules: Jatenzo, Tlando, Kyzatrex
• Nasal gel: Natesto
• Pellets: Testopel

Testosterone is a Schedule III controlled substance (Testopel label), and anyone who prescribes or dispenses a controlled substance must hold a federal registration (21 U.S.C. §822).

Monitoring

The Endocrine Society guideline says to evaluate the patient 3 to 12 months after starting and then yearly; to check hematocrit at baseline, 3 to 6 months after starting, and then yearly; and to stop therapy if hematocrit rises above 54% until it falls to a safe level. For men who choose prostate monitoring, it says to check PSA and do a rectal exam 3 to 12 months after starting, and to refer to urology for a PSA rise above 1.4 ng/mL within 12 months or a confirmed PSA above 4 ng/mL (Endocrine Society guideline, full text). Ask the clinic which of these tests it orders and when.

Fertility

The Endocrine Society recommends against starting testosterone in men planning fertility in the near term (Endocrine Society guideline, 2018). If you want children, tell the clinic before any prescription and ask about a referral to a urologist or fertility specialist.

GLP-1

Medical weight loss and GLP-1s

FDA-approved products

• Semaglutide: Ozempic is approved for type 2 diabetes (Ozempic label). Wegovy is approved for adults with obesity, or overweight with at least one weight-related condition, among other uses; it is a once-weekly injection or a once-daily pill (Wegovy label).
• Tirzepatide: Mounjaro is approved for type 2 diabetes (Mounjaro label). Zepbound is approved to reduce excess body weight in adults with obesity, or overweight with at least one weight-related condition (Zepbound label).

Results from the main trials

• STEP 1 (semaglutide 2.4 mg, NEJM 2021): mean body-weight change of -14.9% with semaglutide vs. -2.4% with placebo at 68 weeks, in adults with a BMI of 30 or more (27 or more with a weight-related condition) and without diabetes (Wilding et al., NEJM 2021).
• SURMOUNT-1 (tirzepatide, NEJM 2022): mean weight change at 72 weeks of -15.0%, -19.5% and -20.9% with 5, 10 and 15 mg, vs. -3.1% with placebo. 85%, 89% and 91% of participants on the three doses lost at least 5% of body weight, vs. 35% on placebo (Jastreboff et al., NEJM 2022).

In both trials, gastrointestinal side effects were the most common, mostly mild to moderate (Wilding et al.; Jastreboff et al.).

Compounded semaglutide and tirzepatide

FDA determined the tirzepatide shortage was resolved on October 2, 2024, and reaffirmed that on December 19, 2024. It determined the semaglutide shortage was resolved on February 21, 2025. FDA’s enforcement grace periods ended February 18, 2025 (503A pharmacies) and March 19, 2025 (503B outsourcing facilities) for tirzepatide, and April 22, 2025 (503A) and May 22, 2025 (503B) for semaglutide (FDA). A 503A pharmacy may still compound for an individual patient when the prescriber documents a significant difference for that patient, but not essentially copies of the approved drug regularly or in inordinate amounts (FDA).

FDA does not review compounded drugs for safety, effectiveness or quality before they are marketed, and has received reports of adverse events with compounded semaglutide and tirzepatide, some requiring hospitalization and some linked to dosing errors (FDA). In February 2026, FDA announced it intends to restrict GLP-1 ingredients used in non-FDA-approved compounded drugs (FDA). If a clinic offers a compounded version, ask for the patient-specific reason it is being prescribed and which pharmacy makes it.

Manufacturer self-pay prices

These are the manufacturers’ published self-pay prices, checked October 29, 2026. They are not Houston clinic prices, and clinic fees for visits and labs are separate.

• Zepbound KwikPen (Lilly): $299 per month for 2.5 mg, $399 for 5 mg, and $449 for 7.5 mg to 15 mg; the $449 price for the higher doses requires refilling within 45 days. The $299 monthly price also applies to vials. Lilly’s savings card expires December 31, 2026 (Lilly).
• Wegovy (NovoCare): pens are $349 per month for doses up to 2.4 mg, with an introductory $199 per month for the first two fills of 0.25 mg and 0.5 mg for new self-pay patients; Wegovy HD 7.2 mg is $399 per month. Wegovy pills are $149 per month for 1.5 mg, $199 for 4 mg, and $299 for 9 mg and 25 mg. NovoCare says pricing will be updated after December 31, 2026 (NovoCare).

Safety

Wegovy and Zepbound must not be used by anyone with a personal or family history of medullary thyroid carcinoma or with MEN 2, and both carry a boxed warning about thyroid C-cell tumors (Wegovy label; Zepbound label). Wegovy’s label lists warnings for acute pancreatitis, gallbladder disease, low blood sugar, kidney injury from dehydration, severe gastrointestinal reactions, and pulmonary aspiration during general anesthesia or deep sedation; it says Wegovy is not recommended in severe gastroparesis and should be stopped at least 2 months before a planned pregnancy. Tell your surgeon or anesthesia team before any procedure if you take it (Wegovy label).

In January 2026, FDA said its review did not find an increased risk of suicidal thoughts or behavior with GLP-1 drugs and asked manufacturers to remove that warning from labels (FDA).

Peptides

Peptides

A 503A compounding pharmacy may compound from a bulk ingredient only if it has a USP or NF monograph, is a component of an FDA-approved drug, or is on FDA’s 503A bulks list; while FDA builds that list, it allows substances in its Category 1 (FDA).

BPC-157, CJC-1295, TB-500, thymosin alpha-1, AOD-9604, GHK-Cu (injectable), melanotan II and epitalon were previously in Category 2, FDA’s group for substances that may present significant safety risks; their nominations were later withdrawn by the nominators. Kisspeptin-10 and ibutamoren are listed in Category 2. FDA’s page lists possible immunogenicity and limited safety data for several of them, and reported serious adverse events for some, such as CJC-1295 and AOD-9604 (FDA). None of these appears in Category 1 on FDA’s current list, updated May 14, 2026 (FDA category list).

Tesamorelin (Egrifta) is an FDA-approved peptide; its approved use is reducing excess abdominal fat in adults with HIV and lipodystrophy (Egrifta WR label).

Ask the clinic whether the product is an FDA-approved drug, and if not, which pharmacy compounds it and on what basis.

IV Therapy

IV therapy and NAD+

Texas HB 3749 (Jenifer’s Law) was signed on June 20, 2025 and took effect September 1, 2025 (Texas Legislature). It covers elective IV therapy, defined as IV fluids, nutrients, medications or blood sought by the patient to relieve temporary discomfort or improve temporary wellness. A physician may delegate prescribing or ordering it to a PA or APRN, and administering it to a PA, APRN or RN, each acting under adequate physician supervision (HB 3749 text).

This page does not rate the evidence for specific wellness drips, NAD+ infusions or vitamin cocktails. Ask the clinic what the drip is meant to do for you, what evidence supports that use, who the supervising physician is, and who will place and monitor the IV.

Thyroid

Thyroid

Hypothyroidism is treated with levothyroxine. Thyroid hormone labels, including levothyroxine (Synthroid) and liothyronine (T3, Cytomel), carry a boxed warning that thyroid hormones should not be used to treat obesity or for weight loss; in people with normal thyroid function, usual doses do not reduce weight and larger doses may cause serious or life-threatening toxicity (Synthroid label; Cytomel label). The levothyroxine label also says overtreatment may cause arrhythmias, particularly in older patients and people with heart disease, and can decrease bone mineral density (Synthroid label).

If a clinic recommends thyroid hormone, ask which test results show you need it and how it will monitor your dose.

Texas Law

The Texas legal framework

22 TAC Chapter 169, Subchapter E (effective January 9, 2025) governs the delegation of nonsurgical medical cosmetic procedures (Texas Medical Board). It applies to cosmetic procedures such as injectables, not to prescribing hormones or GLP-1 drugs in general. Key points:

• Before a delegated procedure, a physician, or a PA or APRN acting under the physician’s delegation, must establish a practitioner-patient relationship with the patient (22 TAC §169.26).
• A physician, PA or APRN must either be on site during the procedure or be immediately available for emergency consultation (22 TAC §169.26).
• The physician delegates through a written order that names the delegating physician and covers patient screening, appropriate care, and procedures for complications and emergencies (22 TAC §169.27). The person performing the procedure must also sign and date a written protocol (22 TAC §169.26).
• The delegating physician’s name and Texas license number must be posted in each public area and treatment room (22 TAC §169.28).

HB 3749 covers elective IV therapy (see above) (HB 3749 text).

Before you book a cosmetic injection or an IV drip at a Houston wellness clinic, confirm:

1. The delegating physician’s name and Texas license number are posted (22 TAC §169.28)
2. A physician, or a PA or APRN acting under the physician’s delegation, establishes a practitioner-patient relationship with you before a delegated procedure (22 TAC §169.26)
3. Whoever prescribes testosterone holds a federal controlled-substance registration (21 U.S.C. §822)

What to Expect

Consultation, labs, monitoring

History. Expect questions about your medical history, current medications, pregnancy plans, family history of hormone-sensitive cancers, heart and clotting history, and sleep apnea.

Tests. Tests depend on the therapy. For testosterone in men, the Endocrine Society recommends a repeated morning fasting total testosterone test, free testosterone when total testosterone is near the low end of normal, and an evaluation of the cause; before starting, it lists PSA and hematocrit among the checks (Endocrine Society guideline, 2018). For GLP-1 drugs, the clinic should ask about medullary thyroid carcinoma and MEN 2 (Wegovy label).

Monitoring. Testosterone: evaluation at 3 to 12 months and then yearly, with hematocrit at baseline, 3 to 6 months and then yearly (Endocrine Society guideline, full text). Menopause hormone therapy: periodic reevaluation of the benefits and risks of continuing (The Menopause Society, 2022). Wegovy injection: dose increases every 4 weeks until the maintenance dose (Wegovy label).

Ask any clinic which tests it will order before prescribing and when it will review the results with you.

Houston Pricing

Houston pricing

This site does not publish a Houston price range for hormone therapy, testosterone, GLP-1 programs, peptides or IV therapy. The only prices on this page are the manufacturers’ own self-pay prices for Zepbound and Wegovy, listed in the GLP-1 section above (Lilly; NovoCare). Ask any clinic for its full price in writing, including visits, labs and the medication itself, and whether it requires a contract.

How to Choose

How to choose a provider, and what to check

Credentials.

• Is the delegating physician’s name and Texas license number posted (22 TAC §169.28)?
• For a delegated cosmetic procedure, does a physician, or a PA or APRN acting under the physician’s delegation, establish a practitioner-patient relationship with you first (22 TAC §169.26)?
• For IV therapy, who is the supervising physician (HB 3749 text)?

Testing and monitoring.

• For testosterone: is the diagnosis based on a repeated morning fasting test and an evaluation of the cause (Endocrine Society guideline, 2018)?
• For testosterone: will they check hematocrit at baseline, 3 to 6 months and then yearly (Endocrine Society guideline, full text)?
• For GLP-1 drugs: do they ask about medullary thyroid carcinoma and MEN 2 (Wegovy label)?

Product sourcing.

• GLP-1 drugs: FDA-approved product, or compounded? If compounded, what is the documented patient-specific reason (FDA)?
• Hormones: FDA-approved, or compounded? If compounded, why will an FDA-approved product not work (FDA summary of the NASEM report)?
• Peptides: is the product FDA-approved, and if not, is it in FDA’s Category 1 (FDA category list)?

Warning signs:

• No delegating physician name or Texas license number posted (22 TAC §169.28)
• Testosterone prescribed on a single test with no repeat or evaluation of the cause (Endocrine Society guideline, 2018)
• Pellets recommended for women without discussion of FDA-approved options (Global Consensus Position Statement, JCEM 2019)
• Compounded semaglutide or tirzepatide offered without a documented, patient-specific reason (FDA)
• Peptides on the menu that are not FDA-approved and not in FDA’s Category 1, such as BPC-157 (FDA category list)
• Thyroid hormone offered for weight loss (Synthroid label)
• Prescribing with no medical history or tests