What is hormone optimization?

Hormone optimization is a phrase clinics use for hormone treatment. It is not the name of a board specialty, and it is not the title of the guidelines that cover these drugs. For men, the Endocrine Society's 2018 guideline is about testosterone therapy in men with hypogonadism. For women, the 2022 position statement of The North American Menopause Society is about hormone therapy for menopause symptoms, and the FDA has a separate page on menopause hormones. Those are two different situations. This page keeps them apart.

A clinic page that promises hormone treatment for energy, aging, or weight, without naming a diagnosis, is using a marketing phrase. Ask which guideline applies to you.

What is hormone optimization?

There is no ABMS specialty by this name. On October 13, 2026, a search of the ABMS certificate list found Family Medicine and Internal Medicine, and did not find the word "hormone." Endocrinology, Diabetes and Metabolism is a subspecialty under internal medicine. Reproductive Endocrinology and Infertility is a subspecialty under obstetrics and gynecology. Neither is named hormone optimization.

"Hormone optimization therapy" is the same kind of phrase. Clinics use it for a course of hormone treatment. The question to ask is which hormone, for which diagnosis, and which guideline the clinician is following.

What do clinics mean by hormone optimization therapy?

They usually mean prescribing a hormone, often testosterone for men or estrogen for women, sometimes as a compounded product. What a visit includes varies by clinic. This page cannot describe one visit, because there is no shared standard under this phrase.

What you can ask at a first visit:

1. What diagnosis are you treating, and which guideline covers it?
2. Is the product a compounded drug? Compounded drugs are not FDA-approved.
3. What benefits and risks apply to someone in my situation?
4. Which license do you hold, and which board certificate, if any?

Care comes from the clinician, not from Vye Health. Vye Health does not diagnose or treat anyone.

What do guidelines say about testosterone treatment for men?

The Endocrine Society published "Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline" in the Journal of Clinical Endocrinology and Metabolism on May 1, 2018. The abstract, read October 13, 2026, says the guideline updates the society's 2010 guideline on testosterone therapy in men with androgen deficiency syndromes. A task force of 10 medical experts and a guideline methodologist developed it with the GRADE approach and commissioned two systematic reviews.

The subject of that guideline is men with hypogonadism. It is not a program for healthy men who want more energy or a different body composition. This page does not restate dose, and it does not list symptoms the abstract does not list. Ask the clinician whether you meet the diagnosis the guideline is about, and what that guideline recommends for you. The right choice depends on your history, your lab results, and other conditions.

Testosterone products have their own risks. Those risks belong in the same conversation as any hoped-for benefit. This page does not have a sourced list of those risks from the full guideline text, so it does not invent one. Read the guideline with your clinician.

What do guidelines say about hormone therapy for women?

The 2022 hormone therapy position statement of The North American Menopause Society was published in the journal Menopause on July 1, 2022. The abstract, read October 13, 2026, says hormone therapy remains the most effective treatment for vasomotor symptoms (hot flashes and night sweats) and the genitourinary syndrome of menopause, and that it has been shown to prevent bone loss and fracture.

The same abstract says the risks differ by type, dose, duration, route, timing, and whether a progestogen is used. Treatment should be individualized, with periodic reevaluation. For women younger than 60, or within 10 years of menopause onset, and with no contraindications, the benefit-risk ratio is favorable for bothersome vasomotor symptoms and for prevention of bone loss. For women who start hormone therapy more than 10 years after menopause, or who are older than 60, the benefit-risk ratio appears less favorable because of greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia.

The FDA menopause page, read October 13, 2026, puts benefits and risks side by side. Benefits it names: relief of hot flashes, night sweats, vaginal dryness, or pain with sex, and a lower chance of osteoporosis. Risks it names for some women: blood clots, heart attacks, strokes, breast cancer, and gallbladder disease. For a woman with a uterus, estrogen alone raises the chance of endometrial cancer, and adding progestin lowers that risk.

The FDA also says menopause hormone therapy is not for everyone. Women who think they are pregnant, have problems with vaginal bleeding, have certain kinds of cancers, have had a stroke or heart attack, have had blood clots, or have liver disease should not take it. If you use hormone therapy, the FDA says to use the lowest dose that helps, for the shortest time you need it. The FDA says not to use hormone therapy to prevent heart attacks, strokes, memory loss, or Alzheimer's disease. It says studies have not shown that hormone therapy prevents aging and wrinkles or increases sex drive.

Those lines are general. A clinician has to apply them to you.

What does the FDA say about compounded hormone products?

Many products sold as "bioidentical hormones" are compounded drugs. Compounded drugs are not FDA-approved. The FDA menopause page, read October 13, 2026, says the agency does not have evidence that those products are safe and effective, or safer or more effective than hormone therapy the agency has approved.

The same page says the agency has approved drugs that contain hormones identical to the hormones women's bodies make in the reproductive years. Those are a different product from a compounded drug. The page also says the agency does not have evidence that estriol is a safer form of estrogen. There is no approved drug containing estriol. Drugs on the market that contain estriol are compounded drugs. Compounded drugs are not FDA-approved.

Ask the clinician to name the product. If it is compounded, treat it as a compounded drug, not as an approved medicine.

Is hormone optimization a medical specialty?

No. The certificate list above does not use that name. A clinician can still be licensed and can still hold a real board certificate, such as internal medicine, family medicine, or endocrinology, and also offer hormone treatment. The certificate and the marketing phrase are different.

You can check an ABMS certificate on Certification Matters. On October 13, 2026, that site's specialty list included Internal Medicine, Family Medicine, and Endocrinology, Diabetes and Metabolism. It did not offer "hormone optimization" as a specialty. A state license is a separate check, through the state medical board.

How do I check a hormone clinic?

Use the four questions in the section above, then look up the license and any ABMS certificate yourself. A city landing page or a med spa menu is not a guideline. This page does not list clinics and does not say where to buy a drug.

Clinicians who want the practice side of this topic can read How to start a hormone replacement therapy clinic. That page is written for prescribers.

This page is general information. It is not a diagnosis, a dose, or advice for one person. Talk with a clinician who can see your history before you start or stop a hormone. You can read more on the patient page.