Hormones fell out of favor after the Women’s Health Initiative (WHI) study was published in 2002. The media sensationalized the results and suddenly everyone was afraid of hormones — even bioidentical ones. Dr. Comeaux continued using them when appropriate because she understood the difference between synthetic and bioidentical hormones, and recognized the flaws in how the WHI data was being applied. Now, the research has caught up. Hormones are coming back into favor — but Dr. Comeaux never left.

Bioidentical hormones are not included in standard medical training — physicians must seek education on their own. Most traditional doctors don’t have the time or resources to develop expertise in this area. Dr. Comeaux underwent extensive training in bioidentical hormone therapy and has specialized knowledge of anti-aging, functional, and regenerative medicine. She also earns continuing medical education in Age Management and Functional Medicine.

Finding the right delivery method is where the art of hormone optimization comes in. Dr. Comeaux uses a variety of approaches:

• Patches — Easy to use, steady absorption, good for maintenance dosing.
• Compounded creams — Customizable strength, applied to skin, ideal for topical preference.
• Injections — Predictable absorption, precise dosing, great for those needing higher levels or with absorption issues.
• Troches — Dissolve in the cheek or under the tongue, partially bypass the liver, convenient and portable.
• Sublingual drops — Similar to troches in liquid form, fast absorption, easy to adjust dosing.
• Pellets — Implanted under the skin every 3–6 months, steady release, no daily dosing — very convenient for the right patient.

There is no one-size-fits-all. We find what works for you.

The Wiley Protocol is a specific method of bioidentical hormone replacement that mimics the natural cyclical pattern of a young menstrual cycle using twice-daily topical creams. It is designed for women in perimenopause, menopause, or surgically induced menopause who want to restore youthful hormone patterns rather than simply replacing to a static level. Dr. Comeaux utilizes this protocol where appropriate to achieve reproductive blood serum levels for optimum hormone restoration.

Follow-up appointments are generally every 3–6 months, and at a minimum every 6–12 months depending on the complexity of your situation. Important: Testosterone is a controlled substance in Texas — patients MUST be seen in the office every 6 months to continue receiving prescriptions. Initial appointments are 1 hour; follow-ups are 30–45 minutes, with exceptions at Dr. Comeaux’s discretion. Follow-up phone appointments (for patients with a long commute) are charged at the same rate as in-person appointments.