Hormone Optimization in Chandler, AZ — Feel Like Yourself Again
Fatigue. Brain fog. Changes in weight, libido, mood, or sleep. These are not just signs of getting older. They are symptoms. And they have solutions.
Hormones influence many systems in your body — including energy, metabolism, mood, sleep, libido, and more. When hormone levels change, the effects can show up in different ways. At New Viva MD, testing, symptoms, and your health history are considered together to understand what may be changing and whether treatment is appropriate.
We treat both men and women with individualized hormone therapy plans guided by your symptoms, health history, lab results, and goals — not a one-size-fits-all protocol.
Hormone Therapy For Women
Perimenopause and menopause are not just about hot flashes. Changing hormone levels can affect sleep, mood, energy, body composition, weight, sexual health, and quality of life. New Viva MD helps women understand these changes and build a treatment plan around their individual symptoms, health history, and lab results.
What We Treat — Women's Hormone Health
- Perimenopause and menopause symptoms
- Hot flashes, night sweats, and insomnia
- Weight gain and difficulty losing weight despite effort
- Fatigue and brain fog
- Low libido and vaginal dryness
- Mood changes, irritability, anxiety, or feeling unlike yourself
- Bone health and other health changes associated with declining estrogen
- Thyroid imbalances that affect metabolism and energy
Treatment Options for Women
- Bioidentical hormone replacement therapy (BHRT)
- Estrogen and progesterone therapy
- Testosterone therapy for women when clinically appropriate
- Thyroid hormone management
- DHEA evaluation and treatment when appropriate
- Comprehensive hormone panel testing
- Ongoing monitoring and dose optimization based on labs and symptoms
“I feel like I lost myself.” This is what we hear most from women who come to New Viva MD. Low energy. Weight that will not move no matter what they eat or how hard they work. Mood changes that feel out of character. Sleep that never restores.
These are not character flaws. Hormonal changes may be part of what you are feeling. When estrogen, progesterone, or testosterone levels change, symptoms can show up in different ways. The goal of physician-led hormone care is to understand what is happening and help you feel more like yourself again.
Your symptoms have answers.
Not all hormone therapy is the same. Your lab results are reviewed alongside your symptoms, health history, medications, and goals. A result that falls within a reference range does not always explain why you feel the way you do, which is why the whole picture matters.
The goal is treatment that makes sense for your health — not simply chasing a number.
Book a hormone evaluation with Dr. Surkunte in Chandler, AZ — comprehensive labs, expert interpretation, and a treatment plan built specifically around you.
Testosterone Replacement Therapy (TRT) for Men
Testosterone levels decline approximately one to two percent per year after age 30. By the time most men notice the symptoms, they have been running on low for years. Low testosterone does not just affect performance in the gym — it affects energy, focus, mood, body composition, sleep, and quality of life.
Symptoms of Low Testosterone in Men
- Chronic fatigue and low energy even after adequate sleep
- Difficulty building or maintaining muscle mass
- Increased body fat, especially around the abdomen
- Brain fog and difficulty concentrating
- Low libido and sexual dysfunction
- Mood changes, irritability, or reduced motivation
- Poor sleep quality
- Reduced motivation and drive
New Viva MD TRT Program
Your TRT program may include total and free testosterone, estradiol, SHBG, LH, FSH, and other relevant testing before treatment. If TRT is appropriate, available options may include injections, topical therapy, or pellets, with follow-up monitoring of testosterone levels, hematocrit, symptoms, and other markers when appropriate. Estrogen management to prevent common side effects of TRT. Integration with medical weight loss program when applicable. Ongoing dose optimization based on labs and how you feel — never set-and-forget.
Many men come in thinking the changes they are noticing are simply part of getting older. Sometimes low testosterone is part of the picture, and when a deficiency is confirmed, treatment may help with symptoms such as low energy, libido, body composition, and overall quality of life.
The goal is not simply to chase a higher testosterone number. Your symptoms, lab results, response to treatment, and safety markers are reviewed together so treatment can be adjusted to a clinically appropriate level for you.
Your symptoms have answers.
Book a hormone evaluation with Dr. Surkunte in Chandler, AZ — comprehensive labs, expert interpretation, and a plan built around you.
Hormone Therapy FAQs
What are the signs that my hormones are out of balance?
The most common signs of hormonal imbalance in women include unexplained fatigue that does not improve with rest, unexplained weight gain or difficulty losing weight despite diet and exercise, brain fog and difficulty concentrating, low libido, mood changes that feel out of character, hot flashes and night sweats, poor sleep, vaginal dryness, irregular periods, and hair thinning. These symptoms often develop gradually and can easily be mistaken for stress or normal aging. A more complete evaluation can help determine whether hormone changes may be contributing.
What is bioidentical hormone replacement therapy (BHRT) and how is it different from conventional HRT?
Bioidentical hormones have the same molecular structure as hormones naturally produced by the body, including estrogen, progesterone, and testosterone. Some conventional hormone formulations use different forms of these hormones, which can have different effects in the body. The right option depends on your health history, symptoms, lab results, and treatment needs, with appropriate dosing and ongoing monitoring playing an important role in hormone therapy.
What hormones may be evaluated during hormone testing?
Hormone testing may include estrogen (estradiol), progesterone, testosterone, DHEA, thyroid markers such as TSH, free T3, free T4 and reverse T3, cortisol, insulin, and sex hormone-binding globulin (SHBG). The exact tests depend on your symptoms, health history, and concerns being evaluated. Results are considered together with how you feel rather than looking at one hormone level by itself.
At what age should women consider hormone therapy?
There is no fixed age when a woman should consider hormone therapy. Hormonal changes can occur in the 30s, 40s, and 50s, and some women notice symptoms such as fatigue, mood changes, low libido, or sleep problems earlier than others. Symptoms often become more noticeable during perimenopause in the 40s and 50s. Whether treatment is appropriate should be based on your symptoms, health history, lab results, and individual needs rather than age alone.
What is the difference between perimenopause and menopause?
Perimenopause is the transition leading up to menopause, often beginning in a woman’s early to mid-40s, when hormones such as estrogen and progesterone begin to fluctuate. This can cause irregular periods, hot flashes, night sweats, mood changes, weight changes, and sleep problems. Menopause is reached after 12 consecutive months without a menstrual period and typically occurs in the early 50s, although the timing varies from woman to woman.
Can testosterone be part of hormone therapy for women?
Women naturally produce testosterone in the ovaries and adrenal glands, and it plays a role in libido, muscle mass, bone health, energy, mood, and other functions. Testosterone levels can decline with age and hormonal changes, and some women may notice low sex drive, reduced muscle mass, fatigue, or other symptoms. Testosterone therapy may be considered in selected women when symptoms, health history, and appropriate testing support its use.
Is hormone therapy safe?
The safety of hormone therapy depends on the hormones used, the dose, how they are delivered, your health history, and how treatment is monitored. The 2002 Women’s Health Initiative raised important concerns about certain HRT formulations and patient groups, and later research has helped clarify how risks differ by treatment and individual factors. Personal and family cancer history, cardiovascular health, clotting history, medications, and other risk factors should all be reviewed before hormone therapy is started.
Can hormone changes affect weight and body composition?
Hormonal changes involving estrogen, testosterone, thyroid function, and other metabolic factors can affect body composition, muscle mass, fat distribution, energy, and how easy or difficult weight management feels. When a true hormone deficiency or thyroid problem is identified, treating it may help improve some of these factors. Hormone therapy is not a weight loss treatment by itself, but addressing a confirmed hormonal issue may support a broader weight-management plan.
How long does it take for hormone therapy to work?
Some women may notice changes in sleep or mood within 2–4 weeks, while improvements in energy, hot flashes, and night sweats may take around 4–8 weeks. Libido and mental clarity may take 1–3 months, and body composition changes generally take longer. These timelines vary from person to person, so symptoms, lab results, and treatment response should be monitored as therapy continues.
What are the treatment options for hormone therapy at New Viva MD?
Hormone therapy can be delivered in several ways, including oral capsules or tablets, topical creams and gels, transdermal patches, subcutaneous injections, and pellet therapy. The best delivery method depends on the hormone being treated, your health history, lifestyle, treatment goals, and how your body responds. Each option has different dosing, convenience, and monitoring considerations.
Does insurance cover hormone therapy?
Many insurance plans may cover some forms of hormone therapy, particularly when there is a documented hormone deficiency or menopause-related diagnosis. Coverage varies by plan, medication, testing, and delivery method, and some treatments may require prior authorization or involve out-of-pocket costs.
What is low testosterone and how do I know if I have it?
Low testosterone, also called hypogonadism or low T, occurs when the body does not produce enough testosterone to meet its needs. Symptoms can include ongoing fatigue, difficulty building or maintaining muscle, increased abdominal fat, brain fog, low libido, erectile difficulties, mood changes, poor sleep, and reduced motivation. These symptoms often develop gradually and can overlap with other health conditions, so lab testing and a medical evaluation are needed to confirm low testosterone.
How are testosterone levels interpreted?
Standard laboratory reference ranges for total testosterone are often around 300–1,000 ng/dL, although the exact range varies by laboratory. Some men with levels in the lower part of the range, such as 300–450 ng/dL, may still report symptoms, but one number alone does not determine whether TRT is appropriate. Total testosterone may be considered alongside free testosterone, estradiol, SHBG, LH, FSH, symptoms, and medical history to understand the overall picture.
How is testosterone replacement therapy administered?
Testosterone replacement therapy can be given through weekly or bi-weekly intramuscular or subcutaneous injections, daily topical gels or creams, or subcutaneous pellets that may last around 3–6 months. Injections allow more flexibility with dose adjustments, topical treatments provide daily delivery, and pellets offer longer-lasting dosing without weekly injections. The best method depends on your lifestyle, preferences, response, and treatment needs.
What lab tests are done before starting TRT?
Testing before TRT may include total testosterone, free testosterone, estradiol, SHBG, LH, FSH, prolactin, a complete metabolic panel, complete blood count with hematocrit, PSA, and thyroid testing when appropriate. These results help establish a baseline, look for possible causes of low testosterone, identify potential safety concerns, and guide treatment decisions.
What are the risks of testosterone replacement therapy?
TRT can raise red blood cell levels and hematocrit, which is why regular blood testing is important. Testosterone can also convert to estradiol, which may contribute to water retention, mood changes, or breast tenderness in some men. TRT can suppress natural testosterone and sperm production, which may affect fertility, and PSA may need to be monitored in men over 40 or those with a family history of prostate cancer. Regular follow-up and dose adjustments help manage these risks.
How long does it take for testosterone replacement therapy to work?
Some men may notice changes in energy, mood, or sleep within 2–4 weeks, while libido may take around 3–6 weeks. Changes in muscle mass and body composition usually develop more gradually over 3–6 months, especially with regular resistance training, and continued changes may occur over 6–12 months. Individual response varies, so symptoms and lab results should be monitored throughout treatment.
Can low testosterone affect muscle mass and body composition?
Low testosterone can be associated with reduced lean muscle and increased body fat, particularly around the abdomen. When a true testosterone deficiency is confirmed, treatment may support improvements in muscle mass, body composition, energy, and activity levels. TRT is not primarily a weight loss treatment, but correcting a confirmed deficiency may support a broader approach to weight management.
Will TRT affect my fertility?
Testosterone replacement therapy can suppress the pituitary signals that support natural testosterone and sperm production, which may significantly reduce sperm count and fertility. If preserving fertility is important, this should be discussed before starting TRT. Alternatives such as clomiphene or human chorionic gonadotropin (hCG) may be considered in some situations.
Does insurance cover testosterone replacement therapy?
Many insurance plans may cover testosterone replacement therapy when low testosterone is confirmed through appropriate lab testing and medical evaluation. Coverage varies by plan and by the formulation prescribed, and some insurers may require repeat lab results, additional documentation, or prior authorization.
What is the difference between TRT and anabolic steroids?
Testosterone replacement therapy is medically supervised treatment used to restore testosterone to a physiological range in men with a confirmed deficiency. Anabolic steroids are often used at supraphysiological doses, meaning levels far above the normal range, for muscle growth or performance enhancement. Misuse of anabolic steroids is associated with cardiovascular, liver, hormonal, and psychological risks that are different from appropriately monitored TRT.
What are the symptoms of a thyroid problem?
The thyroid helps regulate metabolism, energy, body temperature, heart rate, and many other functions. Hypothyroidism, or an underactive thyroid, can cause fatigue, weight gain or difficulty losing weight, brain fog, constipation, dry skin and hair, hair thinning, cold sensitivity, elevated cholesterol, mood changes, and menstrual changes. Hyperthyroidism, or an overactive thyroid, can cause weight loss, heart palpitations, anxiety, heat sensitivity, and tremors.
Why can I still have symptoms when my thyroid test is within the reference range?
Standard thyroid testing often begins with TSH (thyroid-stimulating hormone), which shows how strongly the pituitary gland is signaling the thyroid. Depending on your symptoms and medical history, additional testing such as free T4, free T3, reverse T3, or thyroid antibodies may sometimes provide more information. Thyroid-like symptoms can also have other causes, so test results should be considered together with your symptoms and overall health rather than relying on one number alone.
What is the difference between T3 and T4 thyroid hormones?
The thyroid mainly produces thyroxine (T4), which is converted in the body into triiodothyronine (T3). T3 is the more active form of thyroid hormone and has a stronger effect on metabolism and energy use. TSH, T4, T3, and other thyroid-related markers provide different information about how the thyroid system is functioning, so more than one result may sometimes be considered during an evaluation.
Can thyroid symptoms occur when some lab results are within the reference range?
Yes. Laboratory reference ranges are population-based, and a result that falls within range does not always explain every symptom a person is experiencing. If fatigue, weight changes, cold sensitivity, hair changes, or other thyroid-like symptoms continue, results such as TSH and free T3 may need to be considered alongside other thyroid markers, medications, medical history, metabolic health, and possible non-thyroid causes.
What thyroid treatments are available at New Viva MD?
Thyroid treatment may include levothyroxine (T4), liothyronine (T3), combination T4/T3 therapy, or desiccated thyroid products such as Armour Thyroid or NP Thyroid when appropriate. The treatment selected depends on your diagnosis, symptoms, lab results, health history, and response, with follow-up testing used to monitor thyroid levels and adjust the dose when needed.
PATIENT TESTIMONIALS
What Our Patients Say
4.8 / 5 Stars on Google
“Dr. Surkunte discovered my thyroid and hormones were out of balance. Three months later I am down 22 pounds and have my energy back.”
Maria T. — Chandler — Lost 22 lbs
“They walked me through my insurance options and I ended up paying $25 a month. I am down 31 pounds in four months.”
Robert K. — Gilbert — Lost 31 lbs
“They figure out what is medically wrong. I finally feel like I have a real doctor in my corner.”
Sandra L. — Tempe — Telemedicine patient