Wellness & HRT in Dallas

Overview

What this page covers, and how it is organized

“Hormone therapy” can mean very different prescriptions for two people with similar complaints. One may need FDA-approved estradiol with progesterone, another a vaginal estrogen, another a thyroid workup, another a GLP-1 drug for weight. This page treats wellness and hormone care as a group of therapies, not a single procedure, and sorts it by the problem you bring to the appointment so you know what to ask about.

Most of the space goes to three topics: hormone therapy for women, testosterone for men, and GLP-1 drugs for weight loss. Thyroid treatment, peptides and IV drips are shorter. Two Texas measures come up along the way:

• A Texas Medical Board rule. The board’s rules on delegating cosmetic procedures took effect January 9, 2025 (Texas Medical Board).
• A state law. Texas HB 3749, which governs elective IV therapy, took effect September 1, 2025 (HB 3749 history).

Categories

Starting from your concern

Menopause and perimenopause. Typical complaints include hot flashes, night sweats, trouble sleeping, vaginal dryness and pain with sex. FDA-approved options include systemic estrogen (with a progestogen added for women who still have a uterus) and low-dose vaginal estrogen for genitourinary symptoms (Menopause Society statement, 2022).

Low testosterone in men. The Endocrine Society reserves the diagnosis for men who have symptoms and signs of deficiency and whose levels are consistently low on a repeated morning fasting total testosterone test (Endocrine Society, 2018).

Weight and metabolism. Semaglutide is sold as Ozempic for type 2 diabetes and as Wegovy for weight; tirzepatide is sold as Mounjaro for type 2 diabetes and as Zepbound for weight (Ozempic label; Mounjaro label; Wegovy label; Zepbound label). FDA declared both shortages over during 2024 and 2025, which narrows what compounding pharmacies can now produce (FDA on GLP-1 compounding).

Thyroid. Levothyroxine treats hypothyroidism. Thyroid hormone labels carry a boxed warning against using these drugs to treat obesity or for weight loss (Synthroid label).

Peptides, IV drips and NAD+. FDA at one time placed several peptides sold by wellness clinics in Category 2 for compounding, its group for substances that may pose significant safety risks (FDA safety-risk list).

Name your own concern first. Then ask the clinic what condition it intends to treat and which test results support that diagnosis, before any prescription.

Decision

Symptoms and the first question to raise

Use this as a starting point for the first appointment:

Several of these can overlap. Ask which one the clinic plans to address first, and its reason.

Women

Menopause hormone therapy

The WHI and what came after

The Women’s Health Initiative (WHI) trial, reported in 2002, randomly assigned women aged 50 to 79 to conjugated equine estrogens with medroxyprogesterone acetate or to a placebo. On hormones, women had higher rates of invasive breast cancer, stroke, coronary heart disease and pulmonary embolism, and lower rates of colorectal cancer and hip fracture (Rossouw et al., 2002). With 18 years of follow-up, a later analysis found hormone therapy in the WHI trials was not associated with higher mortality from any cause, from cardiovascular disease or from cancer (Manson et al., 2017).

The Menopause Society’s 2022 position statement draws the line by age and timing:

• Younger women. Starting before age 60, or less than 10 years after menopause began, in a woman with no contraindications: the statement rates the balance as favorable, both for troublesome vasomotor symptoms and for keeping bone from thinning.
• Older women. Starting after age 60, or more than 10 years after menopause began: the balance looks less favorable, since the absolute risk of dementia, blood clots in the veins, stroke and coronary disease is greater (Menopause Society statement, 2022).

Starting in November 2025, FDA has been taking three items out of the boxed warnings on menopause hormone labels: probable dementia, breast cancer and heart and blood vessel disease. One boxed warning stays, the one about endometrial cancer on systemic products that contain estrogen alone (FDA announcement, November 2025).

FDA-approved products

• Systemic estradiol. Examples: patches (Climara, Minivelle, Vivelle-Dot), gels (Estrogel, Divigel) and a spray (Evamist). The Menopause Society says risk varies with the type of therapy, the route, the dose, when it is started, how long it is used, and whether a progestogen is included (Menopause Society statement, 2022).
• Micronized progesterone. For a postmenopausal woman with a uterus who takes estrogen, Prometrium’s labeled dose to prevent endometrial hyperplasia is 200 mg at bedtime for 12 days of each 28-day cycle (Prometrium label). Estrogen labeling states that a progestogen lowers the risk of endometrial hyperplasia, which can precede endometrial cancer (Vivelle-Dot label).
• Vaginal estrogen for genitourinary syndrome of menopause. Examples: Vagifem, Imvexxy, Estrace cream and Estring. When over-the-counter products do not relieve bothersome symptoms, The Menopause Society recommends low-dose vaginal estrogen, or alternatives such as vaginal DHEA or oral ospemifene (Menopause Society statement, 2022).
• Combination products. Examples: Bijuva (estradiol with progesterone) and CombiPatch (estradiol with norethindrone acetate).

Per the Vivelle-Dot label, estrogen is not for women with undiagnosed abnormal genital bleeding, breast cancer now or in the past, estrogen-dependent cancer, a current or past heart attack or stroke, active or past blood clots, or liver impairment or disease (Vivelle-Dot label).

Compounded “bioidentical” hormones

A bioidentical hormone has the same chemical structure as one made in the body, and some FDA-approved products qualify. Prometrium is an example; its label describes its progesterone as chemically identical to the progesterone the human ovary produces (Prometrium label). The distinction that matters is approved versus compounded. A 2020 National Academies review of compounded bioidentical hormone therapy reported that rigorous evidence of safety and effectiveness from well-designed clinical studies was missing (FDA page on the NASEM study). If a clinic offers you a compounded hormone, ask why an approved product would not work for you.

Hormone pellets

A pellet is placed under the skin and releases hormone for months. Testopel is FDA-approved as a testosterone pellet for men, at a labeled dose of 150 mg to 450 mg every 3 to 6 months (Testopel label). That labeling covers males only, so a woman offered a pellet should ask whether the product she would receive is FDA-approved.

The 2019 Global Consensus Position Statement on testosterone for women supports one evidence-based use: hypoactive sexual desire disorder in postmenopausal women, diagnosed through a formal assessment. It advises against testosterone in any form, pellets and injections included, that pushes levels above the normal range (supraphysiologic), and it says compounded “bioidentical” testosterone cannot be recommended for low sexual desire (Global Consensus statement, 2019). In 2020, the National Academies urged FDA’s advisory committee on compounding to consider adding all compounded bioidentical hormone pellets to the list of products that are hard to compound (National Academies, 2020).

Questions to ask if pellets come up:

• Why pellets instead of FDA-approved patches, gels or pills?
• Which hormone levels will be tested?
• What happens if the dose is too high, and how can it be reduced once the pellet is in?

Men

Testosterone therapy for men

Getting the diagnosis right

The 2018 Endocrine Society guideline sets out these steps (Endocrine Society, 2018):

1. Make the diagnosis only in men with symptoms and signs of deficiency and consistently low levels
2. Confirm with a morning fasting total testosterone that is repeated
3. Check free testosterone when the total sits near the low end of normal
4. Once deficiency is confirmed, find out why

The guideline does not set a single fixed cutoff of 300 ng/dL. It cites 264 ng/dL as the lower limit of normal for healthy, non-obese young men on standardized assays (Endocrine Society, full text). Testopel’s label points the same way: it says to confirm the diagnosis by drawing morning testosterone on two or more different days (Testopel label). Before a prescription, find out if the clinic draws a second sample and looks into why your level is low.

The guideline recommends against starting testosterone in men who plan to have children soon, and in men with any of the following: a stroke or heart attack within 6 months; heart failure that is not controlled; thrombophilia; a high hematocrit; severe sleep apnea left untreated; severe symptoms of the lower urinary tract; prostate or breast cancer; a prostate nodule that can be felt; or, until a urologist has evaluated it, a PSA over 4 ng/mL (over 3 ng/mL in men at higher risk) (Endocrine Society, 2018). It also suggests against routinely prescribing testosterone to all men 65 and older (Endocrine Society, full text).

TRAVERSE: the heart-safety trial

TRAVERSE enrolled 5,246 men aged 45 to 80 who had heart disease or high cardiovascular risk, symptoms of hypogonadism, and two fasting testosterone levels under 300 ng/dL. Each day they used either a 1.62% testosterone gel or a placebo gel, for a mean treatment time of 21.7 months (Lincoff et al., 2023).

• Major cardiac events (cardiovascular death, nonfatal heart attack or nonfatal stroke): 7.0% with testosterone and 7.3% with placebo, so testosterone was noninferior.
• Other events: atrial fibrillation, acute kidney injury and pulmonary embolism occurred more often with testosterone.

FDA recommended in February 2025 that all testosterone labels add the TRAVERSE findings and drop the boxed-warning language on higher cardiovascular risk, and it required blood pressure warnings (FDA, February 2025). In June 2026 FDA asked for more label changes, among them removing the limitation of use for age-related hypogonadism (FDA testosterone information).

Approved forms

Federal law lists testosterone in Schedule III (Testopel label). A clinician needs a federal registration to prescribe or dispense controlled substances (21 U.S.C. §822).

Follow-up testing

Under the Endocrine Society guideline:

• Evaluation: 3 to 12 months after starting, then yearly.
• Hematocrit: at baseline, at 3 to 6 months and yearly after that. If it goes above 54%, treatment stops until it returns to a safe level.
• Prostate: for men who choose monitoring, a rectal exam and PSA at 3 to 12 months, with referral to urology for a confirmed PSA over 4 ng/mL or a rise of more than 1.4 ng/mL within 12 months (Endocrine Society, full text).

Ask which of these the clinic orders and on what schedule.

Fertility

The Endocrine Society advises against starting testosterone in men who want to father a child soon (Endocrine Society, 2018). If children are part of your plans, say so before any prescription and ask about a referral to a urologist or fertility specialist.

GLP-1

GLP-1 drugs and medical weight loss

Approved products and their uses

• Semaglutide. The diabetes brand is Ozempic (Ozempic label). The weight brand is Wegovy, which comes as a once-weekly shot or a once-daily tablet; its labeled uses include adults who have obesity, or who are overweight and have a weight-related illness as well (Wegovy label).
• Tirzepatide. The diabetes brand is Mounjaro (Mounjaro label). The weight brand is Zepbound, labeled for cutting excess weight in adults who have obesity, or who are overweight and have a weight-related illness as well (Zepbound label).

Results from the pivotal trials

Gastrointestinal effects were the most common side effects in both trials, and most were mild to moderate (Wilding et al.; Jastreboff et al.).

Compounded versions

Shortage dates. FDA found the tirzepatide shortage resolved on October 2, 2024 and confirmed it on December 19, 2024. It found the semaglutide shortage resolved on February 21, 2025.

Grace periods. For tirzepatide, enforcement discretion ended February 18, 2025 for 503A pharmacies and March 19, 2025 for 503B outsourcing facilities. For semaglutide, it ended April 22, 2025 for 503A pharmacies and May 22, 2025 for 503B facilities (FDA on GLP-1 compounding).

What is still allowed. Making essentially copies of an approved product regularly or in inordinate amounts is off limits for a 503A pharmacy. Compounding for one patient is still possible if the prescriber writes down a significant difference that applies to that person (FDA on GLP-1 compounding).

Compounded drugs are sold without FDA review of safety, effectiveness or quality. FDA has received adverse event reports involving compounded semaglutide and tirzepatide, some needing hospitalization and some connected to dosing errors (FDA concerns with unapproved GLP-1 drugs). In February 2026, FDA said it intends to restrict GLP-1 ingredients used in compounded drugs it has not approved (FDA announcement). If you are offered a compounded version, ask which pharmacy makes it and what patient-specific reason justifies it.

Self-pay prices from the manufacturers

These are the published manufacturer self-pay prices, checked October 29, 2026. They are not Dallas clinic prices, and clinic visits and labs cost extra.

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

Safety

Who should not take them. Wegovy and Zepbound are contraindicated with MEN 2 or a personal or family history of medullary thyroid carcinoma, and both carry a boxed warning about thyroid C-cell tumors (Wegovy label; Zepbound label).

Other label warnings. Wegovy’s label warns of acute pancreatitis, gallbladder disease, severe gastrointestinal reactions, kidney injury from dehydration, low blood sugar, and pulmonary aspiration during general anesthesia or deep sedation. It does not recommend Wegovy in severe gastroparesis and says to stop it at least 2 months before a planned pregnancy. Tell your surgeon or anesthesia team that you take it before any procedure (Wegovy label).

Suicidal thoughts. In January 2026, FDA said its review did not find that GLP-1 drugs increase the risk of suicidal thoughts or behavior, and it asked manufacturers to take that warning off the labels (FDA safety communication).

Peptides

Peptides

What a 503A pharmacy may compound from. A bulk ingredient is usable if a USP or NF monograph covers it, if an FDA-approved drug contains it, or if FDA’s 503A bulks list includes it. Until that list is complete, FDA permits the substances it has put in Category 1 (FDA 503A bulks policy).

Category 2. FDA uses this category for substances it views as a potential significant safety risk. BPC-157, CJC-1295, TB-500, thymosin alpha-1, AOD-9604, injectable GHK-Cu, melanotan II and Epitalon were in Category 2 before the people who nominated them withdrew the nominations. Ibutamoren and kisspeptin-10 are currently in Category 2. For several of these, FDA’s page cites limited safety data and possible immunogenicity, and for some, including CJC-1295 and AOD-9604, it notes serious adverse events (FDA safety-risk list). On FDA’s list as updated May 14, 2026, none of them is in Category 1 (FDA category list).

An approved peptide. Egrifta (tesamorelin) is FDA-approved to reduce excess abdominal fat in adults with HIV and lipodystrophy (Egrifta WR label).

Whatever the peptide, ask whether it is an FDA-approved drug. If not, ask which pharmacy compounds it and why.

IV Therapy

IV drips and NAD+

Texas HB 3749, called Jenifer’s Law, was signed June 20, 2025 and took effect September 1, 2025 (HB 3749 history). The law defines elective IV therapy as IV fluids, nutrients, medications or blood requested by a patient to relieve temporary discomfort or to improve temporary wellness. A physician may delegate prescribing or ordering to a PA or APRN, and administration to a PA, APRN or RN, always with adequate physician supervision (HB 3749 text).

This page does not rate the evidence for particular drips, vitamin blends or NAD+ infusions. Ask the clinic what the drip is intended to do and what evidence supports that, who will start the IV and watch you during it, and who the supervising physician is.

Thyroid

Thyroid hormone

Levothyroxine is the standard drug for hypothyroidism. Labels for thyroid hormones, including levothyroxine (Synthroid) and liothyronine (T3, Cytomel), carry a boxed warning that they are not for weight loss or obesity. In people with normal thyroid function, ordinary doses do not reduce weight, and larger doses can cause serious or life-threatening toxicity (Synthroid label; Cytomel label). The levothyroxine label adds that overtreatment can lower bone mineral density and may trigger arrhythmias, especially in older patients and people with heart disease (Synthroid label).

If thyroid hormone is suggested, ask which lab results show you need it and how the dose will be monitored.

Texas Law

The Texas rules

22 TAC Chapter 169, Subchapter E, the Texas Medical Board’s rules on delegating nonsurgical medical cosmetic procedures, took effect January 9, 2025 (Texas Medical Board). They govern cosmetic procedures such as injectables; they do not regulate hormone or GLP-1 prescribing in general. The main points:

• Relationship before treatment. No delegated procedure may begin until a practitioner-patient relationship exists. The physician sets it up, or a PA or APRN does so on the physician’s delegation (22 TAC §169.26).
• Availability. During the procedure, a physician, PA or APRN must be on site or immediately available for emergency consultation (22 TAC §169.26).
• Written order. Delegation is by a written order that names the delegating physician and addresses patient screening, appropriate care, and the handling of complications and emergencies (22 TAC §169.27). The person doing the procedure must sign and date a written protocol (22 TAC §169.26).
• Posting. Every public area and treatment room must show the delegating physician’s name and Texas license number (22 TAC §169.28).

Elective IV therapy is governed by HB 3749, described in the IV section (HB 3749 text).

Three checks before a cosmetic injection or IV drip at a Dallas-area wellness clinic:

1. You can find the delegating physician’s name and Texas license number on display (22 TAC §169.28)
2. A practitioner-patient relationship with you was in place before the delegated procedure, set up by the physician or by a PA or APRN on the physician’s delegation (22 TAC §169.26)
3. If testosterone is part of the plan, the prescriber is registered federally to prescribe controlled substances (21 U.S.C. §822)

What to Expect

History, labs and follow-up

Your history. Expect questions about your medical history and current medications, plans for pregnancy, any family history of hormone-sensitive cancer, heart and clotting history, and sleep apnea.

Your labs. Testing depends on the therapy. For a man considering testosterone, the Endocrine Society recommends a repeated morning fasting total testosterone, free testosterone if the total is near the bottom of normal, and a search for the cause, and it lists hematocrit and PSA among the pre-treatment checks (Endocrine Society, 2018). Before a GLP-1 prescription, the clinic should ask about medullary thyroid carcinoma and MEN 2 (Wegovy label).

Your follow-up.

• Testosterone: evaluation at 3 to 12 months and yearly thereafter; hematocrit at baseline, at 3 to 6 months and yearly (Endocrine Society, full text).
• Menopause hormone therapy: the benefits and risks of continuing are reassessed periodically (Menopause Society statement, 2022).
• Wegovy injection: the dose increases every 4 weeks until maintenance is reached (Wegovy label).

Wherever you go, ask which tests come before the prescription and when you will go over the results together.

Dallas Pricing

Prices in Dallas

This page gives no Dallas price range for hormone therapy, testosterone, GLP-1 programs, peptides or IV drips. The only prices here are Lilly’s and Novo Nordisk’s published self-pay prices for Zepbound and Wegovy, in the GLP-1 section (Lilly; NovoCare). Ask any clinic for a written total that covers the drug, the labs and the visits, and ask whether you must sign a contract.

How to Choose

A checklist for choosing a clinic

Where the drug comes from

• GLP-1: FDA-approved or compounded? If compounded, what patient-specific reason is documented (FDA on GLP-1 compounding)?
• Hormones: FDA-approved or compounded? If compounded, why is an approved product not suitable for you (FDA page on the NASEM study)?
• Peptides: FDA-approved? If not, is it in FDA’s Category 1 (FDA category list)?

How you will be tested and followed

• Testosterone: is the diagnosis based on a repeated morning fasting test plus a search for the cause (Endocrine Society, 2018)?
• Testosterone: is hematocrit checked at baseline, at 3 to 6 months and yearly (Endocrine Society, full text)?
• GLP-1: does the clinic ask about MEN 2 and medullary thyroid carcinoma (Wegovy label)?

Who is responsible

• Look on the walls: the delegating physician and that doctor’s Texas license number should be displayed (22 TAC §169.28).
• Ask who sets up the practitioner-patient relationship before a delegated cosmetic treatment. The rule allows a physician, or a PA or APRN working under delegation (22 TAC §169.26).
• For a drip, get the name of the physician supervising it (HB 3749 text).

Red flags

• A prescription written with no history taken and no tests
• Thyroid hormone marketed for weight loss (Synthroid label)
• Peptides such as BPC-157 offered when they are neither FDA-approved nor in FDA’s Category 1 (FDA category list)
• Compounded semaglutide or tirzepatide without a documented patient-specific reason (FDA on GLP-1 compounding)
• Pellets offered to women with no mention of FDA-approved alternatives (Global Consensus statement, 2019)
• Testosterone started after a single test, with no repeat and no search for a cause (Endocrine Society, 2018)
• No delegating physician’s name or Texas license number on display (22 TAC §169.28)