If you have been told that what you are experiencing is “just part of getting older,” or that your symptoms are “normal” and there is nothing to be done, you are not alone. Hot flashes, night sweats, brain fog, mood changes, low energy, disrupted sleep, vaginal dryness, painful sex, recurrent UTIs, and loss of sexual desire are real, treatable medical conditions. They deserve a real medical evaluation, not dismissal.
The Women’s Hormone and Sexual Health Program at Urology Associates of Green Bay was created to close the gap between what women are experiencing and what they are being offered. We provide structured, evidence based evaluation and treatment for perimenopause, menopause, genitourinary syndrome of menopause (GSM), and female sexual dysfunction, all under the oversight of board certified urologists in a private practice setting.
This is not a medspa. This is not a hormone mill. This is a physician led medical program that treats symptoms, not lab values, and puts you at the center of every decision.
Ready to feel like yourself again? Call (920) 433-9400 (De Pere) or (715) 732-3420 (Marinette), or request an appointment online. Telehealth available for an initial consultation.
Why a Urology Practice? Because This Is What We Do.
You might not immediately think of a urologist for menopause or hormone care, but the fit is more natural than you might expect. Urology is a specialty built around sexual function, genitourinary anatomy, pelvic health, and quality of life driven conditions. We already manage vaginal dryness, recurrent UTIs, urinary urgency and incontinence, and pelvic pain in women every day. Extending that expertise into a comprehensive hormone and sexual health program is a logical evolution of the care we have always provided.
What makes our approach different from many alternatives is physician oversight, clinical structure, and transparency. Your care is overseen by board certified urologists, not by wellness coaches, nurse practitioners working without physician collaboration, or direct to consumer telehealth platforms. We use FDA approved, pharmacy sourced medications as our standard. We do not sell proprietary supplement lines, and we do not upcharge our patients on medications, injections, or tablets. We help you find the best therapy for your symptoms at the best cost.
What We Treat
Our program addresses the full spectrum of conditions women experience during perimenopause, menopause, and beyond. These are not vague wellness complaints. They are conditions with identifiable physiology and available treatments.
Vasomotor symptoms including hot flashes and night sweats are among the most recognizable signs of hormonal transition and can significantly disrupt sleep, work, and daily life. Sleep disturbance is extremely common during perimenopause and menopause, driven by both vasomotor symptoms and direct hormonal effects on sleep architecture. Mood changes, including increased irritability, anxiety, emotional flatness, and depressive symptoms, frequently accompany hormonal transitions and are often attributed to stress or aging rather than recognized as hormone related. Cognitive changes such as difficulty concentrating, word finding problems, and the experience many women describe as “brain fog” can be among the most distressing symptoms.
Genitourinary Syndrome of Menopause (GSM) includes vaginal dryness, burning, irritation, pain with intercourse, and recurrent urinary tract infections, all driven by estrogen deficiency affecting the vaginal, vulvar, and urethral tissues. GSM is extremely common, significantly undertreated, and highly responsive to therapy. Female sexual dysfunction, including hypoactive sexual desire disorder (HSDD), is estimated to affect 30 to 40 percent of women and remains one of the most under recognized conditions in medicine. Low sexual desire accompanied by personal distress is a legitimate medical issue with available treatments, not something to be dismissed or minimized.
How We Evaluate You: Thorough, Not Excessive
Our evaluation starts with listening. We use a structured intake questionnaire that captures the full picture of your symptoms, including energy, mood, sleep, sexual health, urinary and vaginal symptoms, and a “Not Feeling Like Myself” (NFLM) score that helps us track your overall sense of well being over time. Many women describe their experience as a general feeling of not feeling like themselves anymore, and the NFLM score gives us a way to measure and follow that.
We obtain a focused baseline lab panel before starting systemic hormone therapy, including hormones, metabolic markers, and TSH. These labs provide context and help ensure safety, but they do not dictate treatment. We do not order extensive panels, chase numbers, or withhold treatment because a lab value falls within a “normal” range. Population reference ranges reflect averages, not individual symptom thresholds, and symptoms can absolutely occur within so called normal ranges.
When indicated, we perform a targeted physical examination focused on vulvar and vaginal tissue health, vestibular tenderness (a common and often overlooked source of pain with intercourse), and pelvic floor tone. Not every patient needs an exam at the first visit, and every exam is performed with a trauma informed, permission based approach.
Our Treatment Approach: Symptom Guided, Not One Size Fits All
Treatment in our program follows a structured, stepwise pathway. We start with your primary symptoms and build a plan around them, not around a lab panel or a predetermined protocol.
For women whose symptoms are primarily vaginal dryness, painful intercourse, or recurrent UTIs without significant systemic symptoms, local vaginal estrogen therapy is often all that is needed. This is a safe, well tolerated, first line treatment that can be prescribed in primary care, and many of the women we see have never been offered it despite years of symptoms.
For women with systemic symptoms such as hot flashes, night sweats, sleep disruption, mood changes, brain fog, and fatigue, systemic estrogen therapy is the foundation. We prefer transdermal delivery (patches, gels) for most patients because it avoids first pass liver metabolism and carries a lower risk profile for clotting and metabolic effects. For women with an intact uterus, progesterone is added for endometrial protection. This is a safety requirement, not optional, and is not based on progesterone lab levels.
The majority of women in our program stabilize on estrogen and progesterone and feel significantly better. Libido often improves with estrogen alone. For women who continue to experience low sexual desire, low motivation, or persistent fatigue after estrogen has been optimized, testosterone may be considered as an adjunct. Testosterone in women is off label, and we use it at physiologic female doses with careful monitoring. It is not a first line treatment, not a default add on, and not appropriate for everyone.
We also offer FDA approved non hormonal medications for female sexual dysfunction, including flibanserin and bremelanotide (PT 141), for women who may benefit from targeted treatment for low desire.
What We Are Not: Transparency Matters
There are many clinics, medspas, wellness centers, and direct to consumer platforms now offering “hormone optimization” or “bioidentical hormone therapy.” Some provide excellent care. Many do not. We believe you deserve to understand the difference.
Most hormones prescribed in modern medical practice are already bioidentical, meaning they are structurally identical to the hormones your body produces. The term “bioidentical” describes molecular structure, not clinical superiority. It does not mean safer, more natural, or custom made. When we prescribe estradiol, progesterone, or testosterone, these are bioidentical hormones delivered through FDA approved, quality controlled formulations.
We do not sell proprietary supplement lines, upcharge on medications, injections, or tablets. We do not require expensive recurring lab panels that do not change management. We do not use salivary hormone testing or other unvalidated methods. And we do not frame hormone therapy as anti aging, life extension, or optimization. This is symptom driven medical care, provided transparently, at fair cost.
What Treatment Costs
We believe in cost transparency. Most women on estrogen and progesterone can expect medication costs in the range of $20 to $40 per month. If testosterone is added, the combined total is typically $60 to $120 per month. We help our patients find the most effective therapy at the best available price, using standard pharmacy sourced medications. There are no hidden fees, no proprietary formulations, and no mandatory product purchases.
Shared Decision Making: You Are the Most Important Person in This Process
Hormone therapy involves tradeoffs, and reasonable people can weigh those tradeoffs differently. Our role is to provide you with a thorough evaluation, explain your options clearly, discuss what the evidence supports, and help you arrive at the treatment plan that aligns with your symptoms, your values, and your goals. We do not push treatment on patients who are not interested, and we do not withhold it from patients who are.
Frequently Asked Questions
Why would I see a urologist for menopause or hormone therapy?
Urology is a specialty built around sexual function, genitourinary anatomy, pelvic health, and quality of life driven conditions. Many of the symptoms women experience during perimenopause and menopause, including vaginal dryness, recurrent UTIs, urinary urgency, pain with intercourse, and low sexual desire, fall squarely within the scope of what urologists evaluate and treat every day. Our program extends that expertise into a structured hormone and sexual health program overseen by board certified physicians.
Is this a hormone mill or medspa?
No. This is a medical program within a physician led urology practice. We follow evidence based guidelines, use FDA approved medications as our standard, and take a structured, symptom guided approach to care. We do not sell proprietary supplement lines, push unnecessary testing, or treat lab values instead of patients. Every treatment decision is made collaboratively with the patient and overseen by a board certified urologist.
Will I need lab work?
We obtain a focused baseline lab panel before starting systemic hormone therapy, but we do not order extensive or unnecessary testing. Labs provide context and help ensure safety, but they do not replace your symptoms as the primary guide for treatment. We do not chase lab numbers or treat you based on arbitrary targets.
What does treatment typically cost?
Most women on estrogen and progesterone can expect medication costs in the range of $20 to $40 per month. If testosterone is added, the total may be $60 to $120 per month. We do not upcharge on medications, injections, or tablets. We help you find the best therapy at the best cost, and we use FDA approved pharmacy sourced medications as our standard.
Do I need to take hormones forever?
That depends on your symptoms and goals. Some women use hormone therapy for a defined period and taper off. Others continue long term because the benefits to their quality of life, bone health, and overall well being outweigh the risks. We reassess regularly and adjust your plan as your needs evolve. There is no pressure to continue therapy and no pressure to stop.
What about testosterone for women?
Testosterone can play a role in improving libido, motivation, and energy in select women, but it is not a first line treatment and it is not appropriate for everyone. In our program, testosterone is considered only after estrogen therapy has been optimized and specific symptoms persist. It is used at physiologic female doses, and patients are advised that this is an off label use. We monitor carefully for side effects and adjust as needed.
What is the “Not Feeling Like Myself” score?
This is a simple 0 to 10 scale we use to track how you are feeling over time. Many women coming through our program describe a general sense of not feeling like themselves, a combination of fatigue, mood changes, brain fog, low motivation, and reduced enjoyment of life that is hard to pin down with a single symptom. The NFLM score gives us a way to measure that experience and track your progress at each visit.
Do you see patients from outside the Green Bay area?
Yes. We see patients from across northeastern Wisconsin and the Upper Peninsula of Michigan. Telehealth appointments are available for initial consultations. Your evaluation and follow up can be completed at our De Pere or Marinette office. Call our De Pere office at (920) 433-9400 or our Marinette office at (715) 732-3420.
You Deserve to Feel Like Yourself Again
If you have been living with symptoms that are affecting your sleep, your energy, your relationships, or your sense of self, and you have been told there is nothing to do about it, we respectfully disagree. Effective, evidence based treatment exists, and you deserve access to it in a medical setting that takes you seriously. Call our De Pere office at (920) 433-9400 or our Marinette office at (715) 732-3420 to schedule. Telehealth appointments are available for an initial conversation.
Urology Associates of Green Bay. Physician led hormone and sexual health care for women. Structured, transparent, and built around you.