
111 Church St. | O’Fallon, MO 63366 | adoreustl.com
Hormonal shifts don't announce themselves. For most women, they show up gradually — fatigue that sleep doesn't fix, mood changes that feel out of character, weight that won't move despite doing everything right.
What's happening is a shift in estrogen, progesterone, and testosterone — the hormones that regulate metabolism, sleep, cognition, bone density, cardiovascular health, and skin. When they fluctuate during perimenopause or decline after menopause, the effects are felt across every system in the body.
Many women come in with symptoms they haven't connected to hormones at all. That's exactly what the initial evaluation is designed to sort out.
Aleasha Elliott, FNP-C — AdoreU, O'Fallon MO
12
WEEK INITIAL PROGRAM
4
LAB DRAWS INCLUDED
3
HORMONES ADDRESSED
Qtrly
ONGOING MAINTENANCE
Many women come in with symptoms they haven't connected to hormones at all. That's exactly what the initial evaluation is designed to sort out.
Aleasha Elliott, FNP-C — AdoreU, O'Fallon MO
12
WEEK INITIAL PROGRAM
4
LAB DRAWS INCLUDED
3
HORMONES ADDRESSED
Qtrly
ONGOING MAINTENANCE
Hormonal imbalance in women is frequently underdiagnosed — especially during perimenopause, when labs can still look "normal" even while symptoms are significant. If any of the following are familiar, a comprehensive hormone evaluation is a good place to start.
AdoreU treats women in O'Fallon, St. Charles, Wentzville, Lake St. Louis, and throughout the greater St. Louis metro area. All care is overseen by Aleasha Elliott, FNP-C.
If you have questions at any point, we’re here. Clinical questions go through your OptiMantra patient portal. Scheduling and general questions go to our patient care coordinator, Jon.
Fatigue that doesn't resolve with rest
Brain fog, difficulty concentrating, or memory lapses
Mood changes, irritability, or anxiety that feels hormonally driven
Sleep disruption — difficulty falling or staying asleep
Hot flashes and night sweats
Weight gain, particularly around the midsection
Low libido or changes in sexual comfort
Hair thinning or changes in skin quality
Irregular cycles or significant changes in flow
How Hormones Change Over Time — And Why It Matters
Understanding why you're feeling the way you do starts with understanding how hormones actually decline — because they don't all follow the same pattern, and that matters for how we interpret your results and design your protocol.
Progesterone
Declines First
Begins declining in your mid-to-late 30s — often the first hormone to drop. Low progesterone is frequently the root cause of the sleep disruption, anxiety, and cycle irregularities that women attribute to stress long before they suspect hormones.
Testosterone
Declines Steadily
Declines from early adulthood onward. By perimenopause, testosterone is already significantly lower than it was in your 20s — showing up as reduced drive, lower stamina, difficulty maintaining muscle, and a general flatness in energy and motivation.
Estrogen
Declines Erratically
Does not decline in a straight line. Estrogen levels become erratic — spiking unpredictably then dropping, sometimes dramatically, before declining into menopause. This is why perimenopause can feel disorienting and why a single lab draw can look completely normal even when you feel anything but.
Think of a lab result as a polaroid snapshot — it captures what your hormone levels looked like at the exact moment your blood was drawn. Hormone levels fluctuate constantly throughout the day and across your cycle. A result that looks low might reflect a natural trough. A result that looks normal might have been drawn during a temporary spike.
This is why your symptoms carry as much diagnostic weight as your numbers — and in some cases, more. We treat you, not your lab report.
How Hormones Change Over Time — And Why It Matters
Understanding why you're feeling the way you do starts with understanding how hormones actually decline — because they don't all follow the same pattern, and that matters for how we interpret your results and design your protocol.
Progesterone
Declines First
Begins declining in your mid-to-late 30s — often the first hormone to drop. Low progesterone is frequently the root cause of the sleep disruption, anxiety, and cycle irregularities that women attribute to stress long before they suspect hormones.
Testosterone
Declines Steadily
Declines from early adulthood onward. By perimenopause, testosterone is already significantly lower than it was in your 20s — showing up as reduced drive, lower stamina, difficulty maintaining muscle, and a general flatness in energy and motivation.
Estrogen
Declines Erratically
Does not decline in a straight line. Estrogen levels become erratic — spiking unpredictably then dropping, sometimes dramatically, before declining into menopause. This is why perimenopause can feel disorienting and why a single lab draw can look completely normal even when you feel anything but.
Think of a lab result as a polaroid snapshot — it captures what your hormone levels looked like at the exact moment your blood was drawn. Hormone levels fluctuate constantly throughout the day and across your cycle. A result that looks low might reflect a natural trough. A result that looks normal might have been drawn during a temporary spike.
This is why your symptoms carry as much diagnostic weight as your numbers — and in some cases, more. We treat you, not your lab report.
A complete picture,
not just hormone levels.
Your initial lab evaluation at AdoreU goes well beyond a standard hormone panel. This gives us a clinical explanation for what you're experiencing — not a guess — and ensures your bioidentical hormone therapy protocol addresses the full picture from the start.
Sex hormones
Estrogen, progesterone, testosterone, and DHEA — a full baseline, not just one or two markers.
Thyroid function
TSH, free T3, free T4, and thyroid antibodies — thyroid dysfunction is frequently at the root of hormone-like symptoms and is often missed on standard panels.
Inflammatory markers
Chronic inflammation affects hormone metabolism and how your body responds to treatment. We look for patterns that would influence your protocol.
Metabolic & blood sugar
Insulin resistance and blood sugar dysregulation are common in hormonal imbalance — and frequently missed on a standard panel.
Key vitamins & minerals
Vitamin D, B12, magnesium, zinc, and iron — deficiencies in these directly affect how your body produces and responds to hormones.
Aleasha Elliott
FNP-C · Family Nurse Practitioner
Every protocol at AdoreU is evaluated and managed by a board-certified nurse practitioner specializing in bioidentical hormone therapy for women. Aleasha Elliott, FNP-C reviews your labs personally and builds your protocol around your specific results and symptoms — not a templated starting dose.
A complete picture,
not just hormone levels.
Your initial lab evaluation at AdoreU goes well beyond a standard hormone panel. This gives us a clinical explanation for what you're experiencing — not a guess — and ensures your bioidentical hormone therapy protocol addresses the full picture from the start.
Sex hormones
Estrogen, progesterone, testosterone, and DHEA — a full baseline, not just one or two markers.
Thyroid function
TSH, free T3, free T4, and thyroid antibodies — thyroid dysfunction is frequently at the root of hormone-like symptoms and is often missed on standard panels.
Inflammatory markers
Chronic inflammation affects hormone metabolism and how your body responds to treatment. We look for patterns that would influence your protocol.
Metabolic & blood sugar
Insulin resistance and blood sugar dysregulation are common in hormonal imbalance — and frequently missed on a standard panel.
Key vitamins & minerals
Vitamin D, B12, magnesium, zinc, and iron — deficiencies in these directly affect how your body produces and responds to hormones.
Aleasha Elliott
FNP-C · Family Nurse Practitioner
Every protocol at AdoreU is evaluated and managed by a board-certified nurse practitioner specializing in bioidentical hormone therapy for women. Aleasha Elliott, FNP-C reviews your labs personally and builds your protocol around your specific results and symptoms — not a templated starting dose.
The women's initial hormone optimization program at AdoreU is designed as a complete 12-week clinical experience — not just an insertion and a follow-up appointment.
01
Comprehensive Lab Evaluation
Full panel before treatment begins — sex hormones, thyroid, metabolic, inflammatory markers, and key vitamins. This is the foundation your protocol is built on.
02
Bioidentical Pellet Insertion
Pellets manufactured from granules — not compressed powder — for a controlled, consistent dissolution rate. Continuous hormone release over 3–6 months, no peaks and troughs.
03
Lab Draws & Clinic Reviews
Labs at weeks 4 and 10. Follow-up appointments at weeks 6 and 12 to assess response, answer questions, and refine your protocol.
04
Personalized Supplement Protocol
A targeted supplement plan built around your labs — not a generic wellness stack — to support hormone metabolism, energy, sleep, and cellular health.
05
Women's Hormone Resource Guide
A clinical reference covering key hormones in women's health, the perimenopause and menopause transition, what the research actually says, and how nutrition, lifestyle, and sleep all factor in.
06
12 Weeks of Clinical Coaching Emails
Weekly evidence-based guidance on topics that directly influence how well your body responds to therapy — from the early weeks through transition to quarterly care.
Full program details and pricing are reviewed at your consultation. Once the initial 12-week program is complete, you transition to quarterly maintenance care — ongoing insertions, labs, and clinical oversight on a consistent schedule.
The women's initial hormone optimization program at AdoreU is designed as a complete 12-week clinical experience — not just an insertion and a follow-up appointment.
01
Comprehensive Lab Evaluation
Full panel before treatment begins — sex hormones, thyroid, metabolic, inflammatory markers, and key vitamins. This is the foundation your protocol is built on.
02
Bioidentical Pellet Insertion
Pellets manufactured from granules — not compressed powder — for a controlled, consistent dissolution rate. Continuous hormone release over 3–6 months, no peaks and troughs.
03
Lab Draws & Clinic Reviews
Labs at weeks 4 and 10. Follow-up appointments at weeks 6 and 12 to assess response, answer questions, and refine your protocol.
04
Personalized Supplement Protocol
A targeted supplement plan built around your labs — not a generic wellness stack — to support hormone metabolism, energy, sleep, and cellular health.
05
Women's Hormone Resource Guide
A clinical reference covering key hormones in women's health, the perimenopause and menopause transition, what the research actually says, and how nutrition, lifestyle, and sleep all factor in.
06
12 Weeks of Clinical Coaching Emails
Weekly evidence-based guidance on topics that directly influence how well your body responds to therapy — from the early weeks through transition to quarterly care.
Full program details and pricing are reviewed at your consultation. Once the initial 12-week program is complete, you transition to quarterly maintenance care — ongoing insertions, labs, and clinical oversight on a consistent schedule.
Both approaches are clinically effective. The difference is in how hormones are delivered and how consistently your body experiences them.
PELLETS (ADOREU)
TOPICAL / ORAL HORMONES
FREQUENCY
Every 3–4 months
Daily or as prescribed
HORMONE DELIVERY
Continuous, steady release over 3–4 months
Varies by method; can fluctuate
SYMPTOM CONSISTENCY
Generally more stable
Dependent on application timing
CONVENIENCE
No ongoing self-administration
Daily or near-daily routine required
DOSE ADJUSTMENT
At each insertion based on labs
Can be adjusted more quickly
BEST FOR
Patients who want consistent levels without a daily routine
Patients who prefer flexible dosing control
The right delivery method depends on your symptoms, your lifestyle, and your hormonal picture. This is part of the conversation at your consultation.
Both approaches are clinically effective. The difference is in how hormones are delivered and how consistently your body experiences them.
PELLETS (ADOREU)
TOPICAL / ORAL HORMONES
FREQUENCY
Every 3–4 months
Daily or as prescribed
HORMONE DELIVERY
Continuous, steady release over 3–4 months
Varies by method; can fluctuate
SYMPTOM CONSISTENCY
Generally more stable
Dependent on application timing
CONVENIENCE
No ongoing self-administration
Daily or near-daily routine required
DOSE ADJUSTMENT
At each insertion based on labs
Can be adjusted more quickly
BEST FOR
Patients who want consistent levels without a daily routine
Patients who prefer flexible dosing control
The right delivery method depends on your symptoms, your lifestyle, and your hormonal picture. This is part of the conversation at your consultation.
Hormone optimization takes time. This is not a reflection of whether therapy is working — it's biology. Your body needs weeks to absorb and respond to new hormone levels. Here's what most women report, and when.
WEEKS 1-3
Sleep is often the first thing to shift. Many women notice they’re falling asleep more easily, waking less, and feeling more rested. Mood and irritability may begin to stabilize.
WEEKS 3-6
Energy starts to improve more noticeably. Brain fog begins to lift. Some women notice an improvement in libido and a reduction in hot flashes or night sweats during this window.
WEEKS 6-12
Most women are feeling meaningfully better by this point. Mental clarity, mood stability, and physical energy are more consistent. Vaginal dryness and discomfort with intimacy often improve.
MONTHS 3-4
By the end of your first full pellet cycle, body composition changes may become more visible — less midsection fat accumulation, better muscle tone with activity. Most women feel fully optimized.
ONGOING
Results continue to build with consistent lab monitoring and dose refinement. Your protocol evolves with your body — through perimenopause, menopause, and beyond.
Important: Your first pellet cycle is about establishing your baseline and getting your dose right. Some women feel significant improvement within the first few weeks. Others take a full cycle to reach their optimal level. Both are normal. Results build over time — and most women report that each cycle is better than the last.
Every patient is different, and your protocol will be built around your individual labs and response to therapy. That said, here is what a standard course of testosterone optimization looks like at AdoreU so you know what to expect from the process.
After your consultation and package selection, you'll receive a personalized timeline specific to your protocol.
Hormone optimization takes time. This is not a reflection of whether therapy is working — it's biology. Your body needs weeks to absorb and respond to new hormone levels. Here's what most women report, and when.
WEEKS 1-3
Sleep is often the first thing to shift. Many women notice they’re falling asleep more easily, waking less, and feeling more rested. Mood and irritability may begin to stabilize.
WEEKS 3-6
Energy starts to improve more noticeably. Brain fog begins to lift. Some women notice an improvement in libido and a reduction in hot flashes or night sweats during this window.
WEEKS 6-12
Most women are feeling meaningfully better by this point. Mental clarity, mood stability, and physical energy are more consistent. Vaginal dryness and discomfort with intimacy often improve.
MONTHS 3-4
By the end of your first full pellet cycle, body composition changes may become more visible — less midsection fat accumulation, better muscle tone with activity. Most women feel fully optimized.
ONGOING
Results continue to build with consistent lab monitoring and dose refinement. Your protocol evolves with your body — through perimenopause, menopause, and beyond.
Important: Your first pellet cycle is about establishing your baseline and getting your dose right. Some women feel significant improvement within the first few weeks. Others take a full cycle to reach their optimal level. Both are normal. Results build over time — and most women report that each cycle is better than the last.
The initial program is structured around defined checkpoints — not because we follow a rigid script, but because your body needs time to respond and we need data at the right intervals to get your protocol right. Here's what that typically looks like.
After your appointment and package selection, you'll receive individual information about your specific timeline and what's included in your program.
CARE JOURNEY
TREATMENT BEGINS
Protocol Appointment
Pellet therapy is the preferred delivery method at AdoreU — small bioidentical hormone pellets inserted subcutaneously in a quick in-office procedure. Manufactured from granules rather than compressed powder, they dissolve at a controlled, consistent rate, eliminating hormone bursts and uneven absorption. For patients better suited to a topical delivery method, that's discussed at this appointment.
4
WEEK 4
Lab Draw
Labs are drawn at an outside lab at four weeks — giving us an early read on how your body is absorbing and utilizing hormones before your follow-up appointment.
6
WEEK 6
Follow-up Appointment
You'll come in to review your week 4 labs and talk through how you're feeling. We assess what's working, answer your questions, and make early adjustments to your protocol if needed.
10
WEEK 10
Lab Draw
Labs are drawn again ahead of your final initial program appointment — a current picture of where your levels are as your first pellet cycle approaches completion.
12
WEEK 12 - FINAL APPOINTMENT
Review & Transition To Quarterly Care
You'll review your week 10 labs, discuss your overall response to therapy, and finalize your protocol. From here, you transition into quarterly maintenance — ongoing insertions, labs, and clinical oversight on a consistent schedule so your results stay stable over time.
Overseen by Aleasha Elliott, FNP-C
Every hormone protocol at AdoreU is evaluated and managed by a board-certified nurse practitioner — not a wellness coordinator or virtual provider. Your care is clinical.
The initial program is structured around defined checkpoints — not because we follow a rigid script, but because your body needs time to respond and we need data at the right intervals to get your protocol right. Here's what that typically looks like.
After your appointment and package selection, you'll receive individual information about your specific timeline and what's included in your program.
CARE JOURNEY
TREATMENT BEGINS
Protocol Appointment
Pellet therapy is the preferred delivery method at AdoreU — small bioidentical hormone pellets inserted subcutaneously in a quick in-office procedure. Manufactured from granules rather than compressed powder, they dissolve at a controlled, consistent rate, eliminating hormone bursts and uneven absorption. For patients better suited to a topical delivery method, that's discussed at this appointment.
4
WEEK 4
Lab Draw
Labs are drawn at an outside lab at four weeks — giving us an early read on how your body is absorbing and utilizing hormones before your follow-up appointment.
6
WEEK 6
Follow-up Appointment
You'll come in to review your week 4 labs and talk through how you're feeling. We assess what's working, answer your questions, and make early adjustments to your protocol if needed.
10
WEEK 10
Lab Draw
Labs are drawn again ahead of your final initial program appointment — a current picture of where your levels are as your first pellet cycle approaches completion.
12
WEEK 12 - FINAL APPOINTMENT
Review & Transition To Quarterly Care
You'll review your week 10 labs, discuss your overall response to therapy, and finalize your protocol. From here, you transition into quarterly maintenance — ongoing insertions, labs, and clinical oversight on a consistent schedule so your results stay stable over time.
Overseen by Aleasha Elliott, FNP-C
Every hormone protocol at AdoreU is evaluated and managed by a board-certified nurse practitioner — not a wellness coordinator or virtual provider. Your care is clinical.
We want you to go into therapy with a complete picture — including the clinical details that matter most for safety and consistency.
Progesterone
If you have a uterus, progesterone is not optional when estrogen is part of your protocol — it is a clinical safeguard. Without progesterone to balance estrogen's effect on the uterine lining, the lining can thicken abnormally over time, a condition that carries meaningful risk. Progesterone prevents this. Even after a hysterectomy, progesterone may still be part of your protocol for its independent benefits to sleep, mood, and neurological health.
Menstrual Cycle Changes
In the first few months after your initial insertion, some spotting or irregular bleeding can occur — particularly if your progesterone dosing is being calibrated. This is common and not necessarily a sign of a problem. Any unexpected bleeding should be reported so we can assess it in context with your labs and protocol.
Hair & Skin Changes
Some women may experience minor skin or hair changes — such as increased oil production, mild acne, or slightly faster hair growth. These dose-dependent effects are often related to how your body metabolizes testosterone into DHT. Most are easily managed through protocol refinements. If you observe any of these shifts, reach out promptly for an adjustment rather than waiting for your next scheduled follow-up.
Temporary Weight or Fluid Shifts
Some women experience a temporary weight change of 2–5 pounds in the first few weeks after insertion — typically fluid retention related to testosterone's effect on muscle tissue. Staying well hydrated and reducing sodium intake can help. If it persists, call the office.
Fertility & Contraception
Hormone therapy at AdoreU is not a form of contraception. If you are not in menopause and are not using reliable contraception, this needs to be part of your consultation conversation before starting therapy.
"I didn't realize how much I had normalized feeling terrible. By week six I was sleeping through the night for the first time in years. I keep telling my friends — get your labs done."
Patient, AdoreU — O'Fallon, MO
"The coaching emails actually changed how I eat and think about stress. I came in for hormone therapy and left with an entirely different understanding of what was happening in my body."
Patient, AdoreU — O'Fallon, MO
"Every appointment I felt like my results were genuinely being reviewed, not just checked off a list. The follow-up structure made a real difference in how confident I felt about the process."
Patient, AdoreU — O'Fallon, MO
* Patient experiences are individual. Results vary based on baseline levels, health history, and adherence to care protocols.
AdoreU provides hormone optimization & BHRT for women in O'Fallon, Missouri, serving St. Charles County and the greater St. Louis metro area. All women's hormone therapy is overseen by Aleasha Elliott, FNP-C, a board-certified family nurse practitioner specializing in bioidentical hormone pellet therapy for perimenopause, menopause, and related hormonal conditions.
AdoreU Holistic Beauty & Wellness
111 Church St., Suite 10 · O'Fallon, MO 63366
Serving St. Charles, Wentzville, Lake St. Louis, St. Peters, and the St. Louis metro area.
AdoreU is a cash-pay practice and does not bill insurance. Some patients submit receipts to their FSA or HSA for eligible expenses. Jon can provide a detailed receipt if needed.
The procedure itself takes less than 15 minutes. Most women return to normal desk work and daily activities the same day. Heavy lower body exercise should be avoided for 3–4 days after insertion.
A local anesthetic is used before the procedure, so discomfort during insertion is minimal. The area may feel tender or bruised for a few days afterward, and some swelling is normal. Most women find it very manageable, and the discomfort is typically less significant with subsequent insertions.
Avoid heavy lower body exercise — running, squats, lunges, elliptical — for 3–4 days after insertion. Upper body work and normal walking are fine. This allows the pellet to anchor properly.
Lab reference ranges reflect population averages — not what’s optimal for you specifically. A level that looks “normal” on paper may still be well below your personal optimal, especially if you’re symptomatic. And because estrogen in particular fluctuates so erratically, a single draw can easily miss what’s actually happening. We interpret your labs in the context of how you feel — not in isolation.
No. Many women begin hormone optimization during perimenopause — sometimes years before their last menstrual period — because symptoms can start well before estrogen and testosterone levels drop significantly. Where you are in your hormonal transition matters, and it’s part of how we design your protocol.
Hormones decline naturally with age, and most women who start therapy choose to continue because they feel meaningfully better. That said, this is always your decision. If you stop therapy, your hormone levels will gradually return to where they were before treatment. Long-term hormone therapy carries its own considerations that we discuss in detail at your consultation.
From your first inquiry to ongoing quarterly care, Jon — AdoreU's patient care coordinator — is your point of contact for scheduling, lab logistics, general questions, and anything that doesn't require clinical input. Many patients connect with Jon before ever booking a consultation.
Jon
Patient Care Coordinator
Jon supports every patient through scheduling, lab coordination, appointment follow-ups, and day-to-day questions. If you're not sure where to start, start with Jon. Reach him by phone or text at 636-486-6770 or fill out the inquiry form below.
TAKE THE FIRST STEP
Hormone Optimization Doesn't Start With A Prescription.
It starts with a conversation and a comprehensive look at your labs. If you're ready to find out what's actually going on and build a plan around it, we'd love to help.
NEW TO ADOREU?
Request a Consultation
Fill out our new patient inquiry form and our patient care coordinator will reach out to schedule your consultation and walk you through what to expect.
OR
ALREADY A PATIENT?
Schedule Your Next Appointment
Log in to your patient portal to request your next appointment, review your labs, or message our team.
AFTER WEEK 12
Quarterly Maintenance Care
Once your protocol is optimized, hormone therapy works best as a continuous process. Stopping and restarting based on symptoms leads to inconsistent levels and inconsistent results. Your quarterly maintenance plan keeps insertions, labs, and clinical oversight on a regular schedule — every season of the year — so your levels stay where they should be. Details are reviewed at your week 12 appointment.
Clinical Questions and Treatment Concerns
Use your Optimantra patient portal. This is the right channel for anything related to your symptoms, labs, medication, or protocol.
Scheduling and General Questions
Contact our patient care coordinator, Jon, by phone or text at 636-486-6770.
Established Patient Self-Scheduling
Log in to your Optimantra portal to book your follow-up appointments directly.
Request a Consultation
Fill out our new patient inquiry form and our patient care coordinator will reach out to schedule your consultation and walk you through what to expect.
Phone: (636) 486-6770
Fax: (866) 783-4604
Email: [email protected]
Monday - Friday: 9:00 AM - 5:00 PM
Nurse practitioner-owned and operated in O'Fallon, MO. Serving patients throughout St. Charles County.
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