There are many great providers for Perimenopause and Menopause in the Camp Hill and Harrisburg PA area. This is not a comprehensive list, but are providers I have used myself and recommend.

Here are some of my top suggestions:

1. Dr. Case Troutman of Midlife ReMDy

2. Midi Health an online platform that will use your insurance (typically) CANNOT prescribe testosterone gel because PA does not allow testosterone to be dispensed via telehealth.

3. 4th Tree Health Direct Primary Care

4. The Menopause Society Website can help you find a trained provider in your area. Make sure you vet your provider properly most clinicians even OB-GYN's are NOT trained in midlife hormones.

5. Discover Pelvic Health and Wellness Megan Miller, PT a pelvic floor physical therapist who is knowledgeable about perimenopause and menopause.

Some things to remember cited from Dr. Kelly Casperson's work Menopause Moment:

Estrogen

(Dr. Kelly Casperson – The Menopause Moment)

What estrogen does:

• Supports brain function, mood, and sleep

• Maintains bone density and muscle

• Protects cardiovascular health

• Keeps vaginal, vulvar, and urinary tissues healthy

What happens in perimenopause:

• Estrogen becomes erratic (highs and lows, not a steady decline)

• Fluctuations drive symptoms like:

  • Hot flashes

  • Sleep disruption

  • Mood changes

  • Brain fog

  • Vaginal dryness and urinary symptoms

Casperson key point:
Estrogen is a whole-body hormone, not just a reproductive one.

Progesterone

(Dr. Kelly Casperson – The Menopause Moment)

What progesterone does:

• Calms the nervous system

• Supports sleep quality

• Balances estrogen’s effects on the uterus

• Helps with cycle regulation

What happens in perimenopause:

• Progesterone is often the first hormone to decline

• This creates relative estrogen dominance, even if estrogen isn’t “high”

• Common symptoms:

  • Anxiety

  • Insomnia

  • Irritability

  • Heavier or irregular periods

Casperson key point:
Many early perimenopause symptoms are progesterone loss, not estrogen deficiency.

Testosterone

(Dr. Kelly Casperson – The Menopause Moment)

What testosterone does (in women):

• Supports muscle mass and strength

• Contributes to energy, motivation, and confidence

• Plays a role in libido and sexual response

• Supports bone density

What happens in perimenopause:

• Testosterone slowly declines with age

• Loss contributes to:

  • Decreased muscle

  • Lower energy

  • Reduced sexual desire

  • Reduced resilience to stress

Casperson key point:
Testosterone is not a male hormone — women need it for physical and sexual health.

Why Estrogen Matters (It’s Everywhere)
(Dr. Kelly Casperson – The Menopause Moment)

Estrogen works by binding to estrogen receptors throughout the body, including the brain, bones, muscles, heart, bladder, vulva, vagina, and pelvic floor.

What changes in perimenopause:

• Estrogen levels become erratic rather than steadily declining

• Estrogen receptors receive inconsistent signaling

• Tissues lose predictability, resilience, and repair capacity

Effects of changing estrogen signaling:

• Brain: mood changes, anxiety, brain fog, sleep disruption

• Muscle & bone: reduced muscle maintenance and bone density

• Pelvic & urinary tissues: dryness, irritation, urgency, leakage

• Cardiovascular system: gradual loss of protective effects

FDA Update on Black Box Warnings (2025)

• The FDA has removed the black box warning from many menopausal hormone therapy products — including systemic estrogen and estrogen-progestogen combinations — to align labeling with current evidence. HHS

• This reversal corrects decades of fear based on early WHI interpretations and may improve access to evidence-based care. HHS

• Some specific risks (e.g., endometrial cancer with unopposed estrogen in women with a uterus) remain part of ongoing safety guidance. STAT

• Women should talk with a qualified menopause clinician to understand personalized benefits and risks.

The problem was never estrogen — it was how the data was interpreted and communicated.

🧾 What Really Happened With the Black Box Warning

✔️ The FDA has initiated removal of the black box warning from most hormone replacement therapy products used for menopause.
This includes many estrogen-containing therapies — both estrogen alone and estrogen-plus-progestogen formulations — not just low-dose vaginal estrogen.

✔️ News reports state the FDA’s recent action removes the strictest warning from “hormonal menopause therapies,” suggesting that the broadest warnings about risks like cardiovascular disease, breast cancer, and dementia are being pulled off labels. KSAT

⚠️ BUT — There are still specific warnings that may remain

Some risk information is not entirely erased, particularly for specific products or populations:

✔️ The warning about endometrial cancer risk in systemic estrogen-alone therapy for women with an intact uterus is likely to remain — because unopposed estrogen can stimulate the uterine lining and increase that specific cancer risk, and professional guidance continues to emphasize the need for progesterone in such cases. STAT

✔️ Systemic (oral/patch) vs vaginal estrogen still differ in risk profiles — and experts caution that label changes do not mean all risk disappears for every individual. PBS

🧠 What the FDA and experts are saying

• The FDA’s decision comes after a decades-long re-evaluation of hormone therapy risks and benefits and aims to correct fear-driven labeling based on early WHI interpretations that outlived the science.

• Removing the box warning is intended to reduce stigma and barriers to appropriate menopause care. Healthline

• Some experts still urge individualized risk assessment, especially for systemic therapy, because different formulations and delivery methods have different risk profiles. -PBS, Other Sources