A 42 year old female presents to her gynecologist with hot flashes, night sweats, disturbed sleep cycles, day-time drowsiness, and overall fatigue. Additionally, the patient cites a significant decrease in libido and sex drive within the past six months. After hearing the patient describe her symptoms, the doctor suggests that lab work should be completed. The physician also completes a full physical and medical history, paying particular attention to details that exclude hormone replacement therapy from the potential treatments. The results of the lab work reveal mildly decreased estrogen and testosterone levels. The patient and physician agree that bio-identical hormone replacement therapy is a logical next step in treatment. Using the patient’s history, lab values, and experience, the physician creates a tailored hormone dose to substantially reduce symptoms using the smallest dose necessary.