The dose
Starting doses are deliberately conservative. Many women are never moved up from one.
Your dose was a guess. Nobody checked.
Titrate is a dose review for women already on HRT whose symptoms have not settled. A menopause clinician goes through what you are taking, changes what needs changing, and keeps adjusting until it works.
Are you currently taking HRT?
How it works
We change one thing, measure, then change the next.
Getting a dose right is not one appointment. It is a loop, and running that loop properly is the entire service.
- Day 1
You tell us what you are on and what is still wrong
Ten minutes, online. We also score your symptoms on a standard scale, so from here on “is it working” is a number rather than a feeling. You cannot adjust a dose against a vague sense of things.
- Day 2–3
A menopause clinician changes exactly one thing
Your dose, or your delivery method, or your timing, or your progestin. One, never two. Change two and nobody can tell which one worked — which is how women end up being told “we tried everything”.
- Day 2–3
Blood work, only if they would change the answer
A level shows whether you are actually absorbing what you are prescribed — the question that most often explains a non-responder. Thyroid and iron rule out the conditions that feel identical from the inside.
- Week 1
Your new prescription reaches your pharmacy
No second appointment to book. No waiting room.
- Week 8
We score you again — and this is the part nobody does
Better? We hold there. Not better? We change the next single thing and go round again. Most services bill you for every one of these. We do not.
- Then
You leave
When your number says it is working, you go — with a regimen that works and a letter for your own doctor. We are not trying to keep you forever. If your HRT is sorted, you do not need us, and we would rather you told someone than kept paying us.
What it is not: a service for starting HRT, a supplement, or a reason to leave a doctor you are happy with.
“I was told I was on HRT, so this must just be me now.”
The sentence we built this around
The problem with the whole category
Everyone sells the first appointment.
Menopause services compete on how fast you can be seen and whether it is covered. All of that matters right up until the prescription is in your hand — and then you are on your own with it. Titrate is built for the part after that.
What a real review looks at
The route
Patches, gels, sprays and tablets absorb differently, and absorption varies enormously between people.
The timing
Whether levels trough before the next dose. Flashes returning at a predictable hour are a timing question.
The progestin
Type and schedule change how you feel, and both are adjustable on their own.
Or it isn't the HRT
Thyroid, iron, sleep apnea and several common medications produce identical symptoms.
This is only for women already on HRT.
That is the whole list. If you have not started hormone therapy yet, you want a service built for that — several good ones exist and we are not one of them. Come back if it does not work.
Where are you in this?
Five questions, about thirty seconds. We are using the answers to decide which states to open in first.
You're on the list.
We'll write when Titrate opens in your state. If you told us a review would be worth paying for, you'll hear from us first.
Meanwhile, take those five to your own doctor. "Has my dose ever been titrated, and have my levels been checked?" is the one most likely to change something.