Hormone Replacement Therapy Specialist

Mirela Cernaianu, MD -  - Integrative and Holistic Women's Health

Hera Healthcare

Mirela Cernaianu, MD

Integrative and Holistic Women's Health & Minimally Invasive Aesthetic Center located in Westlake Village, Thousand Oaks, CA

Some women go through menopause like it’s a walk in the park, with only a few, mild hot flashes. Others have such severe hot flashes, depression, and loss of brain power that they struggle to make it through the day. Dr. Mirela Cernaianu at Hera Healthcare offers hormone replacement therapy that safely relieves all of your symptoms by restoring normal hormone levels. If you think you need hormone replacement therapy, contact her office in the Westlake Village area of Thousand Oaks, California, or schedule an appointment online.

Hormone Replacement Therapy Q & A



When do women reach menopause?

Levels of estrogen begin to decline during perimenopause, which occurs in the three to five years before menopause. During this time, menstrual periods often become irregular, with longer or shorter menstrual cycles and lighter or heavier blood flow.

Menstrual periods stop when estrogen production finally drops to a permanently low level. When you haven’t had a period for 12 consecutive months, you’re at menopause. The average age of menopause is 51, but the timing is different for each woman.

What are the symptoms of menopause?

Menopause symptoms often begin during perimenopause and continue for years after menopause. You may experience any or all of these symptoms:

  • Hot flashes and night sweats
  • Vaginal dryness
  • Vaginal atrophy
  • Painful intercourse
  • Low sex drive
  • Difficulty sleeping
  • Fatigue
  • Depression and irritability
  • Poor memory and lack of focus
  • Weight gain or difficulty losing weight

What other health challenges occur from loss of estrogen?

Estrogen impacts many systems in your body. For example, it helps regulate bone metabolism and maintains strength, elasticity, and hydration in your skin. Low levels of estrogen increase the risk for:

  • Osteoporosis
  • Urinary incontinence
  • Loss of muscle mass
  • Dry skin
  • Heart disease and arrhythmias

What types of hormone replacement therapy are available?

Hormone replacement therapy (HRT) relieves symptoms and prevents the health conditions associated with menopause by replenishing estrogen, testosterone, and/or progesterone. Your age, overall health, and medical history determine the type of hormone therapy that’s best for your needs.

Hormones used for HRT may be synthetic, or they may be bioidentical, which have the same molecular structure as the hormones naturally produced by the body. Dr. C. prescribes hormones in the following forms:

  • Estrogen: Oral pills, transdermal gel, patch, pellet, compounded topical cream, and vaginal creams, rings, or suppositories
  • Progesterone: Oral pills, compounded capsule, and compounded transdermal cream
  • Testosterone: Topical gel, pellet, compounded transdermal cream, and injectable for men

What are pellet therapy and SottoPelle®?

Pellet therapy refers to a type of HRT in which the hormones are placed into a pellet about the size of a grain of rice. Dr. C. injects the pellet under the skin on your hip. It lasts for three to four months, continuously releasing the hormones needed to maintain a steady level in your bloodstream.

SottoPelle is a brand of pellets offered by Dr. C. that contains low-dose, bio-identical hormones. The pellets are customized to provide the precise amount of hormones needed to restore hormone levels back to normal.