Reviewed 2026-09-21 · DNP, FNP-BC, PMHNP-BC
Estradiol, progesterone, and the psychiatric differential
Thyroid disorders mimic perimenopause. TSH with free T4 is not optional when the story fits.
What Women's Hormone Therapy actually includes
Perimenopause HRT decisions require a history of cycles, vasomotor symptoms, and psychiatric syndromes.
Thyroid and HRT overlap: check TSH before attributing everything to estradiol.
Protocol elements we do not skip
Bipolar screen before unopposed-feeling antidepressant plans.
VTE/migraine/cancer history every start.
Refer DEXA when premature estrogen loss.
Lactation: pump/dump or compatible med list.
Indications and differentials
SSRI sexual dysfunction plus a hormone question.
Not indicated when VTE or estrogen-sensitive cancer history blocks estrogen without oncology input.
Not indicated as sole treatment of bipolar I mania.
Contraindication counseling itself can be the visit goal.
How Women's Hormone Therapy is structured
Review contraindications to estrogen.
Do not start estrogen and a new antidepressant on the same day without a reason.
Stop or change a hormone if mood destabilizes and the timeline fits.
Map the menstrual, pregnancy, postpartum, and menopausal timeline onto the mood timeline.
Questions we hear about Women's Hormone Therapy
What labs?
Individualized: estradiol, progesterone, FSH, TSH, ferritin, vitamin D as indicated.
How close is the office?
About 0 minutes from Hollywood.
Do you help with libido?
We evaluate causes, including SSRI effects and endocrine factors. No guaranteed outcome.
Can progesterone worsen mood?
Yes in some patients. Tell us; we change the plan.
Crisis?
988 or ER. Especially for postpartum psychosis.
Do you do pellets?
We do not run a pellet-first model. If a GYN uses them, we still require a psychiatric formulation.
How this differs from a 15-minute med check
Compounding pharmacies are tools, not religions.
Med-spa HRT maximizes procedures. We maximize a differential.
Antidepressant-only care can be right; hormone-only care can be right; both can be wrong.
Why Hollywood presentations look the way they do
Thyroid was last checked five years ago.
Brain fog was called anxiety and the sleep study was never ordered.
Progesterone made you depressed and nobody changed the regimen.
Book Women's Hormone Therapy
If Women's Hormone Therapy is the right next step, schedule a 60–90 minute intake with Dr. Dorothy Chatelier, DNP, FNP-BC, PMHNP-BC. Same-week telehealth follow-ups are used after the diagnostic visit when clinically appropriate.
After Women's Hormone Therapy is scheduled, complete intake forms once. Repeating the same history at every visit is what we are trying to avoid.
Related care
Clinician: Dr. Dorothy Chatelier, DNP, FNP-BC, PMHNP-BC, Psychiatric Mental Health Nurse Practitioner. Last medical review: 2026-09-21.
Florida telehealth psychiatry is available to established and new patients located in Florida at the time of the visit, subject to licensure and clinical appropriateness. An in-person evaluation at the Hollywood office may be recommended when a physical exam, vital signs, or a more complete diagnostic interview is needed.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It does not establish a provider-patient relationship. Always seek care from a qualified clinician for questions about a medical or psychiatric condition. If you are in crisis, call 988 or go to the nearest emergency department.