As a compounding pharmacist, I have seen how hormone replacement therapy done right can be of great benefit. Done right is the key. Bioidentical hormones, the same structure as found in the body, given by the right route (topically), in the physiological dose can be of great benefit. Lab values are a start, but they must be combined with patient feedback on how they are feeling. The Prescriptive Optimization approach allows for that interaction. Many labs come back with ranges specified to age. While it may be normal for a 60 year old to have less of a hormone level than a 30 year old, it is optimal to move that level back 30 years. Personally, I want the levels of youth to be the goal. We advocate saliva testing after topical hormones are given to continue monitoring as blood is less reliable once therapy has begun. We can work with patients and providers to assist through hormone replacement therapy as one does not fit all.