Concierge menopause care from a board-certified surgeon who measures what other providers guess at. Hormone therapy prescribing and monitoring inside a full longevity medicine framework. Not a pellet clinic. Not a 12-minute appointment. Not a suggestion to wait it out.
30-minute call. No obligation. We walk you through the Platinum tier and what the first visit covers before you commit.
The first experience most women in Louisville have for perimenopause or menopause is a conversation with their OB/GYN that lasts about 12 minutes. The OB/GYN is managing deliveries, surgical cases, and a full patient panel. Menopause is not the center of their practice. They may check a hormone level or two. They may prescribe a low-dose estrogen patch. They may suggest waiting it out. They are not running a metabolic panel, measuring body composition, testing VO2 max, or building a longevity framework around the hormone conversation. They do not have time.
The second experience some women have is with a “hormone optimization” or pellet clinic. Pellets are the only tool they offer, which leaves a large proportion of women with incomplete care. They do not test your metabolic health or address your lifestyle at all.
The third experience an increasing number of women have is an online HRT prescription from a telehealth company. The telehealth provider never examines them, never measures anything, never adjusts the protocol based on body composition or metabolic data, and is a different provider every time they log in.
None of these options treats the whole person. It is fragmented care that will produce fragmented results.
The reason a woman in Louisville feels confused, ignored, or frustrated about her perimenopause and menopause care is not that she is confused. It is that the system she has been inside has never measured what is actually happening in her body.
At Sano Longevity, hormone replacement therapy is prescribed and monitored as part of a comprehensive longevity medicine program. The Platinum tier of Menopause 3.0 exists specifically for (peri)menopausal women who need expert HRT prescribing inside a framework that also measures and manages everything the hormones affect.
Before Dr. Sweeney prescribes anything, she captures a full metabolic baseline and longevity assessment: body composition on the InBody 580, any relevant hormone levels, and a comprehensive longevity biomarker panel that includes the most important markers of longevity as well as those specific to the menopause transition. Patients on the Elite tier add bi-annual metabolic and VO2 max testing to track cardiovascular and metabolic progress across the year.
| Sano (Platinum) | Sano (Elite) | OB/GYN | Pellet clinic | Telehealth HRT | |
|---|---|---|---|---|---|
| HRT prescribing and monitoring | Yes (Dr. Sweeney) | Yes (Dr. Sweeney) | Sometimes | Yes (pellets) | Yes (remote) |
| Same physician every visit | Yes | Yes | Varies | Varies | No |
| Unlimited InBody body composition | Yes | Yes | No | No | No |
| Bi-annual VO2 max and metabolic testing | Add-on | Yes (included) | No | No | No |
| Monthly 1:1 coaching + registered dietitian | No | Yes | No | No | No |
| Annual strength assessment + bone density | No | Yes | No | No | No |
| Appointment length | 60-90 min | 60-90 min | 12-15 min | 15-30 min | 10-15 min |
Every Platinum-tier Sano patient starts with a comprehensive longevity assessment. This is not a hormone panel and a prescription. This is the full diagnostic workup that shows Dr. Sweeney where you actually are metabolically, cardiovascularly, and compositionally before she makes a single recommendation.
Measures your actual caloric burn at rest. This number changes during perimenopause. Most providers estimate it from a formula. Sano measures it.
Under 15 minutes on a bike or treadmill. Returns your biological age, your cardiovascular fitness relative to your chronological age, and the baseline number that tracks whether the program is working over the next 12 months.
Fasting insulin, Omega-3 index, Vitamin D, inflammatory markers, and others, plus the hormone levels specific to where you are in the menopause transition. Run through Quest Diagnostics.
Visceral fat in square centimeters. Segmental muscle mass. The fat-to-muscle shift that is one of the most clinically significant metabolic changes of perimenopause and menopause, and one of the least measured.
About one month after the first visit, Dr. Sweeney spends 60 to 90 minutes walking you through every result and presenting your individualized plan, including the hormone therapy recommendation if clinically appropriate.
Most hormone prescribers (whether it’s a pellet clinic, telehealth, or a busy OB/GYN) don’t have the knowledge or technology to be able to address the complex multi-system shifts that happen in menopause. It’s not just about the ovaries making less hormones, there are metabolic events that change body composition. Perimenopause and menopause are not just hormone events. They are metabolic events that change body composition, cardiovascular fitness, bone density, insulin sensitivity, sleep architecture, and cognitive performance simultaneously. Treating the hormone shift without measuring and managing the metabolic shift is like tuning one instrument in an orchestra and expecting the whole thing to sound better.
Sano Longevity’s Platinum tier places the hormone conversation inside a longevity framework that measures and manages every system the hormones touch. The quarterly retests track not just hormone levels but body composition, metabolic rate, and cardiovascular fitness across the year. The plan adjusts based on what the data shows, not based on what the symptoms feel like three months later in a 12-minute follow-up.
The women who do best in the Platinum tier are the ones who came in expecting a hormone prescription and left with a plan that covered their protein target, their strength training protocol, their sleep, their stress, their glucose patterns, their visceral fat trajectory, and their VO2 max. They got the hormones too. But the hormones were the beginning of the conversation, not the end.
A real Sano Longevity patient, 41 year old female business owner, perimenopausal. Came in after trying everything to take off the weight around her midsection that seemed to appear overnight. Her PCP didn't have any suggestions and she tried to manage it herself with a GLP from an online prescriber, unsuccessfully. Four months later:
Down 12 lbs total | 10 lbs of pure fat loss (only 2 lbs of muscle loss)
Body fat percentage: from 22% to 17%
Visceral fat: Down 10 sq cm
Successfully maintained results after weaning off GLP-1
A 22% to 17% body fat change during perimenopause is the kind of result that does not happen from a hormone prescription alone. It happens from a hormone prescription inside a framework that also measured body composition, set a protein target, built a strength protocol, and retested every quarter to see if the plan was working.
The Platinum tier at Sano Longevity is specifically for women in perimenopause or menopause who want expert hormone therapy prescribing and monitoring from a board-certified physician, inside a full metabolic and longevity medicine framework.
You are the right patient for this if you are in your late 30s to early 50s and experiencing symptoms your primary care or OB/GYN has not fully addressed: hot flashes, night sweats, weight gain around the midsection, brain fog, sleep disruption, loss of libido, mood changes, joint pain, or fatigue that does not improve with rest.
You have been told to wait it out or have been offered an antidepressant instead of a hormone panel. You have tried hormone therapy elsewhere but it was prescribed without metabolic testing, without body composition analysis, and without a plan for the other systems menopause affects.
You want the hormone conversation to happen inside a practice that also measures your VO2 max, your resting metabolic rate, your visceral fat, your fasting insulin, and your body composition, and that retests every quarter so you can see whether the plan is working.
You want the same physician at every visit and appointments that run 60 to 90 minutes when the data requires it.
Both tiers are built around the same clinical core: hormone therapy prescribed and monitored by Dr. Sweeney inside a practice that measures everything first. The differences are in what gets layered on top.
| Platinum $399/mo | Most Transformational Elite $499/mo | |
|---|---|---|
| Comprehensive longevity assessment | ✓ | ✓ |
| Initial hormone panel | ✓ | ✓ |
| Hormone replacement prescribing and adjusting by Dr. Sweeney | ✓ | ✓ |
| Quarterly physician appointments with Dr. Sweeney | ✓ | ✓ |
| Annual longevity biomarker panel | ✓ | ✓ |
| Unlimited InBody body composition scans | ✓ | ✓ |
| Supplement evaluation and recommendations | ✓ | ✓ |
| Concierge access (text, email, phone) | ✓ | ✓ |
| 20% off IV and IM therapies | ✓ | ✓ |
| Monthly 1:1 coaching sessions (30 min) | — | ✓ |
| Bi-annual registered dietitian meetings | — | ✓ |
| Bi-annual metabolic and VO₂ max retesting | — | ✓ |
| Annual strength, mobility, and injury assessment | — | ✓ |
| Bone density scan | — | ✓ |
Both tiers carry a 12-month commitment. One-time onboarding and comprehensive assessment: $350. Cash-pay, HSA and FSA eligible. Medication and follow-up lab costs are patient responsibility.
Five questions patients ask most often about menopause and perimenopause care at Sano Longevity.
Yes. Both tiers of the Menopause 3.0 program – Platinum ($399/mo) and Elite ($499/mo) – include hormone replacement therapy prescribing and adjusting for (peri)menopausal patients. Dr. Sweeney personally manages all hormone therapy dosing and adjustments.
Pellet and standalone hormone clinics only prescribe limited therapies without giving you access to all the hormone tools that are scientifically valid. They do not measure your metabolism, body composition or provide whole-person care. Sano prescribes and monitors hormone therapy inside a comprehensive longevity medicine framework that also includes VO2 max testing, body composition analysis, resting metabolic rate measurement, a metabolic blood panel, and 60 to 90 minute physician appointments. The hormone conversation at Sano is one piece of a larger metabolic picture.
Menopause 3.0 has two tiers: Platinum at $399/mo and Elite at $499/mo, both with a 12-month commitment and a one-time $350 onboarding and comprehensive assessment fee. Platinum includes HRT prescribing and monitoring, quarterly physician appointments, the annual longevity biomarker panel, unlimited InBody scans, and supplement evaluation. Elite adds monthly 1:1 coaching, bi-annual registered dietitian meetings, bi-annual VO2 max and metabolic testing, an annual strength and mobility assessment, and a bone density scan. Cash-pay only. HSA and FSA eligible. Medication and follow-up lab costs are patient responsibility.
Dr. Meredith Sweeney, MD, FACS, a board-certified bariatric surgeon with more than a decade of hospital surgical experience and membership in the American Academy of Anti-Aging Medicine. She is the only physician in the practice.
No. Cash-pay only. HSA and FSA eligible. Receipts provided for reimbursement documentation.
Book a free consultation. We walk you through what the Platinum tier covers, what the first visit measures, and whether Sano is the right fit for where you are in the menopause transition. No surprise billing. No upsells. The full cost is on the pricing page.
We respond within 24 hours. No pitch. Just data. Or call (502) 208-6476.
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Founder, Sano Longevity in Middletown, Louisville. Board-certified bariatric surgeon. Fellow of the American College of Surgeons (FACS) and formerly the American Society for Metabolic and Bariatric Surgery (FASMBS). Member, American Academy of Anti-Aging Medicine (A4M). Speaker, Longevity Fest 2025. More than ten years of metabolic medicine experience at Norton Healthcare before founding Sano Longevity in March 2025.
Sano Longevity
(502) 208-6476
