Hot flashes, eased.
Sleep, restored.
The spark, returned.
Bioidentical hormone therapy for hot flashes, sleep, and mood. PT-141 — the only FDA-approved peptide for women's desire. Prescribed online by a US-licensed physician and shipped each month.
What women's hormone therapy actually is
Most of what your body does to feel like itself runs on hormones. As you move into your 40s, the supply changes — first in patterns that don't fit the textbook, then in drops that show up as hot flashes, broken sleep, and mood that doesn't track. Hormone therapy is just the term for the prescriptions that put some of that supply back.
Pepvio prescribes two things in this category. Bioidentical HRT — estradiol (in whichever form fits you: patch, gel, or cream), bioidentical progesterone for sleep and uterine protection, and topical estrogen for vaginal symptoms. The same hormones a menopause-trained physician would write for you, compounded in a US pharmacy. PT-141 — the active ingredient in Vyleesi, the only FDA-approved peptide for women's desire. It works on the brain pathway that drives desire, not on hormones, so it's a separate question from HRT — and many women take both.
The model is what's different. No six-month wait for a menopause specialist. No provider who tells you to "just try magnesium." Your online visit goes to a US-licensed physician who actually engages with the symptoms, writes the prescription that fits, and sends it monthly from a US compounding pharmacy. Pause or cancel anytime.
What people are usually noticing
Most people don't come to a women's hormone protocol after a single bad week. It's a few months of "this isn't how it used to feel." If any of these sound familiar, you're in the right place. Pick the protocol that fits — your online visit confirms whether you qualify.
Hot flashes out of nowhere
A wave of heat in a cold meeting. Again at 2am. Then in the grocery store. Nobody warned you it would be this much, this often, and this random — and the layers you keep peeling off don't help.
Sleep that breaks at 3am
You fall asleep fine. You wake up at three — slightly hot, mind running, can't get back under. By noon you're tired and short-tempered, and the next night repeats. Magnesium hasn't fixed it.
Mood and energy that don't feel like you
The patience you used to have is shorter. The energy that used to carry you past 3pm flatlines. The version of you you remember is still in there — it's just been harder to reach lately.
A lower sex drive
Interest is still there. The feeling that used to follow doesn't always show up. It's not about your partner, and it's not just stress — there's real biology underneath it.
HRT and PT-141 — prescribed online
Each protocol is prescribed by a US-licensed physician after a short online visit, compounded by a licensed US pharmacy, and shipped each month. Both qualify for HSA/FSA reimbursement. Pause or cancel anytime.
How it works
Your online visit
A short set of questions — your symptoms, what you're already taking, anything that wouldn't mix well. No video call. You're not charged until a provider says yes.
Physician review
A US-licensed physician reviews your online visit — usually within 24 hours — and writes the prescription if the protocol fits. For HRT, your dosing is personalized at this step.
Compounded + shipped
A licensed US compounding pharmacy fills the prescription and ships it to your door. Refills auto-renew each month — pause or cancel anytime, no annual commitment.
Licensed providers in your state
503A/B pharmacies, USP-grade
No charge until a provider approves
Common questions about HRT and PT-141
What's the difference between Pepvio's HRT and what my doctor would prescribe?+
Pepvio prescribes the same bioidentical hormones — estradiol, progesterone, and topical estrogen for vaginal symptoms — that menopause-trained physicians prescribe. The difference is access: no months-long wait, no insurance gauntlet, no provider who tells you to 'just try magnesium.' A US-licensed physician reviews your online visit and writes the prescription if it fits. A US compounding pharmacy fills it. Same medicine, different model.What is PT-141 and is it FDA-approved?+
PT-141 (bremelanotide) is the active ingredient in Vyleesi — the only FDA-approved peptide for women's desire (specifically for a diagnosis called HSDD). It works on a different pathway than hormones; it acts on receptors in the brain that drive the desire response. Pepvio prescribes it in compounded forms (a spray or an injectable) so you don't pay Vyleesi's branded retail price.Can I take HRT and PT-141 together?+
Yes — they work on different systems and are commonly prescribed together. HRT addresses the symptoms driven by hormone change (hot flashes, sleep waking, mood, vaginal changes). PT-141 addresses the desire pathway directly, which is brain-based, not hormone-based. Pepvio offers them as separate protocols or as a bundled subscription at a discount.Do I need bloodwork before starting?+
For HRT, baseline labs help your provider personalize dosing — but they aren't a wall you have to clear to start. If you have recent labs from your primary care provider, you can share them; if not, your provider may suggest follow-up testing once you're stable. For PT-141, no bloodwork is required.How quickly will I notice changes?+
For HRT, sleep changes often show up first — usually within 2–3 weeks of starting bioidentical progesterone at bedtime. Hot flashes often ease over 4–8 weeks. Mood and energy build over 8–12 weeks. PT-141 is different: it isn't a magic switch. Give the first month to dial in — the first session is information, not a verdict, and most women find their pattern by week 3 or 4. We've written a detailed guide on what to expect — see "How to Set Yourself Up for Success on PT-141" on the blog.Is this HSA/FSA eligible?+
Yes. Pepvio's women's protocols cover FDA-approved diagnoses — perimenopause and menopause for HRT, HSDD for PT-141 — so the prescriptions qualify for HSA and FSA reimbursement. Your monthly receipt has what your plan administrator will need.What if HRT isn't right for me?+
Pause or cancel anytime — no annual commitment. If something isn't working, message your provider through the patient portal and they can adjust dosing, switch you to a different form (patch, capsule, cream), or pause the protocol entirely. The goal is the version that fits your body.
Start with the protocol that fits
A short online visit. US-licensed physician review, usually within 24 hours. Compounded in a US pharmacy, shipped to your door. Cancel anytime.