# Assessment-first hormone health consultations in Pretoria

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- Author and medical reviewer: Dr Luhard Jansen van Vuuren, MBChB (Pret)
- Last reviewed: 12 October 2026
- Location: Medify, Waterkloof, Pretoria

Hormone care should begin with the clinical question, not a promise to “optimise” every number. Dr Luhard assesses symptoms, medical context and appropriate investigations before discussing treatment.

## Clinical principle

Treat a patient and a defined problem, not an isolated laboratory value. A consultation may lead to treatment, further investigation, referral, lifestyle intervention or the conclusion that hormone therapy is not indicated.

## What assessment may include

The exact assessment is individual. It may include symptoms, current medicines and supplements, reproductive and sexual health, sleep, weight change, cardiovascular and metabolic risk, fertility goals, examination and targeted blood testing where the result could change care.

## Testosterone and men's hormone health

Responsible testosterone assessment requires compatible symptoms or signs together with appropriately measured and consistently low testosterone concentrations. Fertility intentions, haematocrit, sleep-related breathing problems, prostate considerations, cardiovascular context and the cause of a low result may change the decision.

## Perimenopause and menopause

Treatment choices depend on the symptoms that matter to the patient, age and stage, medical and family history, previous surgery, personal risks and treatment preferences. Hormone therapy can be valuable for suitable patients, but it is not the only option and is not automatically appropriate.

## Connection with weight management

Weight change, sleep, energy balance, insulin resistance, medicines and chronic illness can affect symptoms and some hormone measurements. Hormone assessment may sit inside a wider plan that includes [medical weight management](https://drluhard.com/medical-weight-loss-pretoria.html), nutrition, activity and [targeted supplementation](https://drluhard.com/targeted-supplementation-pretoria.html).

## Treatment and monitoring

If treatment is appropriate, the plan should identify the objective, expected timeframe, safety monitoring and circumstances in which it should be adjusted or stopped.

## Frequently asked questions

### Does fatigue automatically mean a hormone deficiency?

No. Fatigue has many possible causes. Symptoms, history, examination and targeted investigations should guide whether a hormone disorder is likely.

### Does a consultation guarantee hormone treatment?

No. Treatment is considered only when the evidence from that patient supports it and expected benefits justify the risks.

### What does responsible hormone optimisation mean?

It means identifying and managing a clinically relevant problem. It does not mean pushing laboratory values as high as possible or prescribing hormones as a universal anti-ageing treatment.

## Sources

- [Endocrine Society: testosterone therapy clinical practice guideline](https://www.endocrine.org/clinical-practice-guidelines/testosterone-therapy)
- [World Health Organization: menopause](https://www.who.int/news-room/fact-sheets/detail/menopause)
- [The Menopause Society](https://menopause.org/)

General medical information only. It does not replace a consultation, diagnosis or personalised treatment recommendation.