BridgeWell Transformation Pathway About Dr. Sheri Erwin

Focused Clinical Training: Women’s BHRT Foundations

A focused, systems-based clinical training for nurse practitioners who want to confidently initiate, prescribe, and manage bioidentical hormone therapy using an evidence-based, clinically grounded framework.

Built specifically for licensed NPs. Grounded in real clinical practice.

What This Course Covers:

  • How to stage your patient on the hormonal decline trajectory before you prescribe, including Stage 1 testosterone deficiency, Stage 2 estrogen deficiency across three severity levels, and Stage 3 menopause with FSH interpretation thresholds
  • The clinical distinction between perimenopause and menopause and why the 12-month diagnostic criterion does not determine when hormone support may be initiated
  • Why standard lab ranges miss the perimenopausal patient and how to use the progesterone to estradiol ratio and luteal phase timing as clinical tools
  • How to reframe the Women's Health Initiative findings and apply the Timing Hypothesis to your prescribing decisions
  • How to select the appropriate estradiol delivery route based on patient-specific risk factors including cardiovascular history, skin tolerance, migraine history, and lifestyle
  • Estradiol formulations, starting doses, and titration strategy for perimenopausal and postmenopausal patients
  • The clinical and safety differences between bioidentical micronized progesterone and synthetic progestins and why that distinction changes the breast cancer risk conversation
  • Progesterone dosing across perimenopause and menopause including the cycle-status-driven decision tree for when and how much
  • The neurological and systemic benefits of oral micronized progesterone including the GABA modulation mechanism behind the sleep and anxiety effects
  • The adrenal connection: how HPA axis function, pregnenolone steal, and DHEA decline affect hormone therapy outcomes
  • How to construct a complete baseline lab evaluation before initiating BHRT and what to monitor at follow-up
  • How to document BHRT initiation including shared decision-making language and off-label disclosure for compounded testosterone
  • How to communicate hormone therapy options to patients who have concerns about the WHI or about hormone therapy generally

Enrollment Includes:

  • Full access to all four modules plus the Start Here pre-module staging lesson
  • Hormonal Staging Quick Reference: the complete Stage 1, 2, and 3 criteria with FSH thresholds, progesterone decision tree by cycle status, dosing charts by age and weight, and lab timing reference
  • BHRT Initiation and Monitoring Reference: baseline lab panel with timing, functional hormone targets, progesterone to estradiol ratio guide, and the complete monitoring schedule
  • BHRT Route and Formulation Quick Reference: all estradiol and progesterone delivery routes with commercial products, starting doses, advantages, and supplement support reference
  • BHRT Contraindications Quick Reference: absolute and relative contraindications with route exceptions and documentation requirements
  • Female Hormonal Intake Assessment: a BridgeWell-formatted clinical intake tool with symptom reference, physical exam findings, and integrated staging assessment
  • BHRT First Visit and Follow-Up Documentation Template: structured hybrid documentation guide with narrative HPI section, safety screening checklist, shared decision-making language, and follow-up visit template
  • Progesterone and Uterine Bleeding Protocol: the complete workup decision tree including TVUS thresholds, EMB result pathways, and progesterone alternatives hierarchy
  • BHRT Dosing in Practice: four fully worked patient cases with serial lab tables and clinical reasoning across different staging presentations
  • Patient Handout: Understanding Hormone Therapy for Women, plain language patient education covering bioidentical versus synthetic, delivery routes, the WHI in plain terms, and options for women who cannot or choose not to use hormones
  • BHRT Clinical Troubleshooting Guide: a nine-section clinical reference covering the three-system check, five common side effect scenarios, the non-responder workup, dose adjustment decision framework, documentation language, delivery route troubleshooting, symptom pattern recognition at intake, and compounding and prescription considerations
  • Evidence and Reference List: APA-formatted citations organized by module for all key studies, guidelines, and position statements referenced throughout the course
  • Certificate of Completion
  • Lifetime access

Legal Disclaimer:

Clinical decisions remain the responsibility of the licensed professional using their independent judgment and applicable laws and regulations.