The fatigue, the weight that won't budge, the 3 a.m. wake-ups, the mood swings, the feeling that you're not you anymore — these are real, they're often hormonal, and they're treatable. Whether you're navigating perimenopause, menopause, PMOS, or symptoms no one has been able to explain, Peak HRT helps you feel strong, clear, and like yourself again.
Hormone health isn't one conversation — it changes with every stage of life. Find where you are:
Symptoms starting in your late 30s or 40s, often while your periods are still regular.
Jump to perimenopause12+ months past your last period, and managing the changes that come after.
Jump to menopauseIrregular cycles, weight-loss resistance, and metabolic symptoms in your reproductive years.
Learn about PMOS careYou just know something's off and you're tired of being dismissed.
Jump to how we helpYou've been offered an antidepressant for what feels like a hormone problem. Or you've just been told it's "part of being a woman" and sent on your way. Meanwhile, you're dealing with:
These aren't character flaws or things to push through. They're signals from a hormonal system that's shifting — and there's real medicine for them.
Most women expect menopause. Far fewer are told about perimenopause — the years leading up to it, when hormones don't simply decline, they fluctuate wildly. Estrogen can swing high and low within the same week. Progesterone starts dropping. This is often when symptoms are at their most disruptive — and it can start in your late 30s or early 40s, years before your cycle actually stops.
Because your periods may still be regular, perimenopause is frequently missed or dismissed. You're "too young for menopause," so the real cause gets overlooked. We don't overlook it. We evaluate where you actually are in the transition and treat what's actually happening.
Menopause is officially diagnosed 12 months after your last period — but the hormonal shift, and its effects on your bones, heart, brain, metabolism, and muscle, continues well beyond that. This isn't just about managing hot flashes. It's about protecting your long-term health: maintaining muscle and bone, supporting cardiovascular and metabolic health, and preserving cognition and quality of life for the decades ahead.
Our goal isn't to get you to "tolerable." It's to help you feel genuinely well — and to set you up to age strong.
If irregular cycles, weight-loss resistance, acne, unwanted hair changes, and metabolic symptoms started in your reproductive years, you may be dealing with PMOS — polyendocrine metabolic ovarian syndrome, recently renamed from PCOS to reflect that it's a whole-body hormonal and metabolic condition, not just an ovarian one. It's one of the most common — and most underdiagnosed — hormonal conditions in women, and it responds well to the kind of root-cause, metabolic approach we specialize in.
Learn about our PMOS careWe don't hand out a one-size protocol. We start by measuring, then build a plan around you.
Your first visit is a full hormone, thyroid, and metabolic lab panel — not the bare minimum — plus a body composition scan and an in-depth consultation. We look at the whole system, because hot flashes, weight gain, and mood aren't separate problems; they're connected.
For many women, hormone therapy — including estrogen and progesterone — is a safe, effective, evidence-based option when matched to the right person at the right time. We'll walk through whether it's right for you, including the real benefits and the real risks, in plain language.
Sleep, muscle, metabolism, and stress all shift through these transitions. Your plan may include support for weight and body composition, peptides, nutrition, and recovery — because feeling well is more than one prescription.
We monitor, retest, and adjust. Your body keeps changing; your care should too.
Peak HRT is led by Rebecca Miskew, MS, APRN, A-GNP-C — a board-certified nurse practitioner with 16+ years of clinical experience, certified in hormone replacement therapy, and a woman who has navigated her own hormone journey.
“I built Peak HRT because too many women are told their labs are normal while they feel anything but. You deserve to be listened to, taken seriously, and given a real plan — not dismissed.”
Meet Rebecca and the teamAmazing experience with Becca. She really took her time explaining everything with me, went overtime and was happy to do it. What a great experience and knowledge I learned. Definitely gonna follow up and continue using her service.
Becca was so knowledgeable and helped me understand my labs in a wholistic way. She was able to prescribe supplements needed to increase my overall health and wellness. The labs drawn were comprehensive, and being in healthcare, I learned so much! Highly recommend. Professional, clean and thorough!
Absolutely worth it. I would recommend everyone checking out Peak HRT.
Awesome business, great service. Love being able to get a quick vitamin shot when I'm feeling under the weather!
I can't recommend Peak TRT highly enough. Becca is a talented professional who provides excellent care. She is knowledgeable and thorough, making sure that your treatment plan is perfect for you and makes sure you always understand the process.
If you're ever in the area and need hydration, vitamins, or just a pick me up, Becca and her team are the BEST! I was super sick and came across Peak so I decided to stop in. They made me feel so comfortable and went above and beyond for me!
The incredible team at Peak got me back into ski shape after 4 days of shredding. The IV drip combined with the NAD booster was a game changer! Highly recommend if you're feeling the altitude and exhaustion.
The ladies were extremely pleasant and made me feel more than welcome. They are very knowledgeable about their services. I highly recommend them!
This place is amazing! The customer service was outstanding from start to finish — welcoming, attentive, and truly customer-centered. The staff are incredibly knowledgeable about health, wellness, and disease prevention. I felt safe, informed, and well cared for. Highly recommend.
Becca is a highly knowledgeable and genuine nurse practitioner who runs her practice with total integrity. As a competitive bodybuilder and fitness coach, she understands the science of hormones and performance from every angle. The level of care and education here far exceeds what you'll find at most clinics.
Great experience! Becca is knowledgeable in her work. Explained everything in a way I could understand and why it would help me in the long run. Would recommend to anyone wanting to know what they need to improve their health!
Becca is the BEST!!! I'm 40 and she made me feel 32 again! Peak TRT and Becca are the real deal. If you want to feel like you can take on the world, give them a call. I had no idea just how bad my health was — now I feel great, look great and I'm ready to take on the world!
Don't waste precious mountain time stuck with a hangover or altitude sickness. Peak IV Drip Lounge is absolutely worth every penny. Fast, professional, and incredibly effective — I felt better quickly and was able to get right back out to play in the mountains. Total game changer for mountain trips.
Top tier care! Becca is unbelievably smart, with genuine care and pride in what she does. My normal doctor did a non-comprehensive test, giving me no answers. Becca took care of me like she was my normal practitioner. She and her nurses are welcoming, supportive, and all around the best.
Amazing experience with Becca. She really took her time explaining everything with me, went overtime and was happy to do it. What a great experience and knowledge I learned. Definitely gonna follow up and continue using her service.
Becca was so knowledgeable and helped me understand my labs in a wholistic way. She was able to prescribe supplements needed to increase my overall health and wellness. The labs drawn were comprehensive, and being in healthcare, I learned so much! Highly recommend. Professional, clean and thorough!
Absolutely worth it. I would recommend everyone checking out Peak HRT.
Awesome business, great service. Love being able to get a quick vitamin shot when I'm feeling under the weather!
I can't recommend Peak TRT highly enough. Becca is a talented professional who provides excellent care. She is knowledgeable and thorough, making sure that your treatment plan is perfect for you and makes sure you always understand the process.
If you're ever in the area and need hydration, vitamins, or just a pick me up, Becca and her team are the BEST! I was super sick and came across Peak so I decided to stop in. They made me feel so comfortable and went above and beyond for me!
The incredible team at Peak got me back into ski shape after 4 days of shredding. The IV drip combined with the NAD booster was a game changer! Highly recommend if you're feeling the altitude and exhaustion.
The ladies were extremely pleasant and made me feel more than welcome. They are very knowledgeable about their services. I highly recommend them!
This place is amazing! The customer service was outstanding from start to finish — welcoming, attentive, and truly customer-centered. The staff are incredibly knowledgeable about health, wellness, and disease prevention. I felt safe, informed, and well cared for. Highly recommend.
Becca is a highly knowledgeable and genuine nurse practitioner who runs her practice with total integrity. As a competitive bodybuilder and fitness coach, she understands the science of hormones and performance from every angle. The level of care and education here far exceeds what you'll find at most clinics.
Great experience! Becca is knowledgeable in her work. Explained everything in a way I could understand and why it would help me in the long run. Would recommend to anyone wanting to know what they need to improve their health!
Becca is the BEST!!! I'm 40 and she made me feel 32 again! Peak TRT and Becca are the real deal. If you want to feel like you can take on the world, give them a call. I had no idea just how bad my health was — now I feel great, look great and I'm ready to take on the world!
Don't waste precious mountain time stuck with a hangover or altitude sickness. Peak IV Drip Lounge is absolutely worth every penny. Fast, professional, and incredibly effective — I felt better quickly and was able to get right back out to play in the mountains. Total game changer for mountain trips.
Top tier care! Becca is unbelievably smart, with genuine care and pride in what she does. My normal doctor did a non-comprehensive test, giving me no answers. Becca took care of me like she was my normal practitioner. She and her nurses are welcoming, supportive, and all around the best.
Everything starts here. This isn't a quick 15-minute visit — it's a full medical assessment:
Possibly not. Perimenopause can begin in your late 30s or 40s while your cycles are still regular, and PMOS shows up in the reproductive years. If your symptoms are real, they're worth evaluating regardless of your age.
For many women, hormone therapy is a safe and effective evidence-based option — but the right answer depends on your individual health history, timing, and goals. We review the genuine benefits and risks with you, personally, before any decision. Nothing here is one-size-fits-all.
It was. In May 2026, PCOS was officially renamed PMOS (polyendocrine metabolic ovarian syndrome) to reflect that it affects the whole body — hormones and metabolism — not just the ovaries. You'll still see both names for a while; they refer to the same condition.
No. You can book directly with us.
Peak HRT is a cash-based practice, which lets us offer comprehensive labs and longer, unrushed appointments without insurance restrictions. We accept HSA and FSA, and provide itemized receipts.
If your hormones may be part of the picture and you're tired of being dismissed, now's a good time. For women still cycling, certain labs are most accurate when drawn on specific cycle days — call us and we'll help you time it.
A free 10-minute call. We'll talk through what you're experiencing and whether we're the right fit. No pressure, no commitment.
Peak HRT provides women's hormone therapy, perimenopause and menopause care, and PMOS (formerly PCOS) treatment to patients throughout Silverthorne, Dillon, Frisco, Breckenridge, Keystone, Vail, and the surrounding Summit County mountain communities.
