Kara Wilfong
Doctorate Prepared Advanced Registered Nurse Practitioner
Fleming IslandA doctorally-prepared nurse practitioner who spent a decade as an emergency room nurse before moving into aesthetics and wellness.
BHRT · Fleming Island, FL
BHRT: bioidentical, never synthetic
Bioidentical hormone replacement therapy treated to an optimal level, not just a lab level. Delivered by pellet, cream, or injection and built around how you actually feel.
Written by the Well Labs+ editorial team · Last updated July 2026
Treatment Overview
What BHRT does
Bioidentical hormone replacement therapy replaces what your body is no longer producing at the level it once did, using hormones that are a molecular match to your own. We never prescribe synthetic hormones. Delivered by pellet, cream, or injection, BHRT is built around a comprehensive consultation, not a quick script: we look past a single lab number to understand the symptoms your hormones are actually driving, and treat you to an optimal level rather than just a level that happens to fall inside a normal range.
It is one part of our complete Hormone Replacement (HRT) program, and for patients whose symptoms center on perimenopause or menopause, we also offer a dedicated Menopause Treatment path that routes back here for the mechanism. For men, a dedicated testosterone replacement program addresses the same decline.
Who BHRT Helps
Bioidentical care for women and men
Hormone symptoms rarely respect a single decade or a single gender. Every BHRT plan starts with your symptoms, not an assumption about who hormone therapy is "for."
For women
Bioidentical therapy addresses every relevant hormone, including testosterone, which typical women’s health care routinely leaves out. It’s built around perimenopause, menopause, or an earlier shift.
For men
A declining testosterone level shows up as low energy, flat mood, and a fading drive long before most men think to ask. We screen thoroughly and build a plan around how you feel.
Whole-body balance
Your energy, sleep, mood, weight, and drive are connected. We treat the system, not a single symptom, and track your progress by feel as much as by labs.
BHRT is often paired with a broader wellness plan; your provider walks through what fits at your consultation.
Fleming Island · Northeast Florida
Why Fleming Island trusts us with BHRT
Fleming Island skews toward an educated, research-first, active-aging community that benefits from a supervised, individualized bioidentical plan rather than a guess. BHRT is the mechanism we reach for when a hormone shift is affecting how you feel day to day, delivered by a team that will tell you honestly when it is, and is not, the right next step.
Northeast Florida’s UV index climbs to extreme from spring through late summer, and sun exposure drives much of the collagen loss and visible aging we treat, so care here is as much about prevention as it is about correction.
The practice Fleming Island trusts for medical wellness has been voted the area’s best medspa six years running. We provide care from our Medical Spa on Island Lane.
Serving
- Fleming Island
- Orange Park
- Middleburg
- Green Cove Springs
- Jacksonville
- Clay County
The Pura Vida Approach
Never synthetic, always individualized
Every BHRT plan begins with a comprehensive consultation, typically an hour to an hour and a half, where we discuss your symptoms, set an honest expectation for the timeline ahead, and book every follow-up appointment before you leave. Every hormone we prescribe is bioidentical. We do not use synthetic hormones.
That is the difference between a script and a plan, part of our full Hormone Replacement (HRT) program built around your labs and how you feel.
Is This For You?
Am I a Candidate?
A Good Fit If…
- you have symptoms such as fatigue, mood shifts, sleep disruption, weight or libido changes that point to a hormone imbalance
- you want bioidentical hormones and understand our practice does not prescribe synthetic hormones
- you are ready for a comprehensive consultation and ongoing follow-up, not a one-time prescription
- you want a plan measured by how you feel as much as by your labs
Let’s Talk First If…
- you have a personal or family history that needs review first, so we screen thoroughly before starting BHRT
- you are pregnant, breastfeeding, or have certain hormone-sensitive conditions, so let us talk before assuming candidacy
- you are hoping BHRT will reverse aging, which is not how it works, and we will say so
- you want a guaranteed timeline for symptom relief, which honest hormone care cannot promise
If BHRT is not the right fit for your history, we will tell you honestly and point you toward what is. Declining a treatment that will not serve you is part of how we work.
Ready to Start?
Sounds like you? Let’s build your bioidentical plan.
Request an appointment for a comprehensive consultation and a full hormone panel, here in Fleming Island.
Our Process
What to expect at your visit
A comprehensive consultation
Every BHRT plan starts with a consultation that runs roughly an hour to an hour and a half. We look past a single lab value to understand the symptoms your hormones are driving, and discuss honestly how long relief tends to take.
Testing beyond the reference range
A full hormone panel gives us the starting picture, but we treat you to an optimal level, not just a level that happens to sit inside a lab’s normal range. Every hormone is bioidentical, never synthetic.
A delivery method that fits your life
Pellet, cream, or injection, each chosen for your goals, your history, and how closely your plan needs monitoring. You leave your first visit with every follow-up already booked.
Adjusted as you go
We measure your progress by how you feel as well as by follow-up labs. If your dose needs adjusting, we adjust it. Hormone optimization is an ongoing relationship, not a one-time prescription.
What Our Patients Are Saying
What Fleming Island patients say
4.9★ From 1,400+ verified Google reviews across both Fleming Island locations.
"I visited Pura Vida for hormone health support. Kara is so caring and informational to help you understand how your body works and what you are feeling… a holistic approach of treating from the inside out, down to the cellular and nutrient level, which I appreciate."
"I had my first appointment with Kara today and I have all the faith in the world that she will sort out my perimenopause issues. Look forward to the road ahead."
"We see Kara for BHRT and our overall better health. She is kind, knowledgeable, and relatable. The care we have received is life changing. She is a true professional."
Prefer to Talk First?
Questions before you book? Call us.
Talk through whether BHRT is right for you with our Fleming Island team before you schedule.
Proven Excellence
The most-reviewed medspa in Clay County
BHRT is available at our Island Lane Medical Spa, serving Orange Park, Middleburg, and greater Jacksonville.
1,400+
Five-Star Reviews
More Google reviews than any other medspa in the region.
4.9★
Average Rating
Verified on Google across both Fleming Island locations.
2
Fleming Island Locations
Serving Clay County, Orange Park & greater Jacksonville.
Meet Your Care Team
A clinician-led hormone team
Nurse practitioners and physician assistants led by Kara Wilfong, DNP, APRN, FNP-C provide the same experienced care team, visit after visit.
Brittany Smith
MSN, APRN, FNP-C
Fleming IslandA certified Family Nurse Practitioner specializing in advanced aesthetic medicine, with six years in trauma and progressive care before aesthetics.
Emily Arnold
Physician Assistant-Certified
Fleming IslandA board-certified physician assistant specializing in aesthetic medicine, with a Master of Physician Assistant Studies from Augusta University.
Portrait coming soon
Brooke Taylor
Medical Assistant
Fleming IslandSupports the clinical team through every appointment so your provider can deliver attentive, unhurried care.
Patient Care Team
Scroll to meet the full team
Frequently Asked Questions
BHRT Questions, Answered
What is BHRT, and how is it different from conventional hormone therapy?
BHRT (bioidentical hormone replacement therapy) uses hormones that are a molecular match to what your body already produces, delivered by pellet, cream, or injection. Unlike some conventional hormone therapy, our BHRT addresses every relevant hormone, including testosterone in women, and treats you to an optimal level rather than one that simply falls inside a lab’s normal range. We do not use synthetic hormones.
What are the signs that I need BHRT?
Common signs you may benefit from BHRT include persistent fatigue, mood swings, disrupted sleep, unexplained weight changes, and a drop in libido, especially around perimenopause, menopause, or a similar hormone shift in men. These symptoms are common among the patients we see across Fleming Island and Clay County, many of whom are navigating this exact transition. A comprehensive consultation and full hormone panel, not a single symptom, confirm whether a hormone imbalance is the cause.
Is there a best age to start BHRT, or can it be too late?
There is no single best age to start BHRT: hormone shifts that disrupt how you feel can begin in your late 30s through your 60s and beyond, and it is rarely too late to benefit. What matters more than your age is whether your symptoms and labs point to an imbalance worth treating, which is exactly what your consultation is for.
What are the risks or downsides of BHRT?
Like any hormone therapy, BHRT carries real considerations: possible side effects such as acne, fluid retention, or mood changes while your dose is calibrated, and it requires ongoing monitoring rather than a one-time prescription. It is not right for everyone, including some patients who are pregnant, breastfeeding, or have certain hormone-sensitive conditions, which is why we screen thoroughly before starting and will tell you honestly if BHRT is not the right fit.
Does BHRT reverse aging or cause weight gain?
No, BHRT does not reverse aging, and we will not claim otherwise. It supports how you feel as your hormones shift, helping your energy, sleep, mood, and drive, but it is not a substitute for healthy sleep, nutrition, and movement. Weight changes vary by person: restoring hormone balance can make weight easier to manage for some patients, but BHRT alone will not cause or guarantee weight loss.
Where can I get BHRT near Fleming Island, FL?
Pura Vida offers BHRT at our Medical Spa on Island Lane in Fleming Island, FL, serving patients throughout Clay County, including Orange Park, Middleburg, Green Cove Springs, and greater Jacksonville. We’ve been voted the area’s best medspa six years running, and every BHRT plan is delivered under the medical oversight of our Medical Director.
What does BHRT cost, and does insurance cover it?
BHRT pricing depends on the hormones, dosing, and delivery method your plan calls for, so the exact cost is confirmed at your consultation rather than quoted upfront. Insurance coverage for hormone therapy varies by plan, so check directly with your insurer, and we are happy to help you understand what your visit involves.
Ready When You Are
Let’s build your bioidentical plan
Request an appointment and we’ll start with a comprehensive consultation, look past a single lab number, and build a bioidentical plan treated to an optimal level, not just a lab level.
Not ready to book? Send us a question instead.