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.
Hormone Replacement (HRT) · Fleming Island, FL
Hormone care built around how you feel
Bioidentical hormone replacement, treated to an optimal level rather than just a lab level. Physician-supervised, individualized, and built for women and men navigating a real hormone shift.
Written by the Well Labs+ editorial team · Last updated July 2026
Category Overview
How hormone optimization works
Hormones fall out of balance gradually, and a lab report rarely tells the whole story. Our approach starts with a comprehensive consultation that looks past a single number to understand the symptoms your hormones are actually driving: your energy, your sleep, your mood, your weight, your drive. We treat you to an optimal level, not just a level that happens to fall inside a lab’s reference range.
Every hormone we prescribe is bioidentical, a molecular match to what your body already produces. We do not use synthetic hormones, and bioidentical therapy here addresses the full picture, including testosterone in women, which conventional care routinely leaves unaddressed. This is one part of our complete wellness & body program, and we will tell you honestly when hormone therapy is not the right next step.
Where To Start
BHRT and menopause care, compared
Use this as a guide to the right starting point, then let your provider confirm the plan at your consultation.
Bioidentical delivery & mechanism
BHRT
How bioidentical hormone therapy works at Pura Vida. The delivery methods we offer, why we never use synthetic hormones, and what "optimal, not just in range" means for your plan.
Learn about BHRTPerimenopause & menopause care
Menopause Treatment
For the hot flashes, brain fog, sleep disruption, and weight and libido changes of perimenopause and menopause. A symptom-first path that routes to BHRT for the mechanism.
Learn about Menopause TreatmentDelivery Methods
Three ways to deliver bioidentical hormones
No single delivery method suits every patient. We walk through the honest tradeoffs of each at your consultation.
Pellet Delivery
A small, rice-sized pellet placed just under the skin releases a steady, consistent dose over several months without a daily routine to remember. We discuss whether pellet delivery fits your goals and history at your consultation.
Topical Cream
A measured daily cream applied to the skin, absorbed gradually. Cream gives us an easy way to fine-tune your dose in smaller increments as your levels and symptoms change.
Injection
A scheduled injection, typically weekly or every other week, that lets your provider adjust dose and frequency closely. Often the delivery of choice when a plan needs more frequent monitoring.
Who We Treat
Hormone care is not a women’s-only conversation
For Women
Bioidentical therapy at Pura Vida addresses every relevant hormone, including testosterone, which typical women’s health care routinely leaves out. Whether you are navigating perimenopause, full menopause, or an earlier hormone shift, your plan is built around your symptoms and your labs together.
For Men
Declining testosterone shows up as low energy, flat mood, stubborn body composition changes, and a fading drive long before a man thinks to ask about hormones. We screen thoroughly and build a plan around how you actually feel, not just where a number sits on a chart.
In Expert Hands
Treated to how you feel, by a real clinician
Every hormone plan at Pura Vida starts with a comprehensive first consultation, typically an hour to an hour and a half, where your provider walks through what to expect, how long symptom relief tends to take, and books every follow-up appointment before you leave. Progress is measured by how you feel as much as by your labs.
When hormone therapy is not the right answer, we say so and point you toward what is, part of the full wellness & body program built around you.
Fleming Island · Northeast Florida
Hormone optimization the First Coast trusts
Fleming Island skews toward an educated, research-first, active-aging professional community, including NAS Jacksonville military families who take their long-term energy and longevity seriously. Hormone shifts show up as fatigue, mood changes, and a fading drive long before most people connect the dots, and this is exactly the audience that benefits from a supervised, individualized plan rather than a guess.
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, voted the area’s best medspa six years running and cared for from our Medical Spa on Island Lane.
Serving
- Fleming Island
- Orange Park
- Middleburg
- Green Cove Springs
- Jacksonville
- Clay County
Is This For You?
Am I a Candidate?
A Good Fit If…
- You have symptoms (low energy, mood shifts, sleep disruption, weight or libido changes) that point to a hormone imbalance.
- You want a plan built around your labs and how you actually feel, not a single number.
- You want bioidentical hormones and understand our practice does not use synthetic hormones.
- You are ready for a comprehensive consultation and ongoing follow-up, not a one-time prescription.
Let’s Talk First If…
- You are hoping hormone therapy will reverse aging or replace healthy fundamentals like sleep and nutrition, which it will not, and we will say so.
- You have a personal or family history that needs review before starting hormone therapy, so we screen thoroughly first.
- You are pregnant, breastfeeding, or have certain hormone-sensitive conditions, so let us talk before assuming candidacy.
- You want a guaranteed timeline for symptom relief, which honest hormone care cannot promise.
If hormone optimization 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 hormone plan.
Request an appointment and start with a comprehensive consultation, treated to an optimal level, right here in Fleming Island.
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 your symptoms and your labs with our Fleming Island hormone team before you schedule.
Our Process
How your hormone plan comes together
A comprehensive first consultation
Your first visit runs roughly an hour to an hour and a half. Rather than reading a lab panel in isolation, we walk through the symptoms your hormones may be driving: energy, sleep, mood, weight, drive. Then we set honest expectations for the timeline ahead.
Testing that looks past the reference range
We run a hormone panel, then treat you to an optimal level rather than just a level that happens to fall inside a lab’s normal range. Every hormone we prescribe is bioidentical, a molecular match to what your body already produces, never synthetic.
A delivery method built around your life
Pellet, cream, or injection, chosen for your goals, your history, and how closely your plan needs to be monitored. You leave your consultation with every follow-up appointment already booked.
Monitoring by how you feel, and by your labs
We track your progress both by how you report feeling and by follow-up labs, and adjust your dose when either one calls for it. Hormone optimization is a relationship, not a single prescription.
Proven Excellence
Trusted across Clay County
Hormone optimization 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, the same experienced care team you’ll see 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
Hormone Replacement (HRT) Questions, Answered
What is bioidentical hormone replacement therapy (BHRT)?
BHRT uses hormones that are molecularly identical to the ones your body already produces, delivered by pellet, cream, or injection to restore levels your body recognizes as its own. At Pura Vida, we never prescribe synthetic hormones, and bioidentical therapy addresses every relevant hormone, including testosterone in women, which conventional care often leaves out.
What are the signs you might need hormone replacement therapy?
Common signs include persistent low energy, mood swings or a flat mood, disrupted sleep, stubborn weight changes, and a fading sex drive, symptoms that often build gradually enough that a single lab result can miss them entirely. These signs are not only a menopause story: we see them in women navigating perimenopause and menopause and in men whose testosterone has declined with age, sleep, stress, or body composition change, and both groups are common in Fleming Island’s established, health-conscious community. If several of these sound familiar, a comprehensive consultation and hormone panel are the honest next step.
What does "optimal level, not just a lab level" actually mean?
It means we treat you to the hormone level where your symptoms actually resolve, not just to a number that happens to fall somewhere inside a lab’s wide reference range. A result can sit "in range" while you still feel far from yourself, so we track both how you feel and what your labs show, and adjust your plan as needed along the way.
What is the difference between hormone pellets, cream, and injections?
Each delivery method reaches a different rhythm: pellets release a steady dose over months with nothing to remember daily, cream lets us fine-tune your dose in small increments, and injections give the closest scheduled monitoring. Your provider walks through the honest tradeoffs of each at your consultation and recommends the one that fits your goals and your history.
Can hormone replacement therapy reverse aging or make me look younger?
No, hormone replacement therapy does not reverse aging, and we will not tell you otherwise. It can support how you feel as your hormones shift, your energy, sleep, mood, and drive, but it does not replace healthy fundamentals like sleep, nutrition, and movement. We describe what the evidence supports and nothing more.
Where can I get hormone replacement therapy near Fleming Island?
Pura Vida offers physician-supervised bioidentical hormone therapy at both Fleming Island locations, our Medical Spa at Island Lane and our Day Spa at Eagle Harbor, serving Fleming Island, Orange Park, Middleburg, Green Cove Springs, and greater Jacksonville throughout Clay County. We have been voted the area’s best medspa six years running, and every hormone plan here is physician-supervised and individualized to your labs and symptoms.
How much does hormone therapy cost, and is a consultation required first?
Pricing for hormone therapy is confirmed at your consultation, since the exact hormones, dosing, and delivery method we recommend depend on your labs and your goals. There is no standard package price we can quote before that conversation.
Ready When You Are
Let’s build a hormone plan around how you feel
Request an appointment and we’ll start with a comprehensive consultation, look past a single lab number, and build a bioidentical plan around the energy, sleep, and balance you’re after.
Not ready to book? Send us a question instead.