Institute for Hormonal Balance

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Mandy Cotten, DNP, APRN, FNP-C
BY Meredith Knight | photo by Lauren Medean

Mandy Cotten has a vision for the men and women of the Arlington, Mansfield, & DFW area. She wants them to live happier and age healthier. And she’d like to be their partner in this health journey as she provides full-body wellness care and education. One way she does this is through bioidentical hormone replacement therapy (BHRT) at Institute for Hormonal Balance.

“Hormone imbalance affects women and men, and both can experience dramatic symptom relief with BHRT,” said Mandy, a hormone expert. “Men and women develop hormonal imbalances at every age and for many reasons, including stress, nutritional deficiencies, obesity, autoimmune diseases, and conditions affecting their hormone-producing glands. Hormone therapy with IHB involves personalized treatment for restoring optimal hormone levels.”

The majority of people seek BHRT when their levels of estrogen and/or testosterone start causing them symptoms that affect their daily lives. “Low estrogen and testosterone have a widespread impact on nearly every part of your body — problems that can be prevented or treated with BHRT.” In women these symptoms can look like hot flashes and night sweats, mood swings, vaginal dryness, loss of sex drive, painful intercourse, urinary incontinence, memory problems, dry skin, hair loss, insomnia, weight gain, and depression. Testosterone and estrogen are also essential for maintaining strong bones, making women vulnerable to osteoporosis after menopause and good cardiac blood flow, making menopausal women at increased risk for heart disease.

Low testosterone levels in men often result in low energy, loss of sex drive, erectile dysfunction (ED), loss of muscle mass, loss of body and beard hair, weight gain, insomnia, memory loss, difficulty concentrating, depression, and anxiety.

Now for the good news. “BHRT uses hormones from sources that are natural with the ability to closely match the chemical makeup of your own hormones so you can return to your vibrant life again,” Mandy said. Because they mimic your own natural hormones, BHRT enters your body, goes directly to the receptor site, and achieves the desired results.

BHRT can be tailored to your specific needs and administered through your choice of creams, patches, pills, or pellets. “We recommend pellets because they maintain a better balance by delivering a steady level of hormones directly into the blood stream,” Mandy said. Mandy herself has performed almost 30,000 pellet procedures over the last 10 years. With this therapy, her patients experience balanced moods, improved sleep, reduced brain fog, decreased hot flashes, decreased vaginal dryness, increased stamina, increased muscle mass, decreased fat mass, and increased libido, typically noticing an improvement in seven-to-10 days!

Mandy completed her Bachelor of Science in Psychology and her Bachelor of Science of Nursing (BSN) both from Texas Christian University, and her Doctorate of Nursing Practice from Loyola University in New Orleans, and is certified through the American Association of Nurse Practitioners (AANP). She was the clinical director for BioTE Medical for 8 years and has trained over 4,000 other providers in hormone optimization.

When not on the job, she enjoys spending time with her husband, Casey, and their children Rylie & Ashton. Find out more about the Institute for Hormonal Balance at Donovitz.com.


4224 Park Springs Boulevard
Suite 100
Arlington, Texas 76015

202 South Coleman
Suite 100-5
Prosper, Texas 75078