Refine Her
We believe that when women come together, transformation happens. Refine Her is a collective of women and physicians, working together to redefine what wellness means at every stage of life. It is designed to bring open conversation, education, support and cutting-edge treatments guided by expert physicians who understand women’s unique health journeys.
You deserve to feel and look your best – no matter your age.
What's Actually Driving
How You Feel & How You Look
Your symptoms aren't in your head — they have a biological root. Understanding what's happening inside your body is the first step to changing it.
Hormones are your body's messaging system. When signals are strong, every system — mood, energy, sleep, metabolism, and cycles — stays coordinated. When levels fall, the signals weaken and everything starts to drift.
Perimenopause triggers increased fat storage. Menopause adds muscle loss and a slower metabolic rate. Post-menopause, visceral fat accumulation rises even when weight appears stable. This is why doing everything "right" still doesn't work.
Mitochondria power every cell in your body. They're stable until around 40, then decline sharply — losing ~25% function through perimenopause and up to 50% by age 75. This is why fatigue in midlife feels cellular, not circumstantial.
Estrogen is a natural anti-inflammatory. As levels fall, systemic inflammation rises — increasing markers like IL-6, CRP, and TNF-α. This "inflammaging" contributes to joint pain, autoimmune flares, weight resistance, and cardiovascular risk.
Collagen declines ~1% per year from your mid-20s. But in the first 5 years after menopause, up to 30% is lost rapidly — accelerating skin sagging, thinning, and wrinkling. What you see on the outside reflects a hormonal shift on the inside.
About Refine Her
At Refine by Tulsi, we know women deserve more than quick fixes. That’s why we’re creating Refine Her – a comprehensive, physician-led program designed to support women through every stage of life: from hormone changes and metabolism shifts to skin health, sexual wellness, and longevity.
This isn’t just about treatments – it’s about building a community where women lift each other up and gain the tools to thrive, inside and out.
We focus on the health concerns women most commonly face – and often struggle to get answers for. Our physician-led team takes the guesswork out of wellness with advanced diagnostics, personalized treatment plans, and ongoing support.
Refine Her is not just a program – it’s a movement. Built with women, for women.
Personalized care: Hormone diagnostics, peptides, and advanced wellness therapies tailored to your biology.
Holistic approach: Aesthetics, metabolism, and wellness working together.
Community: A safe space to connect, share, and grow stronger together.
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A Real Treatment Plan,
Built Around a Real Woman
This is what physician-led, integrated women's wellness actually looks like — not a prescription and a follow-up in six months, but a full protocol built around your biology.
*This is an illustrative example. Every Refine Her protocol is fully individualized based on your labs, health history, and goals — designed by Dr. Tulsi Kotecha or Dr. Laura Ruof.
Meet Your Care Team
Refine Her is led by physicians who specialize in women’s health, hormone optimization, longevity medicine, and natural aesthetic care.
Dr. Tulsi Kotecha, MD
Dr. Kotecha is a board-certified physician specializing in personalized aesthetics, regenerative medicine, and longevity-focused wellness. After years in internal medicine, she founded Refine by Tulsi to shift care from reactive treatment to proactive health, helping women feel confident, energized, and supported through every stage of hormonal change. Her approach blends medical precision with natural, individualized results.
Dr. Laura Ruof, MD
Dr. Ruof leads the Refine Her longevity and hormone optimization programs, focusing on perimenopause, menopause, metabolic health, and whole-body vitality. Her care model combines advanced diagnostic testing, precision bioidentical hormone therapy, and evidence-based longevity strategies to restore energy, clarity, sleep, and long-term health for women navigating midlife transitions.
Common symptoms & conditions we help with:
• Fatigue, brain fog, and low energy
• Hormonal changes from PMS, perimenopause, or menopause
• Weight fluctuations and metabolic resistance
• Mood shifts, anxiety, or sleep disturbances
• Hair thinning, skin changes, and premature aging
• PCOS, thyroid imbalances, and other hormone-related conditions
Which Refine Her Program Is Right for You?
8 questions about how you feel right now. We'll match you to the membership tier that fits your symptoms, goals, and where you are in your wellness journey.
Choose Your Level of Care
Every tier includes physician oversight, ongoing support, and a plan that actually evolves with you. Not sure which one fits? Take the quiz above.
- ✓Quarterly physician consultations
- ✓Personalized hormone optimization plan
- ✓Hormone and wellness diagnostics
- ✓Longevity coaching access
- ✓Exclusive member pricing on treatments
- ✓Refine Her community & events
- ✓Bimonthly physician consultations
- ✓Single-stack peptide therapy protocol
- ✓GLP-1 micro-dosing for metabolic support
- ✓Advanced lab testing panel
- ✓10% off all longevity & aesthetic treatments
- ✓Inflammation and metabolic monitoring
- ✓Concierge provider access between visits
- ✓Full GLP-1 metabolic program
- ✓Signature multi-stack peptide protocol
- ✓Monthly NAD+ IV or at-home kit
- ✓20% off all longevity & aesthetic treatments
- ✓Quarterly regenerative aesthetic treatment
- ✓Priority scheduling — same-week appointments
Traditional Care vs The Refine Her Approach
Most women are told their labs are “normal” and their symptoms are just part of aging. Refine Her looks deeper—addressing hormones, metabolism, inflammation, energy, and skin health together to restore how you truly feel.
Traditional Care
- ✕ “Your labs are normal” despite fatigue, weight gain, brain fog, and mood changes.
- ✕ Care split across multiple specialists with no unified plan.
- ✕ Focus on prescriptions instead of root-cause hormone, metabolic, and inflammatory changes.
- ✕ Little guidance on longevity, energy, body composition, or skin aging.
- ✕ Reactive care that waits for disease instead of optimizing health.
The Refine Her Approach
- ✓ Comprehensive hormone optimization including estrogen, progesterone, testosterone, thyroid, and adrenal health.
- ✓ Metabolic and weight support using nutrition guidance, GLP-1 therapy when appropriate, and body-composition focus.
- ✓ Targeted peptides and mitochondrial support to improve recovery, inflammation, energy, hair, and skin.
- ✓ Integrated skin and regenerative treatments that rebuild collagen and help you look as vibrant as you feel.
- ✓ Proactive longevity medicine focused on how you feel in your 40s, 50s, 60s, and beyond—not just today.
Frequently Asked Questions
What is Refine Her?
Refine Her is a personalized women’s wellness and longevity program designed by Dr. Tulsi Kotecha to help women navigate perimenopause, menopause, and beyond. It blends advanced diagnostics, hormone and peptide optimization, functional nutrition, and regenerative aesthetics to restore balance, vitality, and confidence from the inside out.
What makes Refine Her different from traditional hormone therapy programs?
Most hormone programs focus on labs and prescriptions. Refine Her looks at the whole woman – hormones, metabolism, inflammation, gut health, and longevity markers.
We also integrate peptides, regenerative medicine, and aesthetic support, recognizing that feeling well and looking well go hand in hand.
Do I have to be in menopause to join?
Not at all. Many women begin experiencing hormonal shifts years before menopause (perimenopause).
Early testing and support can help prevent symptoms and preserve long-term health. Our approach is preventative, not just reactive.
What treatments or therapies are included?
How much does Refine Her cost?
We offer three tiers of membership to fit your goals:
Foundation — $249/month: physician consult, and personalized hormone optimization plan.
Balance — $599 month: includes hormone & basic peptide optimization, expanded diagnostics, and aesthetic credits.
Thrive — $1,299/month: concierge-level longevity care with advanced testing, peptides, regenerative therapies, and quarterly rejuvenation treatments.
All memberships include ongoing physician oversight, exclusive events, and access to the Refine Her community.
Who is Refine Her for?
Refine Her is for women in their 30s through 60s who feel like something is “off” – changes in mood, sleep, metabolism, energy, or skin – and are ready for a holistic, physician-led approach that goes deeper than routine labs or symptom management.