The wife is looking to get jacked and fit, and it's been really frustrating when all these places just want to "give her a pellet and send her home".
Any ideas, recommendations etc welcome.
Are you and your wife looking for HRT to get her energy levels and hormones potentially balanced out. Or are you looking to get her jacked and fit. Two separate things.
If your wife's hormones, energy levels, and her body's ability to modulate fat storage are in balance and all that you two want to achieve is getting jacked and fit. You're going to throw a lot of money at a HRT clinic for something you can do yourself. Your wife isn't going to get jacked and fit having a clinic over seeing things. HRT clinics focus is to bring someone into balance. I've helped multiple girlfriends out with PEDS with success. First and foremost learn to read your own blood panels, if you haven't already. Do your research and start with low doses and take it slow with monitoring progress.
These HRT clinics aren't going to provide you with anything you can't do yourself, outside of taking money out of your pocket. Follow some of the bikini, wellness, fitness girls and their protocols. Basic low dose anavar, then low dose HGH. My current girlfriend has been on low dose anavar and growth for awhile now and she looks great with zero sides. If your wife needs to shed a liitle, then your standard well-known fat burners if needed. Possibly Primo if your wife wants to step it up a notch or two, after experimenting with the beginning basics.
An ex-girlfriend used Primo with great success. In fact her success with Primo was so successful that she was constantly getting compliments about her physique it ended freaking her out because she wasn't used to getting such compliments. She ended up stopping the Primo because she was constantly being asked if she competed. She just wanted to look good, but she ended up looking too good for her own psyche.
As long as your wife doesn't have a hormone imbalance that needs medical attention, educate yourself with the female side of PEDS usage and be smart about it, which includes paying attention to any onset of unwanted sides (address immediately) and track blood panels.