Which words best describe you?
Soft and mild?
Gentle and humble?
Quiet and calm?
How about the hot headed, overstimulated, sleep-deprived, foggy-brained, libido-less force of nature?
It’s a special season where we’re randomly sweating, suddenly swearing, and barely sleeping.
Thank the hormonal heavens there’s something we can do about all this menopausal mayhem!
Am I talking about hormone replacement therapy (HRT)?
Hell yes, I am.
Have you taken the plunge?
Below, let’s talk about why HRT should be the next conversation topic with your doc.
Do I Take Hormone Replacement Therapy?
Abso-freakin-lutely. Here’s my story.
First, Progesterone.
I started HRT three years ago.
The first hormone I started with was progesterone.
Over the course of six months, I started to feel incredibly overwhelmed. My anxiety was through the roof, and I had trouble sleeping.
I didn’t have the more traditional menopause symptoms at this point, like hot flashes. I just thought I was going crazy. I thought I was overworked and overwhelmed.
When I went to see my practitioner, she said, “Nope! Your hormones are out of whack.”
My testosterone was extremely low, and my progesterone levels were also low. But my estrogen was good.
I didn’t want to start everything at once. I really wanted to be thoughtful about adding hormones and seeing what the benefits were. So, I started with progesterone, taking 100 mg orally before eventually shifting to 200 mg every night under my practitioner’s guidance.
It was a game changer for me.
Game. Changer.
All those feelings of anxiety and overwhelm, and the feelings that made me think I was depressed felt so much more manageable once I started treatment.
For me, addressing my hormones was life changing!
Second, Testosterone.
Then, I definitely wanted to address my testosterone. When testosterone levels are low, you can feel like crap. You can have no energy, no libido, and struggle to build muscle.
So, the second thing I added was testosterone. And that involved a lot of trial and error.
It took some time to find the right dose. It took about 12-18 months to really understand what my ideal dose was.
Then, about six months ago, after finally figuring that out, the bottom fell out…
Finally, Estrogen.
I still thought the problem was my testosterone. I went back and talked with my doctor, saying, “Again, I feel horrible. I don’t know what’s going on. I can’t sleep again. Things are going in the wrong direction.”
So, she ordered more bloodwork, and we discovered that, during that period, my estrogen had dropped significantly.
It happens fast, ladies.
I had finally found out testosterone. Now, it was time to figure out my estrogen.
I started using an estrogen patch. I also started vaginal estrogen as well, because that can be really important for addressing symptoms like vaginal dryness and discomfort.
And, once again, it was life changing!
I felt so much better.
It was all clicking. I didn’t have to sit in misery for a decade and deal with feeling crappy. It was fixable!
The Hardest Parts of HRT
HRT, unfortunately, isn’t as simple as popping a cough drop when you have a cold.
It’s a delicate process that takes time.
One of the hardest parts of HRT is finding a doctor who understands the current evidence and guidelines. Hormone therapy has been the subject of a lot of research, and recommendations have evolved over time.
Finding a practitioner who can explain the latest evidence, understand your symptoms, and help you weigh the benefits and risks is important.
Another challenge? It’s not one-size-fits-all.
What worked for me is not necessarily going to work for you, and vice versa.
There are different ways to use hormones, including oral medications, transdermal patches or gels, and vaginal treatments. Testosterone treatment also comes in different formulations, depending on the circumstances and what’s available.
Your options will depend on your symptoms, medical history, personal preferences, and treatment goals.
For HRT to work, you’ve got to be patient.
Finding the right approach can take time. And your treatment may need to be adjusted several times as your symptoms and hormone levels change.
Regular follow-ups with your doctor will help you assess how you’re feeling, monitor side effects, and determine whether your treatment is working.
Should You Take HRT?
Every one of us is different. We all have different hormone levels, health histories, symptoms, and goals.
The most up to date research on HRT shows that, for the majority of women, the benefits outweigh the risks. It’s definitely worth talking with your doctor and exploring this great option.
But HRT isn’t the right fit for everyone. The benefits and risks depend on things like your age, medical history, the type of hormones used, and how long it’s been since menopause began. That’s why a conversation with a trusted doctor matters so much.
How Long Will It Take to Find My Ideal Levels?
I wish I could give you a magic number, but everyone’s experience with HRT is different.
As my own experience shows, finding the right treatment can take time. I didn’t get everything figured out overnight. It took adjustments, conversations with my practitioner, and additional bloodwork to understand what was happening as my hormones changed.
Some women notice improvements within weeks, while others need several months or longer to find an approach that works for them.
The important thing is to pay attention to how you feel, communicate openly with your healthcare professional, and avoid assuming that one treatment or dose will solve everything.
If something isn’t working, speak up. If your symptoms return or change, don’t be afraid to revisit the conversation.
Your body isn’t static, and your treatment may not be either. But it’s worth the effort!
The Guidelines Around HRT Have Radically Changed. Here’s What You Need to Know.
Our understanding of hormone replacement therapy has evolved significantly over the years, and it’s important to separate outdated fears from what current evidence tells us.
For many healthy women experiencing menopause symptoms, HRT is an effective treatment option. It can help relieve symptoms like hot flashes, night sweats, and sleep disruption. Vaginal estrogen can also help with genitourinary symptoms, including vaginal dryness and discomfort.
For many women, hormone therapy offers other benefits, like helping to prevent bone loss. That said, the benefits and risks vary, and HRT isn’t a universal solution or a guarantee against future health problems.
Timing matters, too. For healthy women younger than 60 or within 10 years of menopause onset, the benefits of systemic hormone therapy generally outweigh the risks when there are no contraindications. Starting earlier in this window may offer a more favorable benefit-risk profile than starting much later.
That doesn’t mean you’ve missed your chance if you’re already in menopause! It means your personal circumstances, symptoms, and health history should guide the conversation.
You have options, and you deserve to understand them.
You Don’t Have to Navigate Menopause Alone
Most of the people I work with in my LEAN program are women between 45 and 65.
We’re a crew of ladies who get it.
We understand what it’s like to wake up exhausted, struggle through brain fog, feel unlike yourself, or wonder why the things that used to work for your body suddenly don’t.
And we know how easy it is to put everyone else first while pushing your own needs to the bottom of the list.
But this stage of life isn’t about giving up on feeling good. It’s about learning what your body needs now, making informed decisions, and finding a community that supports you along the way.
HRT may be part of that journey for you, or it may not be. Either way, you deserve personalized care, practical guidance, and support as you figure out your next steps.
Ready to feel like yourself again? Join LEAN.
LEAN is where women come together to prioritize their health, build strength, support their well-being, and navigate midlife with more confidence. You don’t have to figure everything out on your own, and you don’t have to wait until you’re completely burned out to start taking care of yourself.
Let’s make this next chapter about feeling stronger, feeling better, and showing up for yourself.
Join LEAN today and let’s do this together.
