Hormones Through the Decades

Your hormones were never meant to stay the same — here’s how to work with them (not against them) at every stage of womanhood.

Hormones are not static and they were never meant to be. And yet, because most modern medicine and studies have been done on men, women’s health is often thrown to the wayside because it can be “unpredictable” and because hormones are “always changing”. We can be made to feel crazy because our body naturally wants to go through ebbs and flows of different hormones instead of staying smooth and steady the way men’s hormones do.

But that ebb and flow is important for our health. Our hormones are not meant to be static. They are not meant to be shut off and ignored. Through every decade of life our hormones evolve, shift, and respond to the demands of growth, stress, experiences, and aging. They’re not fixed points — they’re more like tides: rising, falling, and reshaping the terrain as we move through life.

And yet… no one really tells you that.

The conversation around hormones often goes like this: one day you get your period and if you experience any symptoms, here’s a birth control pill to “fix” it. Later if you want to get pregnant, we’ll take you off of it. If you’re lucky you get pregnant quickly and if not you get funneled into IVF without anyone even asking you about the determinants of health or running comprehensive hormone testing first. Had your kid(s)? Let’s pop you back on birth control to keep you steady again. Then menopause comes knocking and they say, “sorry, there’s not much we can do”.

But in my little corner of the internet and in the work I do with my patients, I’m here to tell you: there’s so much more to the story of our hormones. There are so many ways to work with the body rather than feel like you’re constantly fighting against it. When you understand what’s happening hormonally in each stage of life, you unlock access to a powerful truth: your hormones aren’t betraying you. They’re evolving with you. And every phase has its own magic when you know how to support it.

So let’s break it down — decade by decade.

Teens: Building the Foundation

The beginning of the teenage years usually comes with the onset of the menstrual cycle.

The brain and ovaries start talking through the HPO axis (hypothalamic-pituitary-ovarian), kicking off the body’s production of estrogen and progesterone. But you don’t go into your cycles on a perfect note — it takes time to find rhythm. Periods can be irregular, ovulation can be inconsistent, and emotions can swing wildly. That’s not dysfunction, that’s calibration.

And yet, so often the first solution handed to a teen experiencing irregular cycles or acne is birth control. You’re 14, your body is figuring itself out, and suddenly you're given a pill that shuts the whole system down. Most of the time, it’s offered without any discussion of why those symptoms might be happening or what the body might need to find balance on its own.

Let me be clear: I’m not here to demonize birth control. It has its place and can be helpful for some. And of course it has it’s uses when it comes to contraceptive care. But what frustrates me is that it’s often the first (and only) tool offered and it trains the body to depend on an external hormone source before it’s even had the chance to develop its own rhythm.

I remember going to the OB/GYN at 16 because of excruciating periods. I was immediately offered the pill. My mom said I was too young, so I suffered for two more years because there were no other conversation or solutions given to me other than take birth control or power through it. Eventually, I got on it at 18 because my periods did not get better (they got worse actually) but I always wonder what might’ve happened if someone had offered to support my symptoms naturally instead of just shutting my cycle off. That’s why this work matters to me.

Nutrition & Lifestyle
Start with the foundations: blood sugar balance, minerals, and liver support. Most people look back fondly on how they were able to eat so much worse in their teenage years and not feel the symptoms they do now (bloating, slowed metabolism). But just because your metabolism can handle eating like that, doesn’t mean that your hormones and skin can. The teenage years are a great time to gently establish a healthy routine around eating, encouraging young ones to eat more nutrient dense foods in order to feel better inside and out.

Every meal should include protein, healthy fats, and fiber — and if you want guidance on how to build a blood sugar supportive diet, I have a substack on that! Blood sugar swings can worsen acne, mood, and cramps. And if blood sugar instability becomes an ongoing issue, it can eventually lead to PCOS as high insulin can promote the ovaries to overproduce androgens like testosterone.

Other key nutritional areas to focus on is the nutrient content in food. Introduce mineral rich foods like leafy greens, seeds, and bone broth to support adrenal and ovarian development. Add liver loving foods like beets, salmon, cruciferous vegetables, and ginger to support the body’s detox pathways — especially helpful for navigating the surges of estrogen common in puberty. Add in natural anti-inflammatories in the diet like papaya, kiwi, pineapple, mango, ginger, and turmeric to help mitigate cramps and inflammatory acne.

And don’t underestimate the power of education. Teaching teens how their cycle works, what ovulation is, and why their body is changing builds self trust and confidence that will serve them for decades. Instead of feeling frustrated by why they might look and feel different throughout the month, empower them with the knowledge of what their hormones are doing and how to support each menstrual cycle phase in order to feel the best.

Key Supplements to Consider

• Magnesium glycinate: Calms the nervous system, eases cramps, supports sleep

• Omega 3s: Balances inflammation, supports skin and mood

• Zinc picolinate: Helps with acne, immune health, and ovarian function

• Vitamin D3K2 (if low): Supports hormone signaling and is often low in this age group

Key Herbs to Consider

• Ginger tea: Supports liver health and reduces inflammation

• Schisandra: Supports skin, liver detox, and emotional resilience

• Spearmint tea: Helpful for excess androgens (testosterone), especially if acne or early PCOS signs are present

20s: The Hormonal “Prime”

The 20s are often called the golden era of hormone health. Fertility is robust, energy is high, metabolism is strong, and your skin might be glowing with very little effort. Estrogen, progesterone, testosterone, and DHEA are generally working together in harmony — supporting everything from cognition and libido to skin health and mood stability.

But even in these peak years, cracks in the foundation can quietly start to form.

Late nights, high stress, skipped meals, endless to-do lists, and workouts fueled by iced coffee instead of actual food can all set the stage for hormonal imbalances. Maybe you're still on hormonal birth control and haven't felt quite like yourself in years. Or maybe PMS, cramps, or breakouts have started to creep in. These are often the first whispers from your body asking for a shift in how you care for it.

And here’s the thing: you don’t have to be hyper rigid. But you do have to be intentional. Because what you do in your 20s lays the foundation for how well your hormones will support you in your 30s and beyond.

Nutrition + Lifestyle in Your 20s

1. Start your day with real food, not just caffeine

That oat milk latte might be what you crave in the morning but if it’s replacing breakfast, your blood sugar and hormones are paying the price. Running on cortisol first thing in the morning might feel productive, but it leads to crashes, irritability, and eventually hormone disruption.

Start with this instead:

• Eggs + avocado + sautéed greens + sourdough bread

• Greek yogurt + berries + chia + almond butter

• Avocado toast + chicken or turkey sausage + fruit

Aim for 25–30g of protein and 10g of fiber at breakfast. This alone can transform your energy, blood sugar, and hormonal stability.

2. Eat like your hormones depend on it

Your body literally builds hormones from the nutrients you give it — cholesterol, amino acids, minerals, and vitamins are raw materials for hormone production. Every meal is a chance to give your body what it needs. During our 20s, its easy to succumb to restrictive diets and body image concerns given how rampant it is in our society. From one moment to another you see shifts in what’s desirable - the stick thin look of the early 2000s to the BBL era we just went through, it can be really damaging on women’s psyche. And with that ever changing trends, restrictive diets come and go too.

But the key here is to always prioritize healthy protein intake, daily fiber, complex carbohydrates, and healthy fats. These are all essential building blocks for a well functioning system. Healthy fats are quite literally what your hormones are made from. Every peptide hormone (from insulin to growth hormone) is strung together from amino acids from proteins you eat.  Complex carbohydrates aren’t the enemy—they feed your thyroid by providing the glucose it needs to convert T4 to the active T3 and they signal safety to your adrenals, keeping stress hormones in check.  Fiber is crucial for supporting a healthy gut microbiome, which is key for overall hormonal health and detoxing excess estrogen.

When protein, complex carbs, and fiber show up on your plate at every meal, you’re essentially giving your endocrine system the raw materials, the energy, and the cleanup crew it needs to keep everything in harmonious balance.

3. Don’t skimp on minerals

Magnesium, zinc, B6, selenium, and iron are foundational for hormone function and most women in their 20s aren’t getting enough. If you're on birth control, you're likely even more depleted.

Focus on:

• Magnesium : pumpkin seeds, leafy greens, black beans, dark chocolate

• Zinc: pumpkin seeds, chickpeas, oysters, lamb

• B6: bananas, potatoes, salmon, pistachios

• Iron: grass fed beef, spinach, lentils

• Selenium: 2 Brazil nuts a day

Even small increases in these minerals can improve energy, skin, cycles, and mood.

4. Your gut is your hormone detox center

This is the decade when gut issues (bloating, acne, irregular digestion, sensitivities) often flare. Most of my gut health patients are either in their 20s or 30s and the most common thing I hear is: “I’ve always had a history of constipation but now everything has gotten SO much worse”. If you aren’t pooping daily, you need to divert your attention to your gut health!

Your gut plays a massive role in estrogen clearance — and if it’s not moving things out, you can end up with PMS, chronic low grade inflammation, uncomfortable day to day bloating, skin issues, brain fog, and fatigue.

My checklist for foods to incorporate for a well functioning gut:

• 30g+ of fiber daily

• Fermented foods like sauerkraut, kimchi, probiotic yogurt, and kefir

• Prebiotic fibers like banana, apple, asparagus, and oats

• Bitter foods like arugula, radicchio, and grapefruit

• Carminative herbal teas like fennel, chamomile, and peppermint

• Lots of water!!

• And if your gut feels off, don’t ignore it — testing and working with someone can change everything.

5. Balance workouts with recovery

You don’t have to destroy yourself at every workout to be healthy. Fasted cardio + HIIT + low calories is the fast track to burnout and losing your menstrual cycle.

If you’re still trying to figure out what workout split works best for you, I often recommend:

• Strength training 2–3x/week to build and maintain lean muscle (muscle mass is incredibly important in your later decades)

• Walking daily to maintain cardiovascular health

• Pilates or yoga 1-2x a week to support balance and flexibility

• Actual rest days with zero guilt

And as always, pay attention to your energy cues throughout your cycle! Your workouts on day 26 of your cycle are gonna look different than your day 7 workouts. Typically, we feel more energized & stronger from the follicular phase through early luteal phase. From mid luteal up through our period, it’s normal to experience a drop an energy and a desire for less intense workouts. Honor those cues. If you’re workout leaves you feeling lethargic and drained instead of energized, it’s a sign you pushed too hard.

6. Manage stress like your future self depends on it

Because she does. The stress you normalize now becomes the imbalance you wrestle with later. And no, it’s not just bad days that fuel stress. It’s skipping meals, overcommitting, perfectionism, constantly being on, suppressing emotions, lack of boundaries, ignoring past trauma, and never fully decompressing.

Create space to:

• Say no

• Sleep in

• Lay on the floor and breathe

• Laugh, rest, read

• Do something just because it feels good

Your nervous system is the soil that your hormones grow in so nourish it accordingly!

Key Supplements for Your 20s

• Magnesium glycinate: Calms the nervous system, supports ovulation, and eases cramps and anxiety

• Omega 3s: Reduces inflammation, supports skin and mood balance

• Multivitamin: Replenishes key nutrients depleted by birth control, stress, and poor sleep

Key Herbs for Your 20s

• Adaptogenic herbs: Supports resilience to chronic stress and nourish the adrenals

• Chamomile: Supports the nervous system, sleep, and digestion

• Milk thistle: Gently supports liver detoxification and helps clear excess estrogen and toxins

30s: The Subtle Shifts

Your 30s are a bit of a hormonal in-between — not quite the peak of your 20s, but not in perimenopause either. You’re likely still ovulating, still cycling regularly, and still overall feel pretty good (but maybe you feel a bad night’s sleep a little more in your body than you did in your 20’s).

Or maybe your PMS is getting worse. Maybe your luteal phase is shortening or your energy is dipping harder than it used to. Maybe your skin is moodier, your sleep isn’t as deep, or you bloat from meals that never used to bother you. These aren't just signs of “getting older” — they’re gentle nudges from your body asking for a shift.

The good news? When you catch these shifts early, you can course correct with ease. The 30s are the perfect time to optimize and strengthen the foundation — especially if you want to feel vital in your 40s and beyond.

This is the most dominant age group I see in my practice. Most women come to me in their late 20s and early 30s feeling like their body has changed dramatically in the course of a year or two. But the truth is, it’s often the slow crawl of the lifestyle habits making an impact or years of sub-optimal digestion showing itself. But it’s never too late to shift these patterns in your body in order to feel like your most thriving and radiant self.

I’m in my 30’s now and I can honestly say that I feel better in my body now than I did in my 20’s (if you’re not familiar with my back story my health was horrible in my 20’s!). My cycles are better, my mood is steady, my skin is great, my digestion is at its peak. And it’s not from some miracle, but instead years of really optimizing my lifestyle and hormones to allow me to feel like my most thriving self now. So although we often hear that once you hit your 30’s it’s all downhill… I’m here to tell you that it’s absolutely not.

Nutrition + Lifestyle in Your 30s

1. Support progesterone

Progesterone is the first hormone to dip when you’re stressed, underfed, or overworked — and you’ll feel it: worse PMS, shorter cycles, insomnia, cravings, anxiety. It’s your calming, cycle stabilizing, sleep promoting hormone, and it needs fuel to thrive.

That means:

• Eating enough because chronically under-eating tanks ovulation

• Prioritizing blood sugar balance to foster safety in the body

• Eating carbs — yes, carbs: sweet potatoes, rice, squash, lentils, oats

• Prioritizing sleep because progesterone builds at night

• Really focusing on your mental health and stress resilience

If your luteal phase is falling apart, your body is likely asking for more fuel not more discipline.

2. Build meals like you're protecting your metabolism

Your metabolism naturally starts to shift in your 30s — but don’t confuse that with needing to “eat less.” In fact, over restriction backfires harder now.

You need:

• 90–100g+ of protein daily

• Anti-inflammatory fats (olive oil, wild fish, nuts, seeds)

• 30–35g of fiber per day

• Colorful plants (berries, greens, carrots, sweet potatoes, cabbage, etc.)

Example day:

• Breakfast: Eggs, turkey bacon, avocado, sourdough, berries

• Lunch: Salmon bowl with wild rice, arugula, roasted carrots

• Snack: Chia pudding with greek yogurt, raspberries, blueberries, walnuts

• Dinner: Chicken, sweet potato, cruciferous & bitters salad

• Dessert: Dark chocolate (for the magnesium, of course)

3. Stop skipping strength training)

If you aren’t optimize your workouts, you can begin losing muscle in your 30s. And less muscle = lower metabolism, weaker insulin sensitivity, and more fatigue. But this is reversible if you fight for it.

Aim for:

• Strength training 2–3x per week

• 10k steps daily

• At least one full rest day

• Less focus on HIIT, more focus on recovery and smart movement

Muscle is your hormonal safety net — treat it like gold. If you feel really unsure of what to do, find a personal trainer in your area that is aligned with your health goals to come up with a routine you feel good with.

4. If you haven’t started tracking your cycles yet, you need to be

Your cycle is your monthly report card from your hormones. In your 30s, it can start to subtly shift and tracking helps you catch early signs of imbalance and treat it.

Watch for:

• Shorter luteal phases

• Increased PMS (especially mood swings or breast tenderness)

• Spotting before your period

• Ovulation changes (or anovulatory cycles)

• Increased cramps

5. Gut + liver love are non-negotiable now

Estrogen metabolism is the name of the game in your 30s. If your gut is sluggish or your liver is overwhelmed, estrogen gets reabsorbed — and that can lead to heavier periods, mood swings, bloating, and weight gain.

If you want an even more in depth guide to how to support your estrogen and progesterone balance, check out this substack I made a while back.

6. Make peace with slowing down (and redefining strength)

You might not recover like you did at 24 — and that’s okay. The body is wiser now and it's asking for more support, not more stress.

Protect your nervous system by:

• Saying no without apology

• Creating white space in your day

• Taking your sleep seriously

• Ditching productivity guilt

• Prioritizing joy: music, nature, sunlight, connection, rest

Key Supplements for Your 30s

• Magnesium threonate: Supports sleep, mood, and cognitive clarity

• Fish oil (high DHA): Reduces inflammation, protects brain + hormone health

• CoQ10: Supports egg quality, energy production, and cellular repair (great for fertility support too)

Key Herbs for Your 30s

• Rhodiola: Boosts endurance and supports your stress response without overstimulation

• Chaste Tree (Vitex): Helps lengthen luteal phase and promote natural progesterone, but only beneficial if progesterone is low

• Dandelion Root: A gentle liver supportive herbs that helps clear excess estrogen and supports detox pathways

40s: The Rise of Perimenopause

Your 40s are when your hormones start to look at you like, are we ready for perimenopause?

Even if your cycle still shows up like clockwork, you’re likely noticing that something feels different. Maybe your periods are heavier. Maybe you’re wide awake at 3am. Maybe you’re waking up in the middle of the night drenched in sweat. Maybe you’re weepy one month, ragey the next. That’s perimenopause starting to show itself: the 5 to 10 year lead up to menopause when your hormones start shifting behind the scenes before your period ever officially “ends.” And most women hit this phase of life in their 40’s!

But here's the kicker: hormones don’t decline evenly.

Progesterone is usually the first to dip, especially if you’ve been running on high stress or poor sleep. Cue the anxious thoughts, short luteal phases, and insomnia. Estrogen, meanwhile, starts to fluctuate — spiking high some months (hi sore boobs and mood swings) and dropping low other months (cue hot flashes, dry skin, and weepiness). Thyroid function often takes a hit from the hormonal chaos and adrenal stress which can lead to mood and metabolic changes. And finally, testosterone production can start to wane too leading to lower energy and metabolic changes.

This is where symptoms can feel really unpredictable — one month you’re fine, the next you’re feeling awful. That unpredictability is one of the clearest early signs of perimenopause. But there’s a lot you can do to support your body, keep things stable, and feel good as you enter this next stage of life.

Nutrition + Lifestyle in Your 40s

1. Your nervous system is now a hormonal organ

If you don’t slow down, your hormones will do it for you. The nervous system now plays a starring role in how you feel day to day — especially because your adrenal glands are supposed to start helping produce sex hormones (via DHEA) as your ovaries begin winding down. But if you’re running on empty, they can’t do their job.

This is not the decade to power through — this is the decade to optimize recovery. Try:

• Morning sun exposure + early meals to anchor your circadian rhythm

• Daily walks (bonus if post-meal for blood sugar support)

• Say no more often than you say yes

• Keep your phone out of reach for the first and last hour of the day

• Protect your bedtime like it’s a sacred ritual

• Reduce bright and blue light an hour before bed

• Don’t skip joy — pleasure, laughter, intimacy, and play are biological medicine now

2. Protein becomes non-negotiable

In your 40s, you need 100g+ of protein/day to maintain muscle, mood, blood sugar, and metabolism — especially as estrogen becomes less reliable. If you’ve been skimping on protein or relying on coffee and crackers — this is your upgrade moment. And don’t forget, protein can slow down gut motility so it’s equally important to continue to prioritize your fiber intake and hydration!

3. Lift heavy and recover harder

Muscle loss starts to accelerate in this decade unless you’re strength training. Muscle = better insulin sensitivity, metabolism, mood, and energy. If you feel wiped after workouts instead of energized, it’s not a sign to push harder. It’s a sign to train smarter.

But not only that, you need to be incorporating exercises like yoga and pilates to support your sense of balance! In the upcoming decades, bone health is incredibly important to pay attention to. Build muscle, support balance, and move often to keep yourself protected.

4. Support estrogen metabolism before it backfires

Estrogen doesn’t just go away — it often spikes erratically, especially if detox pathways aren’t flowing. That can mean heavier periods, migraines, bloating, breast tenderness, and wild mood shifts.

Help your body out by incorporating:

• 30–35g fiber/day

• Cruciferous veggies

• Bitter greens

• Start the morning with warm lemon water

• Make sure you are having daily bowel movements, and if you aren’t you need to address this!

• Good sleep (again, hormonal detox happens at night)

If you’ve got a history of hormonal birth control, sluggish gut function, or liver overload, this becomes even more crucial.

Key Supplements for Your 40s

• Magnesium glycinate or threonate: Supports sleep, calms the nervous system, and offsets cortisol

• Omega-3s: Reduces inflammation and protects your brain + heart

• Calcium + D3 + K2: Begin proactively supporting bone density as estrogen drops

Key Herbs for Your 40s

• Maca: Supports adrenal glands and estrogen (my favorite herb for perimenopause!)

• Black Cohosh: Can reduce hot flashes and emotional swings during perimenopause

• Motherwort: A gentle nervine that supports the heart, anxiety, and emotional overwhelm

50s+: The Menopausal Transition

By now, you’ve likely entered menopause which is defined as 12 full months without a period. Estrogen and progesterone have settled into their lowest baseline. And while this new hormonal rhythm can feel more stable in some ways (goodbye unpredictable cycles), many women feel like they’re slowly unraveling. Not because they’re doing anything wrong — but because the hormonal protection they once had is now gone.

And here’s what’s often left out of the conversation: For most of human history, women didn’t live decades past menopause. Average life expectancy was 40–50. But now? Many of us are spending a third or more of our lives in this low-hormone state. That matters. Our bodies weren’t necessarily designed to coast hormone free for decades, which is why so many women feel like they’re suffering after menopause. It’s not just “getting older” — it’s biology shifting without the same hormonal protection we once had. That’s why it’s so important to nourish your body during this transition — and for many, why exploring options like HRT can be truly life giving (more on that in a sec).

Nutrition + Lifestyle in Your 50s

1. Bone health becomes top priority

You lose 10–20% of your bone density in the first 5 years after menopause. And you usually won’t feel it until there’s a fracture.

Support your bones with:

• Calcium rich foods (sardines, sesame, greens, tahini)

• Magnesium (pumpkin seeds, spinach, dark chocolate)

• Vitamin D3 + K2

• Resistance training + continued focus on movement (bone cells respond to pressure)

2. Protein becomes your metabolic lifeline

Estrogen used to help you maintain muscle. Now it’s gone and your body will break down muscle unless you give it a reason not to. You need 30g of protein per meal minimum. It helps:

• Preserve muscle

• Regulate blood sugar

• Support cognition

• Prevent abdominal weight gain

• Improve energy and satiety

3. Blood sugar matters more than ever

With less estrogen, you become more insulin resistant — which means your body struggles more to handle carbs and sugar. Incorporate:

• Walks after meals

• Eat carbs with fat/protein/fiber

• Minimize refined sugar and alcohol (which hit harder now)

• Prioritize whole food carbs over processed ones

4. Sleep becomes a survival skill

Poor sleep = higher cortisol = faster aging, more cravings, worse insulin resistance. Protect your sleep with:

• Magnesium before bed

• Cold, dark room

• Wind down routine

• Low evening light

• Reduce or eliminate alcohol (and if you do drink, cap it off 2-3 hours before bed)

• Herbal support (passionflower, lemon balm, valerian root)

Key Supplements for Your 50s+

• Calcium and Vitamin D3 + K2: Essential for bone, heart, and immune support

• Magnesium (glycinate): Supports sleep, stress, and blood sugar

• Collagen peptides: Helps skin, joints, bones, and connective tissue

• High DHA fish oil: Supports memory, cognition, and reduces inflammation

Key Herbs for Your 50s+

• Red Clover: Contains phytoestrogens that may ease menopause symptoms

• Lion’s Mane: Supports cognitive health

• Maca: Boosts libido, energy, and emotional resilience post-menopause

Let’s Talk Hormone Replacement

In the realms of hormone replacement, there’s both HRT and BHRT. Let’s break down what each one is so that you have a clear idea of what might be a good fit for you.

HRT stands for hormone replacement therapy. It’s an umbrella term for medications that replace estrogen, progesterone, and sometimes testosterone in people whose levels have declined — typically due to menopause.

Traditional HRT most commonly uses synthetic forms of these hormones:

• Conjugated equine estrogens (yes, from horse urine)

• Medroxyprogesterone acetate (a synthetic progestin)

These are still widely prescribed, though there’s been a growing shift away from synthetic progestins due to concerns around cardiovascular and breast cancer risks (more on that in a second).

BHRT stands for bioidentical hormone replacement therapy. The “bioidentical” part just means that the hormones are molecularly identical to the ones your body naturally produces. They’re often derived from plant sources like yams or soy and then chemically modified in a lab to match human hormones exactly.

BHRT can be:

• FDA-approved formulations (like Estrace, Prometrium, or patches like Climara or Vivelle-Dot)

• Compounded (custom-dosed versions from a compounding pharmacy)

In my practice, I work with BHRT from compounded pharmacies.

Why consider hormone replacement at all?

Because for many women, the post-menopausal hormone crash doesn’t just cause annoying symptoms — it has long term health consequences. We’re now living 30–40+ years in a low-estrogen state. Estrogen isn’t just about periods and fertility, it plays a crucial role in:

• Maintaining bone density

• Supporting brain health and memory

• Protecting the heart and vascular system

• Helping maintain skin elasticity and collagen

• Supporting bladder and vaginal tissue integrity

• Regulating mood and sleep

When estrogen drops dramatically, all of these systems take a hit. That’s why HRT and BHRT aren’t just about symptom relief — they’re also about long term prevention and quality of life.

Benefits of HRT/BHRT:

• Reduces or eliminates hot flashes, night sweats, vaginal dryness, insomnia, and mood swings

• Supports bone density (significantly lowers osteoporosis risk)

• Protects against brain fog and possibly even Alzheimer’s (especially when started early post-menopause)

• Improves sexual function, skin health, and urinary symptoms

• May help prevent metabolic slowdown, insulin resistance, and belly fat gain in menopause

Risks (and how to navigate them)

You’ve probably heard about the WHI study from the early 2000s — the one that scared millions of women (and doctors) away from HRT due to a small increased risk of breast cancer, blood clots, and stroke.

But here’s what didn’t make headlines:

• Those risks were mainly seen with synthetic progestins, not with natural progesterone

• The study was conducted on women over 60, many of whom started HRT long after menopause

• The estrogen only group (women without a uterus) actually had a lower risk of breast cancer and heart disease

Since then, newer research has clarified that timing matters: Starting HRT within the first 10 years after menopause (ideally before age 60) appears to carry the lowest risk and the most benefit.

The form matters too. For example:

• Transdermal estrogen (patches, gels, creams) avoids first-pass liver metabolism and doesn’t carry the same clotting risk as oral estrogen

• Micronized progesterone (Prometrium) is considered much safer than synthetic progestins when it comes to breast and cardiovascular risk

That’s why it’s so important to work with someone who understands the nuance — this isn’t a one-size-fits-all protocol. In my practice, I layer on nutrition, lifestyle, and supplemental support to optimize BHRT for a well rounded approach.

But with that said, not every women needs BHRT. Some do remarkably well navigating menopause with lifestyle, herbs, and supplements alone. I am by no means saying everyone needs hormones. Health is always unique and someone’s health history plays a big role in making these decisions. It’s about having informed options and not accepting suffering as “just how it is”.

Final Thoughts

Each decade brings new rhythms, new needs, and new invitations to partner with your body in a deeper way. When we understand what’s happening internally, we stop reacting with fear… and start responding with trust.

This isn’t about staying “young” forever. It’s about feeling vital, clear, and connected to your body — no matter what age you are.