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Expanded - MENOPAUSE, HORMONES — HRT Without Fear
- helenfkws
- May 24
- 12 min read
Updated: Jun 15
If you’re a woman, you will experience perimenopause and menopause - the timing, symptoms, and intensity from hormonal decline may vary, but the transition is universal.
"Menopause isn’t an ending it's a natural phase of life — it’s a powerful new beginning and with the right lifestyle and hormonal support, you can navigate it with strength, clarity, and confidence. It's a time to be fully in tune with your body if you plan to age strongly."
The Hormone Shift: Your Guide to everything Menopause & Safe Hormonal Therapy HRT
Content:
Empower Yourself through Self-Education
Why it Matters so Much
THE NEXT CHAPTERS post Baby Bearing: Real Current Hormone Talk for Real Women
PERIMENOPAUSE: Common Symptoms from Hormonal Decline
MENOPAUSE: Common and Not So Common (but very real) Symptoms
Positive Management of Estrogen and Hormone Deficiency
Understanding and Challenging Outdated Beliefs Around HRT
HRT Through the Years: Fear, Facts, & the Future
3 Key Hormone Studies and Current Guidelines
Pre 2002
1. 2002 Women’s Health Initiative (WHI): The impact on women
2. 2023 Revisiting the WHI Hormone Therapy Trials: 20 years later: The Proven Safety for women
3. LATEST Guidelines: The Good News for All Women
Key Takeaways: Safe and Effective. Be informed, educated, and ready to self-advocate
Are you TOO OLD for Hormone Therapy? NO! Explained by two leading Doctors in this field
If This Doesn’t Give You Confidence to Start Your Hormone Therapy Journey, Nothing Will!
NO SYMPTOMS: The Silent Breakdown. Why Estrogen still Matters
I want to go All NATURAL! Great, BUT you still don't have the hormones you need
BENEFITS of Estrogen (or Estrogen + Progestin), and Testosterone Therapy
RISKS of Declining and Low Estrogen
OPTIONS: Hormonal Therapy (HRT) for Women-Find what’s right for you and choose
Note: It’s Not One-Size-Fits-All
EEEK!!!! Where did this BELLY FAT come from!!!
Research Findings. The Estrogen Link and Visceral/Belly Fat Risks
SMART Strategies to Tackle Visceral/Belly Fat
You must be your own best advocate. Not all healthcare providers are up to date — many still lack proper training in menopause care and may offer outdated advice or dismiss your symptoms entirely.
YOU deserve evidence-based care, not outdated fear
YOU deserve to be a 'Stronger Woman' with the correct SELF CARE
REPEAT Reminder!!! NO you are NOT TOO OLD for Science-Backed Menopause Support
Have a LISTEN to these brilliant podcasts by leading doctors and menopause experts who are on a mission to educate, empower, and equip both women and healthcare providers with real, science-backed tools and never stop learning.
I'm excited for YOU-Let's Go!!!!
Empower Yourself Through Self-Education
Menopause is NOT just something to "get through". Too many women enter it unprepared, misinformed, or unheard and suffer unnecessarily!
Reclaim YOU with Evidence and Empowerment
Why Self-Education Matters
Knowledge = Power
Understanding what’s happening in your body reduces fear and confusion. From perimenopause to menopause, every stage can be managed with confidence when you know what to expect.
Better Conversations with Healthcare Providers
When you're informed, you're empowered to ask the right questions and seek out the support you deserve — whether it’s about HRT, nutrition, bone, heart and muscle health, or mental wellbeing.
Fewer Surprises, More Support
Hot flashes, mood swings, sleep issues, weight gain — have become common but are NOT always “normal" along with many less common or often seemingly unassociated symptoms. Learning about all these symptoms helps you distinguish between what’s manageable and what needs attention.
Lifestyle Changes Become Intentional
With the right knowledge, you can make targeted shifts in diet, exercise, stress management, and self-care that truly work for you.
You don’t have to suffer in silence, guess your way through it, or go it alone.
Self-education is the first step toward self-advocacy — and thriving, not just surviving, through this chapter of life.
THE NEXT CHAPTERS post baby bearing: Real Hormone Talk for Real Women Desiring a Really Great Life
PERIMENOPAUSE is the transitional phase before menopause, when a woman’s hormones—especially estrogen—begin to fluctuate. It typically starts in the 40s but can begin as early as the mid-30s and lasts anywhere from a few months to several years.
Common Symptoms:
Irregular periods
Hot flashes and night sweats
Mood swings or anxiety
Sleep issues
Brain fog
Weight gain, especially around the belly
Changes in libido or vaginal dryness
Perimenopause ends when a woman has gone 12 consecutive months without a period.
MENOPAUSE is then officially reached—a natural life phase, typically between ages 45 and 55, marking the permanent end of menstrual cycles.
Common and Less Obvious (but very real) Symptoms of Low Hormones:
Brain and Mood
Brain fog or forgetfulness
Word-finding difficulty ("menopause brain")
Loss of confidence or motivation
Sudden anxiety or panic attacks
Increased irritability or mood swings
Low resilience to stress
Depression, especially in women with no history
Body and Function
Joint pain, stiffness, or “menopause arthritis”
Muscle aches or feeling weaker
Frequent injuries or slow recovery
Loss of coordination or balance
Dry or itchy skin (especially hands, scalp, or vulva)
Heart and Circulation
Heart palpitations or skipped beats
Rising cholesterol despite no lifestyle changes
Increased blood pressure
Sexual and Reproductive Health
Vaginal dryness, itching, or burning
Painful sex (without clear cause)
Loss of libido or arousal issues
More frequent UTIs or urinary urgency
Sleep and Fatigue
Waking up at 2–4 a.m. and can’t fall back asleep
Fatigue that feels hormonal, not just tiredness
Restless legs or strange body sensations at night
Other Surprising Signs
Tinnitus (ringing in the ears)
Burning tongue or metallic taste
Hair thinning (especially at temples or crown)
Dry eyes or blurry vision
Bloating or digestive changes
Why It Matters:
These symptoms are often dismissed, misdiagnosed and mismanaged—but they can all be linked to the loss of estrogen’s protective, balancing effects on the brain, skin, joints, heart, and more.
Positive Management of Estrogen and Hormone Deficiency
Lifestyle habit changes, and whole food nutrition
Exercise in the form of strength training and cardio
Sleep and positive mindfulness
Hormonal therapy HRT. YES, it is safe for most women of all ages as the up-to-date research findings now show.
Understanding and Challenging Outdated Beliefs Around HRT
Much of the fear and hesitation around hormone replacement therapy (HRT) stems from preconceived ideas shaped by flawed interpretations of early research, particularly the 2002 Women’s Health Initiative (WHI) study.
That study was prematurely halted and widely misrepresented, leading to decades of confusion, fear, and missed care opportunities for millions of women.
The results were not applicable to most women entering menopause, yet the fallout dramatically shifted medical practice — creating a culture of caution, and in some cases, complete avoidance of HRT.
We now know better:
Low risks can be age-dependent and far lower for women under 60 or within 10 years of menopause. But research also shows you are never too old and it is based on individual requirements.
Modern HRT formulations and delivery methods are safer and more individualized.
Estrogen alone may even reduce the risk of breast cancer in certain women.
It’s time to re-evaluate outdated research and protocols and empower both patients and providers with the latest, evidence-based knowledge — not fear-based medicine.
HRT Through the Years: Fears, Facts, & the Future
3 Key Hormone STUDIES and GUIDELINES-from misleading to empowering
Pre 2002 HRT was prescribed throughout the world without question to many women who were benefiting and thriving.
2002 Women's Health Initiative (WHI) Menopause Study:
This Study refers to a landmark clinical trial conducted as part of the Women’s Health Initiative (WHI) — one of the largest and most negatively influential women’s health studies in history.
What Was the WHI Menopause Study?
Full Name: Women’s Health Initiative (WHI) Hormone Therapy Trial
Launched: 1991; Hormone Trial findings published in 2002
Participants: Over 160,000 postmenopausal women with no symptoms, aged 50–79
Focus Areas: Heart disease, breast and colorectal cancer, osteoporosis, and effects of hormone replacement therapy (HRT)
The trial—specifically combined estrogen and progestin (CEE + MPA).
The study had significant limitations and misinterpretations, including the age of participants, preexisting conditions, type of hormones used, and grossly inflated and misunderstood statistics.
The exaggerated conclusions in the report raised significant concerns among women.
↑ Breast cancer risk
↑ Heart disease, stroke, and blood clots
↓ Colorectal cancer and hip fractures (some benefits observed)
These have since been debunked or corrected
The Impact on Women:
Created widespread fear and confusion about hormone therapy (HRT)
Millions of women who were having positive outcomes stopped using HRT
Major shift in menopause treatment guidelines and medical practices. A whole generation of medical care and women have been affected.
The most recent research has re-evaluated and clarified those early conclusions.
2023 Reassessment of WHI Study:
Key Findings from the 2023 Reassessment:
HRT is safe and advantageous for numerous women, particularly when initiated before the age of 60 or within 10 years after the onset of menopause, with no indication of a specific age limit for its benefits.
The initial breast cancer risk was overstated, especially for estrogen-only therapy, which actually showed a reduction in breast cancer risk in some groups.
The type, timing, and delivery method of hormones matter significantly (e.g., transdermal estrogen and bioidentical progesterone have different risk profiles than oral/synthetic options).
HRT provides clear benefits for vasomotor symptoms (hot flashes), bone health, and quality of life.
Bottom Line:
The 2023 review did not completely "debunk" the WHI in the sense of proving it false, but rather corrected misinterpretations and placed its findings in proper context using 20 years of follow-up data and newer studies.
Further advocacy and study since 2023 have provided newer research showing that HRT is safe and effective for many women—especially when started near the onset of menopause.
Latest 2025 GUIDELINES
Timing Matters
New evidence shows that HRT started before age 60 or within 10+ years of menopause onset is safe for many women and can even offer protective benefits against heart disease and osteoporosis.
Type of Hormone Therapy
- The WHI study used a specific combination of hormones—synthetic progestin (MPA) and oral conjugated equine estrogen (CEE)—which are not the most commonly prescribed forms of HRT today.
- Newer forms, such as bioidentical hormones and transdermal (patch or gel) estrogen, carry less risk and be better tolerated.
Breast Cancer Risk Is Small and Context-Dependent
- Later analyses of WHI data show the increased risk of breast cancer was very small, and mostly associated with long-term combined HRT use (rarely used estrogen + synthetic progestin).
- Estrogen-only therapy (for women without a uterus) showed no significant increase—and even a reduction—in breast cancer risk in some groups.
Benefits Often Outweigh Risks for Symptomatic Women
- Current guidelines from groups like The North American Menopause Society (NAMS) and The Endocrine Society support the use of HRT for symptom relief and long-term health.
Key Takeaway:
HRT isn’t the universal threat it was once believed to be. For many women, it can be a safe and effective option—especially when it's personalized to their unique health history.
As the medical system continues to evolve, it's more important than ever to be informed, educated, and ready to self-advocate. Outdated beliefs and healthcare practices are still catching up, but you don’t have to wait and suffer.
ARE YOU EVER TOO OLD for Hormone Therapy... The answer is a BIG fat NO!!
If This Doesn’t Give You Confidence to Start Your Hormone Journey, Nothing Will!
You Were Not Born to Suffer!
For too long, women have been told to "just deal with it". That hot flashes, brain fog, mood swings, sleepless nights, and unexplained weight gain are just part of aging.
But here's the truth:
You don't have to suffer in silence. You don't have to accept feeling like a stranger in your own body. You don't have to push through — exhausted, unheard, and unsupported.
Modern, evidence-based hormone therapy is not about chasing youth —It’s about reclaiming your clarity, energy, and confidence. It's about giving yourself the care you deserve.
This is your body. Your health. Your choice. Educate yourself. Ask the hard questions. Advocate for what you need. Because you were never meant to just survive — you were born to thrive.
NO Symptoms—The Silent Breakdown. Why Estrogen Still Matters
Even if you’re not dealing with hot flashes, night sweats, or mood swings, estrogen plays critical roles in your long-term health. After menopause, your body produces far less estrogen—and that can silently affect several important systems.
I Want to go ALL NATURAL
Wanting to go all natural is great—many women and me feel the same.
But here’s the truth: once you’re in menopause, your body no longer produces the hormones it once did. So technically, you’re not 'natural' anymore in the way your body functioned before.
Estrogen, progesterone, and sometimes testosterone are no longer at optimal levels—these are key for bone, brain, heart, and muscle health.
Choosing hormone therapy isn’t about going against nature—it’s about restoring what’s missing to protect your long-term health and quality of life.
It’s like wearing glasses, a hearing aid, using sunscreen or taking iron when you’re low or other medications to manage health issues.
BENEFITS of Estrogen (or Estrogen + Progestin) Therapy
Relief from Menopausal Symptoms
Reduces hot flashes and night sweats
Improves sleep quality
Eases mood swings, anxiety, and irritability
Reduces vaginal dryness and painful intercourse
Improves urinary tract health
Protects Bone Health
Helps prevent bone loss and osteoporosis
Lowers risk of fractures, especially in the hip and spine
Supports Heart Health
May lower risk of coronary heart disease when started before age 60 but it's not too late after 60
Supports Brain Health
Potentially reduces brain fog and may help with cognitive clarity
Research is ongoing on the connection to dementia prevention when started early
Improves Metabolism & Body Composition
Helps reduce central weight gain (visceral/belly fat) and maintain lean muscle mass
May improve insulin sensitivity and cholesterol levels
RISKS associated with a DECLINE and LOW Estrogen After Menopause:
No woman can escape this!
Bone Loss & Osteoporosis
Low estrogen weakens bones, increasing the risk of fractures—especially in the hips, spine, and wrists, even if you feel fine now.
Heart Disease
Estrogen helps protect blood vessels. Its decline can raise LDL ("bad") cholesterol and increase the risk of heart disease, the #1 cause of death in women over 50.
Brain Function and Cognitive Changes
Estrogen influences memory, mood, and cognitive sharpness. Even without symptoms, lower estrogen levels are linked to brain fog, memory decline, and a higher dementia risk over time.
Vaginal & Urinary Changes
Thinning vaginal tissues, dryness, painful intercourse, and more frequent UTIs can occur.
Estrogen helps maintain vaginal tissue, elasticity, and bladder function. These issues may start subtly but often worsen over time without treatment—even without early symptoms.
Mood Swings & Depression
Estrogen influences neurotransmitters like serotonin; its drop may affect mood and emotional well-being.
Skin Aging & Elasticity Loss
Estrogen helps maintain collagen and skin hydration, so low levels can accelerate skin thinning and wrinkling.
Bottom Line:
You don’t need symptoms to benefit from estrogen support. HRT can still help protect your quality of life long-term. Talk to a healthcare provider who stays current with the latest research to decide if it's right for you.
OPTIONS: Hormonal Therapy (HRT) for Women
Finding What’s Right for You
Hormone Replacement Therapy (HRT) can be life-changing for many women navigating perimenopause and menopause. The goal is to restore declining hormone levels — mainly estrogen and sometimes progesterone or testosterone — to help manage symptoms and support long-term health.
1. Estrogen Therapy
Used for women who have had a hysterectomy and no longer have a uterus.
Used to relieve symptoms like hot flashes, night sweats, vaginal dryness, brain fog, mood changes, and bone loss.
Common Forms:
Patches: applied to the skin, slow release
Gels: absorbed through the skin
Tablets: taken orally
Vaginal options (creams, rings, pessaries): local treatment for vaginal dryness or urinary symptoms
2. Combined Estrogen & Progesterone Therapy
For women with an intact uterus, progesterone is added to protect the uterine lining from overgrowth caused by estrogen alone.
Options:
Oral combined tablets
Separate estrogen + natural progesterone (e.g. micronised progesterone)
IUD (Mirena): delivers progesterone locally and also provides contraception
3. Testosterone Therapy
Used off-label in many countries for low libido, energy, and mood in women who are testosterone-deficient. Usually prescribed in low-dose gels or creams designed specifically for women.
Choosing the Right HRT: What to Consider
Your symptoms and goals (relief, prevention, or both)
Your age and stage (perimenopause vs. post menopause)
Medical history
Personal preference (oral vs. transdermal, convenience, etc.)
Risk profile (HRT has been shown to be safe for many women)
Note for All Women: It’s Not One-Size-Fits-All
The safest and most effective HRT is the one tailored to you, by a practitioner trained in menopause care.
EEK!!! Where did this BELLY FAT COME FROM?!!!!!
(Belly Fat) is known as VISCERAL FAT and can increase during the Menopause estrogen decline
It's one of the most common and frustrating symptoms. Stubborn belly fat seems to appear out of nowhere (even without altering diet or exercise) — and refuses to budge.
Research Findings and Visceral/Belly Fat Risk:
1. Hormonal Changes Drive Fat Redistribution
A 2009 study in Journal of Clinical Endocrinology & Metabolism showed that the drop in estrogen, not just aging alone, directly contributes to increased visceral fat.
Estrogen helps regulate fat distribution. After menopause, fat shifts from the hips and thighs to the abdomen (more like a man).
2. Increased Risk of Metabolic Disease
Visceral fat is more metabolically active than subcutaneous fat and is linked to:
Insulin resistance
Type 2 diabetes
Heart disease
Inflammation and oxidative stress
The Study of Women’s Health Across the Nation (SWAN) confirmed that visceral fat increases independent of BMI, meaning even women who don’t gain weight overall may accumulate harmful belly fat.
3. HRT May Help Limit Visceral Fat
Research (e.g., Menopause, 2012) shows that estrogen therapy may reduce visceral fat accumulation and improve insulin sensitivity when started early in the menopause transition.
Takeaway:
Even if overall body weight stays the same, after menopause, visceral fat becomes a major health concern.
Major contributors to Visceral/Belly Fat:
Estrogen loss
Reduced physical activity (particularly resistance/strength training)
Inadequate nutrition particularly protein (critical as women age)
The Slower Metabolism related to these factors
SMART Strategies to Tackle Visceral/Belly Fat
Lifestyle and Medical interventions
Resistance training and regular functional movement
A high-protein whole food eating plan and healthy lifestyle habits (sugar and alcohol are major offenders)
Adequate sleep and stress reduction
Hormonal Therapy
Remember Self Education and Self Advocacy are crucial
You are the expert on your body.
If your doctor isn’t current on the latest research about hormone therapy, that’s not a signal to stay silent—it’s a call to speak up and self-advocate knowing you have the backing of research and many up-to-date health professionals around the world.
Science has evolved.
We now know that HRT, when used appropriately, is safe and effective for many women.
Your symptoms are real. Your quality-of-life matters.
YOU deserve evidence-based care, not outdated fear.
Don’t take “no” as the final answer if it doesn’t sit right with you. Instead:
Come prepared with evidence-based information
Ask clear, informed questions and if you feel your provider isn't up to speed request a referral.
Seek out a menopause-literate practitioner who respects your concerns and works with you.
You deserve real options, real support, and real relief. Be informed. Be assertive. Be heard.
"You’ve navigated life — now step into your prime with knowledge, action, purpose, strength, power, and pride."
YOU deserve to be a 'Stronger Woman' with the correct SELF CARE.
xx
ANSWER REPEAT!!!!! NO "YOU are NOT TOO OLD"?
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