If you’ve been researching hormone replacement therapy (HRT), chances are you’ve come across the term bioidentical hormones more than once. Maybe your friends are on them. Or maybe you stumbled across them while trying to make sense of the symptoms that don’t feel “normal” for your age—fatigue, brain fog, mood swings, weight gain, disrupted sleep, heavy painful periods, or loss of libido.

If you’ve been researching hormone replacement therapy (HRT), you might feel overwhelmed—like every article leads to more questions than answers. You’re not alone. Many women come to me after sifting through dozens of conflicting opinions, only to realize that what they really need is a provider who truly specializes in hormones, not just thinks they know, or dabbles in them, or thinks birth control is HRT.

There’s a powerful cultural shift happening around hormone enrichment for women. What was once seen merely as a “treatment to get through menopause” is now being recognized for what it truly is: a foundational tool for long-term vitality. We now understand that the aging process accelerates as sex hormones decline—and that decline begins as early as our 30s.

So, you’re considering Hormone Replacement Therapy (HRT). Maybe you’ve read about the benefits, or you’ve started experiencing symptoms like fatigue, brain fog, insomnia, weight gain, anxiety, irritability, or low libido and want to take control of your health. Maybe you are considering it because you have heard the anti-aging potential and you want to feel and look your best as you get older.

Menopause is literally just one day! One day of your entire life—it's when the period stops. However, what about the 30 years before and after menopause?

Question from a 40-Year-Old Woman: "Dr. Sarah, I feel like something is off, but my doctor says my labs are normal. I’m tired all the time, I can’t lose weight like I used to, I am so irritable with my husband and kids, I can't sleep and my cortisol is high. Could this be my hormones?

Women are often told that they have to wait until their period stops (menopause) to start hormone replacement therapy. And when we hear about hormones dropping, we often associate it with menopause. However, most women start to experience symptoms in their 30s and 40s - long before their period stops.

If you’ve landed here, you have likely already tried numerous solutions to hormone-related issues: supplements that didn't work, changing your diet, and exercising more. You might have even spent thousands of dollars and are not getting the results you want.

You’ve probably heard about hormone replacement therapy (HRT). Maybe your best friend swears by it, or a coworker mentioned how it changed her life. Or perhaps you’ve been up late, scrolling through articles, looking for solutions to the brain fog, the weight gain, or the sleep that seems to elude you more often than not. If any of this sounds familiar, you’re not alone.

If you’ve ever noticed changes in vaginal odor, you’re not alone. It’s a topic many women hesitate to discuss, yet it’s incredibly common—especially after the age of 30, when perimenopause hits. This gets progressively worse as women age - with its greatest impact during menopause.

Aging is inevitable, but having our health decline while we age is optional. Bioidentical hormone replacement therapy (BHRT) is one of the most powerful tools available for women to maintain vitality, prevent chronic disease, and age more slowly. It isn’t just about living longer anymore - women already outlive men.

For decades, progesterone was thought to be only necessary for pregnancy, leading to the widespread belief that it had little role outside of fertility and gestation. Many women who have had a hysterectomy are not prescribed progesterone under the assumption that they no longer need it.

Progesterone begins to decline naturally after the age of 30 due to aging—this is purely biological and inevitable. Unlike other hormones that can be influenced by lifestyle factors, nothing can stop this decline—not lowering stress, not taking supplements, and not even high-protein diets.

For years, women have been warned about the dangers of \"estrogen dominance,\" a term that has been widely misunderstood and misrepresented. Many assume that estrogen dominance means high estrogen levels, leading to weight gain, breast cancer, and other health issues. But what if I told you that estrogen dominance isn’t actually about high estrogen at all?

As women transition through perimenopause and menopause, declining hormone levels can lead to a range of frustrating symptoms, including dry skin, hair thinning, mood changes, and fatigue. One of the most effective ways to restore hormonal balance and improve these symptoms is through estradiol therapy.

Don’t wait until you have hot flashes, or your period to stop before you consider hormones as a cause of your symptoms. Women start to experience health problems when estrogen gets below 500 pg/mL.

As we approach our fabulous 40s and beyond, our bodies go through some changes that can bring about a rollercoaster of symptoms. 

The world of injectables is vast — some are labeled and referred to as neuromodulators (Botox, Dysport, and Xeomin). In reality, a neuromodulator is a neurotoxin.

Just because you are getting older doesn’t mean your sex life shouldn’t have to come to a screeching halt.  As you approach 40, your reproductive cycle slows down and prepares to stop and your ovaries make less estrogen and progesterone. When this happens you may find it challenging to get aroused and excited about sex.

When women complain of sexual dysfunction — they are prescribed anti-depressants, supplements, vaginal lubrications, or simply dismissed.  Despite the evidence in the research literature that estrogen is a very effective therapy for sexual dysfunction for women.

Lets talk about what gives skin that youthful, hydrated appearance — hyaluronic acid (HA).  It attracts and retains moisture, contributing to the skin’s hydration, plumpness and elasticity.  It helps maintain skin hydration by binding to water molecules.

Metabolic health is more than just what the scale says — it means you are healthy and balanced on the inside.  It is possible to reprogram and even reset your metabolic system and it doesn’t work to just restrict calories and exercise.

Is there a stubborn muffin top that seems to have appeared out of nowhere since hitting menopause. Its frustrating right? Let’s take a moment to see why this is happening and why taking hormone replacement therapy won’t make it worse.

Fibrocystic breast disease is a very common – it is when there are lumps, pain, and changes in breast tissue.  It is non-cancerous, but it can still cause discomfort and anxiety and raise women’s concerns about the health of their breasts.

Emotional well-being and mental health is just as important as any other aspect of health.   However, women after 40 report higher rates of irritability, anxiety, depression and inability to concentrate.

Attention Deficit Disorder (ADD) and can include hyperactivity (ADHD) is a form of neurodiversity represented by differences in neurotransmitter chemistries.  These neurological variations are to be recognized and respected as we would any other human difference.