Many Women Wonder: Is HRT Only for Menopause? The short answer: Absolutely NOT!
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. The medical community calls this 20-year period “perimenopause,” but in reality, it can just be called ovarian fatigue, or low ovarian function and can happen at any age!
Could bioidentical HRT be an option for any women experiencing symptoms but still having a period? Yes!
Women benefit greatly from optimizing hormones at any age. It’s not just about treating hot flashes, or vaginal dryness, or getting through menopause anymore! That is an outdated way to think about hormones! Hormones regulate every process in the body. Keeping them optimized means increasing your health span and aging well.
You’re Not Alone: Early Symptoms of Hormonal Decline
Perimenopause, or the 20-year period before menopause, is simple biology. Our ancestors didn’t live as long as we are living now, and women were not meant to have babies beyond the age of 30. Our ovaries simply do not produce progesterone and estradiol at the rate we need them to — to have the life we want, which is to age well and feel amazing as we age. Studies show that up to 80% of women experience perimenopausal symptoms such as fatigue, mood swings, brain fog, irregular cycles, and decreased libido years prior to the period finally stopping. What is the root cause of the 100+ symptoms that women experience? Low levels of estradiol, progesterone, and testosterone! When they drop, not only do women get symptoms, but it completely impacts daily life, long-term health, jobs, relationships, and wellbeing.
Studies support early intervention with HRT is best and not waiting until your period stops! When women start earlier they are more likely to prevent heart disease, diabetes, weight gain, osteoporosis, dementia, Alzheimer’s and even potentially cancer 3-4.
What Do I Know?
As a longevity, hormone, and peptide specialist, I’ve worked with countless women navigating their health and hormones. This includes young women struggling with endometriosis, polycystic ovarian syndrome, or postpartum symptoms to perimenopausal and menopausal women. Women are searching for a natural solution that actually works. Through bioidentical hormone replacement therapy (BHRT), I’ve seen firsthand how early intervention can prevent years of discomfort and improve long-term wellness. Why would you wait to feel better? There is no benefit to waiting as long as you can. Trust me, things just get worse! Women are finding that hormones are about prevention and health maintenance.
The Benefits of Starting HRT As Soon As Symptoms Start (What I’ve Seen in My Practice)
Women who begin HRT as soon as they start to have symptoms:
- Improved relationships & satisfaction with life
- Improved mood stability and cognitive function
- More restorative sleep
- Enhanced libido, sensitivity, and orgasms
- Fewer vaginal infections, urinary tract infections, and overall improved vaginal health & microbiome
- Reduced anxiety, depression & irritability
- Greater satisfaction with skin & hair, all while using fewer products
But don’t just take my word for it—let’s look at real stories of women who benefited from starting BHRT before menopause.
Real Stories: Women Who Started HRT As Soon as Possible
Case 1: Emily, 42 – The Exhausted Mom of 3
Emily came to my clinic feeling drained. Despite a clean diet and regular exercise, she struggled with brain fog, anxiety, fatigue, & insomnia. Her lab showed a normal estradiol of 466 pg/mL, but absent progesterone and testosterone. Her FSH was completely elevated at 11. Her labs indicated that her ovaries were struggling to make hormones. Even with a normal estradiol, she is unable to make the other two hormones that she needs. She was started on both progesterone and estradiol. Within a couple of weeks, she felt lighter, calmer, and was getting more restful sleep. Her brain fog also got better over a few weeks. After 6 months, all 3 hormones came back at normal levels: Estradiol (520 pg/mL), Progesterone (5,000 pg/mL), and testosterone (255 pg/mL).
This is where women get confused about if they need to start. Emily was able to make some estradiol, but her other labs were low, and her FSH indicated that she wasn’t making estradiol all the time. Women need all three hormones to feel their best!
Case 2: Rachel, 37 – The Active Runner Who Lost Her Energy
Rachel was an avid runner but noticed increased fatigue, joint pain, muscle aches, and decreased endurance. On top of that, she started getting acne and thinning, dry hair. She was really unhappy with the way she was starting to age. She also found herself to be more irritable with her husband, although this wasn’t her primary concern. She wanted to keep running and was told that she couldn’t run anymore because it was raising her cortisol.
Elevated cortisol in women is from low estradiol and progesterone. Estradiol prevents the overproduction of cortisol, and progesterone competes for the receptor, dampening the effects of cortisol. Rachel was unsure she needed to start hormone replacement therapy but decided to try it anyway.
She saw results in weeks with her training, performance, endurance, and recovery. On top of that, her libido came back, which she acknowledged was a problem she was ignoring.
Case 3: Samantha, 39 – The Ultrafit Woman with Bloating and Gut Concerns
Samantha was an ultrafit Taekwondo instructor who was always concerned about her health. She wanted to age well and feel great. She came into my clinic because she noticed her GUT getting worse—bloating, constipation, and sensitivity to practically every food. She admitted that it was a full-time job to make sure her diet was just right—if anything was off, then she would pay for it for days—insomnia, mood instability, and fatigue. She also admitted spending hours at the gym each week with no results or gains. In fact, she felt that if she didn’t spend hours at the gym, she would easily gain weight. Certain foods, it seemed, would also give her a migraine.
Samantha definitely needed estradiol and progesterone. Women often think GUT issues are the root cause of their problems and spend time working on dietary restrictions, seeing no results.
She started bioidentical hormone replacement therapy and noticed a difference in a few weeks. Months later, at follow-up, Samantha reported gaining more muscle at the gym, and she was even able to eat some of her favorite foods without it impacting her skin or sleep like it used to.
All 3 cases are examples of women who benefit greatly from optimizing hormones.
Who Should Consider HRT?
It’s not just about treating hot flashes, or vaginal dryness, or getting through menopause anymore! If you have any of the symptoms of aging, you should consider starting. Life is too short to feel terrible! Insomnia alone is reason enough to start—sleep is so important!
Problems where low hormones is often the root cause:
- High cortisol
- Leaky GUT, constipation, bloating
- Fatigue, brain fog, or lack of motivation
- Insomnia
- Irritability, anxiety, depression, or rage
- Heavy or painful periods
- Weight gain, difficulty working out
- Low libido, vaginal dryness, vaginal odor, or frequent infections
- Dry skin, hair, eyes, ears, and lips
- Sensitivity to foods, chemicals, or rashes, eczema
- Autoimmunity
- Itchy ears, skin, and vagina (all from dryness or histamine)
- Increased histamine
Common Misconceptions About HRT
Myth #1: You must wait until your period stops (menopause) to start hormone replacement therapy (HRT). False! The period stopping is the last thing to happen. Why wait until that happens when symptoms start around age 30? We call this Perimenopause, but it can also just be low ovarian function at any age!
Myth #2: HRT is dangerous. Outdated myth!* Hundreds of studies show that bioidentical hormones are safe and effective.
Myth #3: HRT will cause weight gain. Not true! Women gain weight when hormones are low. Too much testosterone can cause women to gain weight if they are put on too much. But the proper HRT regimen shouldn’t cause weight gain. Hormonal balance optimizes metabolism and body composition, supporting healthy weight maintenance and muscle tone. Especially in reducing visceral fat.
What to Ask Your Doctor
Unfortunately, there is no training in medical school for hormones, menopause, perimenopause, or the impact of low hormones on women. There is also no training on diagnosis, lab testing, or how to effectively replace missing hormones in women. OBGyns, primary care physicians, and endocrinologists DO NOT have specialty training either. That is why their solution is always birth control. Women are often told that they need to wait until their period stops, or that if they are having their period, their “hormones are normal.” This is misinformation.
It is important that you see a hormone specialist, anti-aging specialist, or someone who knows how to balance hormones. At Inner Balance, we have specialists and we believe you.
What about labs?
Hormones fluctuate from hour to hour, and there is a lot of variability in lab testing. On top of that, estradiol can be normal while the others come back low. This causes a lot of confusion and misunderstanding. Low hormones in women is a clinical diagnosis, not a laboratory diagnosis. If you have symptoms, then you are a candidate.
If you choose to get labs to screen and diagnose perimenopause, all you really need is a follicle-stimulating hormone (FSH)!
Every Woman is Unique, Yet We All Need the Same Thing
Every woman is different, but we all need progesterone, estradiol, and testosterone to feel great, age well, lose weight, and increase our healthspan. No matter what age you are, keeping your hormone levels optimized will benefit you and your health!
