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. And now you are wondering if it’s time to take the dive. Perhaps you’ve been struggling for years and doctors have told you that your hormones are normal and you are starting to question that.
The good news? You’re not alone — and you have options.
As a doctor specializing in hormone therapy, peptide therapy and anti-aging, I’ve spent years diagnosing and treating women with hormone deficiencies. I’ve seen firsthand how bioidentical hormone replacement therapy (BHRT) transforms lives — helping women regain energy, improve mood, restore libido, and protect long-term health. If you’ve been wondering whether HRT is right for you, this guide will help you recognize the signs and make an informed decision.
First: what is hormone replacement therapy used for?
Bio-identical hormone replacement therapy is designed to restore optimal levels of vital hormones like estrogen, progesterone, and testosterone, which naturally decline with age. It’s most commonly used to manage perimenopause and menopause symptoms, but it can also help with conditions like endometriosis, polycystic ovarian syndrome, postpartum symptoms, post-birth control syndrome, or infertility. By replenishing these hormones, HRT helps balance the body, alleviating disruptive symptoms and supporting long-term wellness.
💡 Take our health quiz to see if HRT is right for you!
The Most Common Signs It’s Time for Hormone Therapy
Based on our experience with women at Inner Balance, these are the most common signs that indicate hormone replacement therapy might be the right solution for you:
1. Fatigue or lack of motivation
How HRT Helps: Estrogen and progesterone are needed for the brain to make neurotransmitters like dopamine and norepinephrine that help us think clearly, focus and prevent depression and anxiety. Testosterone also plays a role in mental clarity for women. Keeping them optimized not only helps us think, it prevents dementia, Alzheimer’s and memory loss.
2. Irritability, Anxiety, or Depression
How HRT Helps:Both estrogen and progesterone stabilize mood and reduces anxiety by supporting neurotransmitter function. Dopamine plays a huge role in anxiety and women need hormones to make dopamine! Hormonal lows can significantly impact mental health. Many women find relief from anxiety and depressive symptoms once their estrogen and progesterone levels are restored — within days sometimes.
3. Brain Fog and Memory Lapses
How HRT Helps: Estradiol, testosterone, and progesterone all enhance cognitive function and protect brain health. Forget why you walked into a room? Can’t find the right words? Estrogen especially plays a crucial role in cognitive function. Low levels are linked to memory issues and brain fog, which can improve with HRT. Progesterone is important too, but women won’t notice an improvement in brain fog on progesterone-only treatment.
4. Heavy bleeding or painful periods
How HRT Helps: Progesterone maintains the lining of the uterus and prevents and treats heavy bleeding. Women notice their periods getting lighter and shorter on our treatment. Estrogen is supposed to be there—it’s the absence of progesterone that causes the heavy bleeding and painful periods, not the presence of estrogen.
5. Low Libido, decreased sensitivity and less intense orgasms
How HRT Helps: Testosterone isn’t the only hormone women need for sexual wellness! Progesterone and estradiol are critical too. They help put you in the mood, increase clitoral sensitivity, improve ease of orgasm, restore feel, and improve vaginal lubrication. The limbic system of the female brain is full of estrogen receptors! Women report a huge improvement in sexual health and intimacy after starting treatment with us.
6. Weight Gain
How HRT Helps: Estradiol and progesterone support metabolic function and help with good fat distribution. They reduce visceral (bad) fat and move it to the subcutaneous area (which makes the skin more vibrant, youthful and resilient). GLP-1 is a hormone that drops once estradiol drops — which means the root cause of metabolic dysfunction is likely low estrogen and progesterone in women.
7. Insomnia
How HRT Helps: Estradiol and progesterone modulate GABA receptors, increase melatonin production, increase dopamine, regulate body temperature, and prevent early rising in the morning by keeping cortisol regulated. If you’re struggling with insomnia or waking up frequently, women say this is one of the first things to get better on treatment.
8. Joint Pain, Muscle Pain and Weakness
How HRT Helps: Estradiol, progesterone, and testosterone all help relax muscles, reduce inflammation, and support muscle growth and recovery. Women notice a huge improvement within a few months.
9. Dry skin, hair, eyes, lips, ears and vagina
How HRT Helps: Estradiol is hydrating — it stimulates the production of hyaluronic acid all over the body and helps the skin maintain moisture. This is why skin & hair become dry and brittle and crepey when levels drop. Progesterone also plays a huge role in the health of hair and skin. Stop itching your ears, eyes, and skin — treat the root cause!
10. Increased cortisol
How HRT Helps: Estradiol downregulates the production of cortisol and prevents too much from being produced. Progesterone competes for the receptor, damping the unwanted effects of cortisol. Together they help regulate and keep it in check. Elevated cortisol isn’t the root cause — low hormones are the root cause of the elevated cortisol and also the insomnia, mood swings, and weight gain!
11. Declining GUT health
How HRT Helps: Progesterone and estradiol play a huge role in healthy digestion for women. They maintain gallbladder health (which helps prevent bloating), increase zonulin and mucin production which both help prevent leaky gut. Estradiol is needed for iron absorption – so women with iron deficiency often are low in estradiol. And hormones also play a big role in maintaining a healthy microbiome!
12. Increased autoimmunity, histamine, or immune reactions
How HRT Helps: Progesterone and estradiol directly regulate the immune system. Estradiol boosts immunity and progesterone keeps it in check and from getting too stimulated. When progesterone levels drop women notice increased histamine for example because progesterone regulates mast cells and prevents the over release of histamine.
Frequently Asked Questions
What Age Do Women Commonly Start HRT?
Traditionally women have been misinformed and told that they need to wait to start until they are menopausal (period stops). You can start before menopause. And not only can you start before your period stops, you should be thinking about it much much earlier. Women can consider starting as soon as they start experiencing symptoms to help prevent the symptoms of aging.
Meanwhile men’s health is a decade ahead and men over the age of 21 are offered testosterone when it is low. Women are recognizing that this starts young — sometimes in their 20s — and largely depends on environment, genetics, and due to birth control use.
If you are over the age of 21, you are a candidate to start hormone replacement therapy.
Once I start, do I have to stay on it forever?
Women often tell me that they are hesitant to even try HRT because they don’t want to “mess something up.” If you are having symptoms, then your hormones are already messed up! With HRT, we are enriching the hormones that you are no longer making on your own. It is the most natural supplement in this sense.
Hormones are about health maintenance — you take them to stay fit and healthy. You don’t just stop eating healthy, or brushing your teeth, or washing your face.
You will feel well and reap the benefits for as long as you decide to take them. It’s your choice if and when you stop.
I had a bad experience with birth control. Will this be the same?
Not at all! Bioidentical hormone replacement therapy (BHRT) works differently than birth control. Birth control pills are designed to suppress your natural hormone production to prevent ovulation, often leading to zero production of your natural hormones and unwanted side effects.
BHRT, on the other hand, is meant to restore and optimize hormone levels that your body naturally needs. Instead of shutting down hormone production, it replenishes declining levels of estrogen, progesterone, and testosterone in a way that mimics your body’s natural rhythms. This key difference is why many women who didn’t tolerate birth control well find BHRT to be a completely different and beneficial experience.
Your symptoms are not your imagination!
You know your body isn’t the same as it was five or ten years ago. You may be noticing subtle — or not-so-subtle — changes in your energy, mood, or overall well-being. Despite your best efforts with diet, exercise, and self-care, you might feel like you’re running in place, unable to regain the vitality you once had. What’s happening? The answer often lies in your hormones.
Hormones are the body’s master regulators, influencing everything from metabolism and mood to sleep and skin health. As they decline with age, they can lead to over 100 potential symptoms that impact both physical and emotional health. Some other symptoms women experience that aren’t listed above include dryness in the skin, eyes, ears, and vagina — leading to discomfort and increased susceptibility to irritation. Muscle aches and joint pain can become a daily struggle, making even routine movements feel stiff and tiresome. Hormonal imbalances can also contribute to headaches, dizziness, heart palpitations, and even arrhythmias.
These changes are not just “part of aging” that you have to accept. Understanding the role of hormones and how to restore balance can be a game-changer in reclaiming your vitality and well-being.
