Midlife Solutions with Karen Martel

First, Let’s Talk Menopause & Why HRT Matters

Menopause usually happens between ages 45 and 55, when your ovaries dramatically scale back estrogen and progesterone production. That drop is what triggers hot flashes, night sweats, mood changes, vaginal dryness, sleep issues, and a sharp uptick in your risk for osteoporosis and heart disease.

HRT replenishes those missing hormones—often transforming your day-to-day life while also protecting your bones, heart, and brain.

Best Practices for Starting HRT

1. Timing is Everything
Start within 10 years of menopause or before age 60 for the biggest benefits and lowest risks. Even better, start HRT in peri menopause! Early initiation not only eases symptoms, helps avoid the weight gain and other metabolic issues but also supports heart and bone health.

2. Make It Personal
No two women are the same. Your age, time since menopause, symptoms, medical history, and even whether you still have your uterus all play a role in what’s best for you. You deserve an honest conversation about benefits (relief from misery!) and risks.

3. Choose the Right Type & Dose

• No uterus? Estrogen alone is NOT okay. Many physicians will tell you "No uterus no need for progesterone." This is bad advice and find another practitioner that knows the many benefits of bio identical prosgterone. Progesterone is excellent for mood, sleep, brain, bones and heart. 
  

• Uterus intact? You’ll still need estrogen + progesterone. 
  

• More bad advice that is still circulating out there is "Go with the lowest effective dose that gets the job done." WRONG! Studies show in order to get the brain, bone and heart protection of hormones you need physiologic dosing. You want to work with a hormone specialist that knows this and makes sure you get proper amounts of HRT. 
  

• Always choose a transdermal patch, gel, or cream when it comes to estrogen—they have a no increased clot risk unlike oral estrogen.
  

4. Pick the Right Regimen

• Cycling: Cycling progesterone is best and mimics the natural hormone production in a woman's body. Estradiol and Testosterone can be taken daily. 
  

• Continuous combined: Estrogen, progesterone and testosterone daily. 
  

5. Keep Checking In
You don’t “set it and forget it.” Schedule follow-ups to make sure your symptoms are improving, side effects are minimal, and your screenings (breast exams, blood pressure, gynecologic exams) are up to date.

6. Special Situations
If menopause came early (before 45—or especially before 40), HRT is strongly encouraged. If you decide to stop later, know that about half of women see symptoms return, whether they quit suddenly or taper off.

7. Pair It with Lifestyle Care
HRT is powerful, but it’s not magic. You’ll get the best results if you also:

• Exercise regularly including lifting heavy
  

• Eat nutrient-rich foods
  

• Quit smoking
  

• Consider non-hormonal tools if HRT isn’t an option for you
  

The Bottom Line

HRT can be a game-changer—but only when it’s tailored to you. Start early, use the optimal doses, follow up regularly, and never be afraid to ask questions. You deserve to feel like yourself again—and to protect your health for decades to come.