
Navigating Menopause: Optimizing Hormones and Understanding HRT
Menopause—a natural yet often bumpy transition in a woman's life—marks the end of reproductive years. While it’s a normal biological process, the hormonal shifts that come with it can feel anything but normal. Hot flashes, mood swings, brain fog, weight gain, sleep struggles—sound familiar? If so, you’re not alone. The good news? Understanding these changes and exploring hormone optimization and Hormone Replacement Therapy (HRT) can make a world of difference in how you navigate this transition.
Understanding Menopause and Perimenopause
Menopause is officially diagnosed when a woman has gone 12 consecutive months without a menstrual period. This typically happens between the ages of 45 and 55, with the average age being 51 in the U.S. However, the rollercoaster leading up to menopause—perimenopause—can begin years earlier, sometimes even in the late 30s or early 40s. During this phase, estrogen and progesterone levels fluctuate wildly, creating symptoms that range from annoying to downright debilitating.
Common perimenopause symptoms include:
-
Irregular periods
-
Night sweats and hot flashes
-
Mood swings, anxiety, and depression
-
Brain fog and memory issues
-
Sleep disturbances
-
Weight gain and increased belly fat
-
Vaginal dryness and reduced libido
If any of these sound familiar, don’t worry—you’re not going crazy! These are all signs of shifting hormones, and there are solutions to help you regain balance and feel like yourself again.
Not-So-Common Symptoms to Look Out For
While hot flashes and mood swings get most of the attention, there are plenty of other symptoms linked to hormonal imbalances during menopause that often go unnoticed. Here are some lesser-known signs that your hormones may be out of whack:
-
Itchy Ears: A surprising yet common symptom of estrogen decline that can cause irritation and dryness in the ear canals.
-
Sore Joints & Low Back Pain: Estrogen plays a role in reducing inflammation, so as levels drop, you may experience more joint pain and stiffness.
-
Dry Skin, Wrinkles & Age Spots: Collagen production slows down with declining estrogen, leading to increased skin dryness and signs of aging.
-
High LDL Cholesterol & Blood Sugar Deregulation: Hormonal changes can negatively impact heart health and insulin sensitivity, increasing the risk of metabolic issues.
-
Increased Hunger & Cravings: Fluctuations in estrogen and progesterone can mess with appetite regulation, leading to intense cravings and increased hunger.
-
Insomnia & Poor Sleep Quality: Lower progesterone levels can make it harder to fall and stay asleep, leading to fatigue and brain fog.
-
Urinary Tract Infections (UTIs) & Yeast Infections: Estrogen is crucial for maintaining vaginal and urinary tract health, and its decline can lead to increased infections.
-
Fatigue & Low Energy: Many women report persistent fatigue, even with adequate rest, due to shifting hormones affecting mitochondrial function.
-
Emotional Rollercoaster: Sudden mood swings, irritability, and even bouts of depression or anxiety can hit hard during this transition.
If you’re experiencing any of these symptoms, know that you’re not alone—and more importantly, that solutions exist to help you feel better.
The Role of Hormones in Menopause
Hormones are your body’s messengers, influencing everything from metabolism to mood. During menopause, the ovaries slow down production of key hormones—primarily estrogen and progesterone—leading to symptoms that can impact your quality of life.
-
Estrogen: Helps regulate body temperature, supports brain function, maintains bone density, and keeps skin, hair, and vaginal tissues healthy.
-
Progesterone: Works as a calming hormone, supporting sleep and mood stability. It also helps counterbalance estrogen’s effects.
-
Testosterone: Often overlooked in women, testosterone supports energy, libido, muscle tone, and motivation.
When these hormones decline, it’s no wonder we experience a host of frustrating symptoms. But here’s the good news: hormone optimization and HRT can help restore balance.
Hormone Replacement Therapy (HRT): What You Need to Know
HRT is one of the most effective ways to relieve menopausal symptoms and improve overall well-being. But thanks to outdated research and myths, many women hesitate to explore it. Let’s clear up the confusion.
Types of HRT
-
Bioidentical HRT (bHRT) – Derived from plant sources, bioidentical hormones are structurally identical to those produced by your body. They come in various forms, including creams, gels, patches, and pellets. Many women prefer bioidenticals because they tend to be well-tolerated and can be customized to individual needs.
-
Synthetic HRT – These are lab-created hormones that differ slightly from the hormones naturally produced in your body. While they can be effective, they may not be as easily metabolized and can carry more side effects.
Benefits of HRT
-
Reduces hot flashes and night sweats
-
Improves sleep quality
-
Enhances mood and cognitive function
-
Helps maintain bone density
-
Supports heart health
-
Improves vaginal dryness and libido
Is HRT Safe?
This is one of the biggest concerns women have, and understandably so. The fear stems from the 2002 Women’s Health Initiative (WHI) study, which linked HRT to an increased risk of breast cancer, heart disease, and stroke. However, newer research has debunked many of those findings, showing that HRT is not only safe for most women but can actually offer protective benefits when started at the right time (typically within 10 years of menopause).
Of course, HRT isn’t a one-size-fits-all approach. The key is working with a knowledgeable provider to determine the right type, dosage, and delivery method for your unique needs.
Optimizing Hormones Naturally
If HRT isn’t the right fit for you or you’re looking for additional ways to support your hormones, lifestyle and nutrition play a massive role. Here are some top strategies to optimize your hormones naturally:
-
Prioritize Protein & Healthy Fats: Support hormone production with nutrient-dense foods like grass-fed meats, wild-caught fish, avocados, and olive oil.
-
Balance Blood Sugar: Stabilize energy and mood by reducing sugar and processed carbs while increasing fiber-rich foods.
-
Manage Stress: Chronic stress depletes hormones. Practice deep breathing, meditation, or gentle movement like yoga.
-
Strength Train: Resistance training helps maintain muscle mass and boosts metabolism, both of which decline with age.
-
Get Quality Sleep: Poor sleep worsens hormonal imbalances. Support deep sleep with magnesium, melatonin, and good sleep hygiene.
-
Support Gut Health: A healthy gut microbiome aids hormone metabolism. Load up on probiotics, fermented foods, and fiber.
The Bottom Line
Menopause isn’t something you just have to suffer through. Understanding what’s happening in your body and taking proactive steps—whether through HRT, nutrition, lifestyle changes, or a combination—can make this transition smoother, healthier, and even empowering.
Want to learn more about how to optimize your hormones and regain control of your health? Join me inside Midlife Solutions, where we dive deep into personalized strategies for thriving in perimenopause and beyond!
Your next step?
Drop a comment below or book a consultation to find out what’s right for you!
References:
-
National Institute on Aging. (2020). What Is Menopause? https://www.nia.nih.gov/health/what-menopause
-
Mayo Clinic. (2023). Hot flashes. https://www.mayoclinic.org/diseases-conditions/hot-flashes/symptoms-causes/syc-20350917
-
Harvard Medical School. (2021). Perimenopause: Rocky road to menopause. https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause
-
The North American Menopause Society (NAMS). (2024). Menopause Symptoms. https://www.menopause.org/for-women/menopauseflashes
-
National Osteoporosis Foundation. (n.d.). Bone Health and Menopause.
-
WebMD. (n.d.). Menopause and Diet. https://www.webmd.com/menopause/guide/menopause-diet
-
Mayo Clinic. (2024). Exercise during menopause: Why it matters. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/exercise-during-menopause/art-20045722

Find Karen Martel on Apply Podcast
Karen Martel is a Certified Hormone Specialist and Transformational Nutrition Coach dedicated to empowering women through their health journeys.
As the host of the popular podcast The Hormone Solution, Karen tackles the complexities of hormonal health, weight loss resistance, and the challenges that come with perimenopause and menopause.
Her mission is to disrupt outdated narratives surrounding women's health, providing reliable information and practical solutions that help women reclaim their vitality. With personal experience overcoming her own health struggles, Karen offers insights into hormone optimization and sustainable weight management strategies.
Join her as she engages in enlightening conversations with experts and shares actionable advice, all aimed at helping women navigate their unique hormonal landscapes with confidence and clarity. Tune in to discover how to embrace life's stages while enhancing overall well-being.