What Are the Signs You Need Hormone Replacement Therapy?

The comment I hear over and over again from women in perimenopause or menopause is: “I don’t feel like myself anymore. “They go on to say: “I am doing the same things and yet nothing works. Weight is building up in my middle despite eating healthy and exercising. I am tired, moody, can sleep and when I go to a healthcare provider they tell me I am normal, stressed or just getting old.”

Does this sound familiar? . These changes can be frustrating, confusing, and downright overwhelming. The good news is, you’re not alone, and there’s something you can do about it: Hormone Replacement Therapy (HRT).

While there are no specific tests to tell if you are in perimenopause and the definition of menopause is one year without a period, these symptoms are characteristic and can indicate that perimenopause or menopause could be the cause.

Persistent Fatigue and Low Energy Levels

Let’s start with the constant tiredness. Do you wake up every morning even if you slept well? Do you push through your day, fueled by coffee and sheer willpower, only to collapse into bed exhausted and then repeat the cycle? This unrelenting fatigue can be a sign that your hormones are out of balance. Hormones like estrogen and progesterone are crucial for regulating your energy levels, and when they drop or fluctuate, you can feel perpetually drained.1

Mood Swings and Depression

Have you found yourself on an emotional rollercoaster lately? One minute you’re fine, and the next, you’re snapping at loved ones or fighting back tears. Or maybe you’re struggling with a pervasive sense of sadness or anxiety that you just can’t shake. These emotional ups and downs can be a direct result of hormonal changes. Estrogen plays a key role in mood regulation by influencing the production of serotonin, the “feel-good” neurotransmitter. When estrogen levels fall or fluctuate, your mood can take a hit.2,3 Estrogen, progesterone, testosterone, cortisol and thyroid hormones all play a role in mood. They are interconnected and affect each other. When one is off, it can affect the others.

Weight Gain and Difficulty Losing Weight

It’s not just about the number on the scale; it’s about how you feel in your own skin. Are you noticing that your clothes don’t fit the way they used to? Despite eating well and exercising, is the weight—especially around your belly—just not budging? Hormonal imbalances can slow your metabolism and make it incredibly difficult to lose weight. It’s not your fault; your body’s chemistry is changing.4 Lack of estrogen makes you insulin resistant and can cause your body to store fat along the waistline.

Hot Flashes and Night Sweats

Hot flashes and night sweats are more than just uncomfortable—they can be downright disruptive. Imagine going through your day, suddenly feeling like you’re on fire from the inside out or waking up drenched in sweat. These episodes can leave you feeling embarrassed and exhausted. They’re caused by fluctuating estrogen levels, and HRT can help bring those levels back into balance, reducing the frequency and severity of these symptoms.5 Hot flashes are like your check engine light indicating that you have something else going on. They are associated with an increased risk of cardiovascular disease, dementia, osteoporosis and/or inflammation.

Sleep Disturbances

Are you finding it difficult to fall asleep or stay asleep?? Hormonal changes can wreak havoc on your sleep patterns, leading to insomnia or frequent waking. Without restorative sleep, everything else in life feels harder. You might find yourself more irritable, less focused, and constantly fatigued. Progesterone is a calming hormone that acts on the GABA receptors in the brain to calm your nervous system. Patients say they get the best sleep of their life! HRT can help you get the restful sleep your body desperately needs because estrogen and progesterone are required for good sleep.6

Decreased Libido and Sexual Dysfunction

Intimacy is an important part of life, and changes in your sexual health can be distressing. If you’ve noticed a decrease in your libido or experience discomfort during intercourse, it might be due to declining estrogen levels. Hormones like estrogen and testosterone are vital for maintaining sexual health, and HRT can help restore your desire and comfort, making intimacy enjoyable again.7 Both enhance libido and testosterone can boost orgasm.

Cognitive Issues and Brain Fog

Have you ever walked into a room and forgotten why you were there? Or struggled to concentrate on tasks that used to be easy? This “brain fog” can be another sign of hormonal imbalance. Estradiol is like fuel for the brain. It powers neurons, boosts memory circuits, and protects against inflammation. When estrogen levels fall, the brain temporarily runs on “low power mode.” Without that fuel, memory, attention, and language skills can dip—even if test scores remain technically normal. HRT can help clear the fog and improve your mental clarity if started early.2

Bone Density Loss

Your bones need estrogen to stay strong. As estrogen and progesterone levels decline, your risk for osteoporosis increases. In fact about 20% of bone loss occurs in perimenopause when estrogen levels are high, but progesterone is low. If you’ve had a bone density test showing significant bone loss or have a family history of osteoporosis, HRT can help maintain your bone density and reduce your risk of fractures.8

Changes in Skin and Hair

Are you noticing that your skin is drier, or your hair is thinning? These changes can feel like a loss of your youthful self. Estrogen helps maintain skin elasticity and hair health. With HRT, you can help restore the vitality of your skin and hair, bringing back some of that youthful glow.9

If you’re experiencing these symptoms, you don’t have to accept them as your new normal. Bioidentical Hormone Replacement Therapy might be the solution you need to get back to feeling like yourself again. Don’t wait until these symptoms impact every aspect of your life—take action now. Consult with a healthcare provider about whether HRT is right. Apply for a no obligation clarity call to if you are in NY, NJ, PA or FL. We can both determine if we are a good fit.

Still on the fence? You can take the course Are Hormones Right for You? You can gain the knowledge, courage and confidence to age gracefully and decide based on the studies provided in the course.

You deserve to live vibrantly, without the constant struggle. Remember, it’s not just about surviving menopause; it’s about thriving through it.

References

1. Chiu HH, Tsao LI, Liu CY, Lu YY, Shih WM, Wang PH. The Perimenopausal Fatigue Self-Management Scale Is Suitable for Evaluating Perimenopausal Taiwanese Women’s Vulnerability to Fatigue Syndrome. Healthcare. 2021;9(3):336. doi:10.3390/healthcare9030336
2. Weber MT, Maki PM, McDermott MP. Cognition and mood in perimenopause: a systematic review and meta-analysis. J Steroid Biochem Mol Biol. 2014;142:90-98. doi:10.1016/j.jsbmb.2013.06.001
3. Stute P, Spyropoulou A, Karageorgiou V, et al. Management of depressive symptoms in peri- and postmenopausal women: EMAS position statement. Maturitas. 2020;131:91-101. doi:10.1016/j.maturitas.2019.11.002
4. Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga PL. Weight Gain at the Time of Menopause. Arch Intern Med. 1991;151(1):97-102. doi:10.1001/archinte.1991.00400010111016
5. Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531-539. doi:10.1001/jamainternmed.2014.8063
6. Kravitz HM, Zhao X, Bromberger JT, et al. Sleep disturbance during the menopausal transition in a multi-ethnic community sample of women. Sleep. 2008;31(7):979-990.
7. Khani S, Azizi M, Elyasi F, Kamali M, Moosazadeh M. The Prevalence of Sexual Dysfunction in the Different Menopausal Stages: A Systematic Review and Meta-Analysis. Int J Sex Health Off J World Assoc Sex Health. 2021;33(3):439-472. doi:10.1080/19317611.2021.1926039
8. El Khoudary SR, Greendale G, Crawford SL, et al. The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause N Y N. 2019;26(10):1213-1227. doi:10.1097/GME.0000000000001424
9. Zouboulis CC, Blume-Peytavi U, Kosmadaki M, et al. Skin, hair and beyond: the impact of menopause. Climacteric J Int Menopause Soc. 2022;25(5):434-442. doi:10.1080/13697137.2022.2050206