Most longevity conversations are written for men. At The Livelong Woman, this one’s for us. This week: my personal Hormone Replacement Therapy (HRT) story and what the latest science reveals about hormone therapy as a longevity tool.
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Let’s Get Personal
What My Perimenopause Symptoms Taught Me About Women’s Longevity Health
A year and a half ago, I thought my body was falling apart. I got my period once every 17 days for three months, and then not at all for nearly two months. I had heart palpitations, anxiety spikes, fatigue, and even sound sensitivity. My symptoms were all over the place, and kept getting weirder. After endless tests, doctors said I was “fine.” But I knew something was off.
Fortunately, I regularly see an endocrinologist for hypothyroidism, which I developed the last time my hormones went haywire (hey, thanks, pregnancy), and she also treats women’s hormonal health. So I asked about my new symptoms.
I quickly learned these symptoms were all classic signs of perimenopause (which, BTW, can start as early as your 30s or as late as your 50s). And while I had of course heard of hot flashes, I hadn’t expected just how many other symptoms there could be.
With the help of my endocrinologist, I decided to try hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT).
I was able to choose bioidentical HRT, which was my preference because it mirrors the body’s natural hormones as it’s made from plant-derived compounds that match what our bodies already produce. My current regimen is a 0.05mg estradiol patch twice weekly, plus 200mg oral progesterone for 12 days each month. (Side note: There are so many options out there–pills, IUD, gels, patches. It’s important to talk to an expert about what is right for you.)
👉🏼Tip: If your primary care doctor or OB/GYN isn’t helpful, look for an endocrinologist who specializes in women’s hormonal health.
Nearly a year in, I feel more like myself. My sleep is deeper (thank you for the 411, Oura ring) and my energy is back to baseline (keep in mind though, my baseline is a working mother of three school-aged kids, not what it was in my 20s). My anxiety is steadier, and my cycle has normalized. The biggest downside for me is progesterone’s knockout effect—the hormone makes me drowsy fast. And to be honest, that isn’t always a downside.
These pieces all play a role in my longevity plan. I need energy to exercise and eat well, my mental health is more manageable without anxiety spikes, and I want to be around people more often now that I feel more like myself.
My biggest takeaway from this experience? We don’t have to just “push through” feeling off or hide away from the world. With the right information, we can find a new, better normal. 💜
HRT is a tool, not a cure-all.
We should always balance lifestyle supports alongside HRT. Ahem, I’m talking about sleep, fitness, diet, and stress management.
Poll
What is your experience with Hormone Replacement Therapy?
Hormones And Health
Is Hormone Therapy The Longevity Tool Too Few Women Are Using?
Over the past two decades, there was a striking decline in hormone therapy use for women’s health, dropping from nearly 27% to just under 5% from 1999 to 2020.
The why.
This drop is often attributed to the widely publicized initial results of the 2002 Women’s Health Initiative that suggested a link between hormone therapy and higher risks of breast cancer and heart disease.
Those early results didn’t tell the full story, but millions of women stopped treatment overnight, and doctors grew wary of prescribing it.
The problem.
Much of the initial fear traces back to how the WHI findings were communicated. The original participants were, on average, older (often a decade past menopause) when they began therapy, and that timing matters.
Unfortunately, many physicians trained during the post-WHI backlash haven’t revisited the updated data. (Only about 7% of OB-GYN, internal-medicine, and family-medicine residents report feeling competent to treat menopausal women.)
Add short appointment times and lingering misconceptions, and women are left managing symptoms alone.
What we
now know.
A deeper analysis of that same WHI study, and numerous follow-up studies, has shown a lower absolute risk and a better benefit-risk profile when hormone therapy starts in women under 60 or within 10 years of menopause, personalized to their health history.
Newer evidence shows that for many women in midlife, HRT is not only safe but can also protect bone health, reduce hot flashes and night sweats, improve sleep, and even support cardiovascular function.
Like most things in healthcare, this decline has disproportionately affected Black and Hispanic/Latina women, even though these groups report more severe and disruptive vasomotor symptoms than non-Hispanic white women. These gaps aren’t accidental. For decades, women of color, particularly Black and Latina women, have been underrepresented in menopause research and under-diagnosed in care.
The good news.
Experts are rethinking hormone therapy as more than symptom relief. When used appropriately, HRT can be a preventive tool for long-term health—helping safeguard the systems most affected by estrogen loss: the heart, brain, and bones.
Considering discussing HRT with your healthcare provider?
Consider these tips.
Bring a list of your symptoms, including when they began, their severity, and how much they affect your daily life.
Ask your provider to clarify which form of HRT they recommend, the dose, route (patch vs. oral vs. topical), and duration.
Evaluate your personal risk factors: family history of breast or heart disease, clotting issues, stroke, etc.
Monitor and re-assess: once you start (if you do), check in regularly to see how symptoms respond and monitor side effects.
The Watchlist
What’s on our radar
Estrogen and Aging: What Every Woman Should Know
Dr. Lisa Mosconi, neuroscientist and author of The XX Brain, breaks down the role of estrogen in brain health, cardiovascular resilience, and bone density, and why menopause management is central to healthy longevity.
The Longevity Blueprint for Women: Sleep, Stress, and Cellular Health
On the Ageless Future podcast, Dr. Sandra Kaufmann discusses how women can use sleep optimization, stress reduction, and mitochondrial support to slow biological aging and improve energy across decades.
How I'm Helping Women Feel Empowered During Menopause and Beyond
This personal narrative by Lorrie King explores her menopause journey, including the lesser-discussed aspects like skin and hormonal health.
P.S. Know someone who’s curious about hormone therapy or feeling off lately? Forward this issue. It might help them start their own conversation toward a healthier, longer life.
The information provided about wellness and health is for general informational and educational purposes only. We are not licensed medical professionals, and the content here should not be considered medical advice. Talk to a doctor before trying any of these suggestions.