What I’ve learned about hormone therapy

5 years navigating the great divide

Photo by Arthur A on Unsplash

Five years ago, I launched Hotflash inc with a single newsletter. I was scared to even say the word menopause to the 200 people I asked to be on my initial list,, let alone ‘hormone therapy’. But I knew the information out there wasn’t good enough. It wasn’t clear, it wasn’t balanced — and it definitely wasn’t helping.

Since then, I’ve interviewed more than 150 experts, heard from thousands of women, reviewed so many studies, all while experiencing and struggling with it firsthand.

And after all that, here’s what I’ve learned about hormone therapy.

1. Hormone therapy is not the answer, but it can be an important one

For some women, hormone therapy is life-changing. When I met UAE changemaker Shelley Frost – a harpist and founder of The Fridge Entertainment – a few months ago, she told me it was “like flicking a switch.” She went from sleepless and overwhelmed to her old self.

“In less than 24 hours, I was 100% back,” she said. “Literally. And it’s remained that way ever since.”

But others – like women I hear from every week – feel worse on it, even in small doses.

“I’m constantly chasing the supplement fix and MHT makes me feel awful, even in the smallest doses. But I keep trying because everyone says I’m going to die without it.” – @staceyyoi on Instagram

You can feel better on hormone therapy. You can also feel worse. The pressure to conform either way is real — and unhelpful.

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2. The confusion is real – even among doctors

Many women don’t know the difference between progesterone and progestin — and to be honest, a lot of doctors don’t either. I’ve seen medical professionals use the terms interchangeably, despite the fact that progestin is a synthetic hormone with very different risk factors, and not all of the benefits. Sleep and mood, for example.

I clocked this difference early on in Hotflash inc, along with the fact that some of the doctors I was interviewing seemed not to know about or rate the difference.

If this is new to you, that’s not your fault. The system is unclear by design.

3. The extremes are loud — but most of us are in the middle

There are doctors and other practitioners online shouting – and sometimes rapping – that estrogen is the key to preventing every disease. There are others who warn against even touching a flaxseed.

I’ve mapped it out. It goes from the people who prescribe physiologic levels that will have you bleeding until you die all the way to accounts like @estrogenfree, warning you off chickpeas because they are phytoestrogens – and phytoestrogens are bad (somewhere in the middle is menopause nutritionist and naturopath Jenn Salib-Huber, who recommends them to naturally boost estrogen). Then there’s Lara Briden, with her “light fairy dusting of estrogen”, reminding us progesterone is often the more helpful tool in perimenopause.

We’ve got a pretty cool crowd here at Hotflash inc. People who are on hormone therapy who are open-minded, and people who tried it and can’t deal with it. And everything in between. That’s the middle. And that’s who I’m here for.

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"Menopause is not an accident of living too long. It’s something we evolved to do."

– Dr. Lara Briden, naturopathic doctor and author of Hormone Repair Manual, speaking on Hotflash Inc podcast, Episode 167: Hormones, GLP-1s, shrinkage and supplement breaks – Dr. Lara Briden unpacks what really matters in midlife

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4. There’s too much pressure to do this perfectly

There’s a weird undertone to a lot of menopause content that doesn’t embrace hormone therapy. If you’re still tired, still not sleeping, still gaining weight — it must be because you’re not trying hard enough. You haven’t “gotten it together”.

On one hand, a carrot salad’s not going to change your life. Women can’t just go for a walk when they’re carrying trauma, caring for everyone, and still expected to perform, and just be all better.

And on the other, hormone therapy can help, but it’s not a replacement for support, healing, rest, self-acceptance and care.

5. Most of what we hear is marketing

There’s a script being pushed. I’ve seen the exact same language used by different doctors in different videos. I’ve seen it happen in crypto, too.

This is not an accident. Messaging like ‘compounded hormones are a scam’ or ‘natural is a weapon to keep women in their place’ — messaging that multiple doctors have delivered in Instagram posts – that’s not coming from them. It’s coming from PR.

Follow the messaging and you’ll usually find the money.

Watermelon is my favorite. And their protein powder is fire. Check it out here.

6. We need better tools to decide for ourselves

The real problem? Most women don’t know where to start. They’re overwhelmed, under-informed and being pushed by fear on both sides.

That’s why I’m building a tool — something simple, honest, and grounded in what I’ve learned over five years. A guide to help you figure out hormone therapy for you, without the noise.

It’ll be available first to VIPs of the Hotflash Inc Summit this September (Great news: Hotflash inc Pro members – current and those who sign up between now and September 15 –will automatically get VIP access, and hence the tool!) I’ll release it later to everyone.

I’ll be keeping you posted on how to get access either way.

If there’s one thing I know for sure:

There’s no single right way to do this. There are too many women killing it not on hormone therapy for that to be true; a long line of successful, happy, healthy old ladies.

The people who impress me the most? They don’t sit on stage with Oprah Winfrey, echo-chambering. They’re the ones who understand this important piece of common sense.

If you’re in the middle – cautious, curious, tired of being pushed by those who would scare you – you’re not alone. And I’ve got a lot more coming for you.

Thanks for being here.

AMx

Hotflash inc is for educational purposes only and not to be used as or considered medical advice.

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