A peer-reviewed study using PET imaging to reveal how estrogen receptor density evolves in menopausal brains—highlighting menopause as a neurological transition.

An evidence-based article outlining how estrogen decline contributes to joint pain, muscle loss, and osteoporosis in menopause.

Hormones regulate so many of the systems in your body. At times, it seems unclear exactly what each of them accomplishes, or why certain levels of particular hormones are floating around. This conversation comes up, especially around perimenopause, and even post-menopause, when specific hormone therapies can be utilized as treatments for bothersome menopause-related symptoms like hot flashes, low energy, and low libido. Estrogen is the most common hormone used in hormone replacement therapy, also known as menopausal replacement therapy, but what about testosterone? Yes, we’re talking about that hormone, the one that’s typically known as the “male” hormone. That’s right — testosterone is found in women’s bodies (at one-tenth of the amount in men’s bodies, but still) and any people born as female. Ovaries make testosterone and technically produce it at even higher levels than estrogen. And during menopause, when the ovaries slow down in their functioning, estrogen levels lower, as do testosterone levels in the body. Just like estrogen, testosterone can be safely used as a hormone replacement therapy during menopause. Still, not many people know that, because it’s not well-studied or officially FDA-approved for women. Keep on reading for everything you didn’t know about testosterone in women, testosterone replacement therapy, and how to know if it could be the right treatment for you.

A timely Substack essay challenging outdated age-based limits for HRT and advocating for a personalized approach to hormone health.

There’s no doubt that menopause can be tough, but support is out there. We asked Dr Naomi Potter, menopause specialist and co-author of the book Menopausing, for her expertise on navigating your body and mind through this transformative time.

Every year, about 1.3 million American women enter menopause—the stage of life when your estrogen levels diminish and your periods stop completely. It’s a natural part of aging and nothing to fear.

That said, the symptoms of menopause—including hot flushes, low sex drive, trouble sleeping, weight gain, UTIs and vaginal dryness, brain fog, heart palpitations, muscle and joint aches, and mood changes—can be miserable and debilitating. You also lose the health benefits of estrogen itself, like heart and brain protection, says Avrum Z. Bluming, MD, a hematologist and medical oncologist who has spent decades investigating the benefits of estrogen. Women can avoid many of these problems with one treatment: hormone replacement therapy, or HRT. Alternatively called MHT, for menopausal hormone therapy, HRT refers to the combination of estrogen and progesterone given to women who still have their uterus; estrogen alone is given to women who have had a hysterectomy.

Unfortunately, HRT remains controversial, due mostly to the results of the decades-old Women’s Health Initiative, the largest study done on the health of postmenopausal women in the United States. In 2002, findings from the WHI were released suggesting that women on HRT had greater risks of heart disease, stroke, dementia, and, scariest of all, breast cancer; as a result, millions of women of menopausal age either quit or avoided it at all costs. Subsequent studies have walked back these claims, but many women remain gun-shy about taking estrogen. The fallout has been enormous: Among menopausal women in the United States, just under 5 percent are currently on HRT, and it’s been estimated that between 2002 and 2012, over 90,000 American women died prematurely, mainly from heart disease, as a result of avoiding HRT.