The Last Hot Flash

Thoughts on Hormone Replacement Therapy

Here’s what I found out about myself last week (it’s huge:) there is no amount of cleansing or detoxing, no amount of green juice or salads, B complex, magnesium, exercise, water, or sleep that can create the estrogen and progesterone my body needs to feel normal. Last week I got myself on Hormone Replacement Therapy (HRT) and the change is already apparent.

For quite some time, even though I’ve felt ultimately strong and able, even though my blood work is amazing and my diet is super clean and I exercise and take exquisite care of myself…I have fought against a deep and cruel exhaustion that saturated every part of my life. (Think of yourself at your most exhausted and then imagine not recovering from it. ) While I would say fatigue was my main symptom I also had: serious brain fog, migraines, the feeling that I was drying out from head to toe, and eventually the good ol’ hot flashes.

As my readers know, several weeks ago I decided to try one more thing to combat these symptoms which was Chinese Herbs. If they didn’t work I decided I was going to consider HRT. After three weeks of drinking bitter, noxious herbs twice a day I unveiled this deeply profound insight: these herbs ain’t doin’ f-in shit.

After 2 days on HRT (estrogen patch and progesterone capsule) I woke up in the middle of the night with the distinct awareness that my brain chemistry had shifted. I can’t find the words to explain it other than saying a dark fog had lifted from behind my eyes and my heart felt open and happy. I felt free instead of put upon. I felt space. I wasn’t suffering from feeling strangely “hungover.” I felt like myself!

Here’s what I then accepted as truth and in no way my fault: No amount of detox or healthy lifestyle can “fix” the biological depletion of estrogen and progesterone.

But WHHHYYY???? Why do women have to suffer this awful hormonal challenge in middle age? ANSWER: women get cut off from these essential hormones because our endocrine systems have not biologically caught up to the fact that we are living longer. Back in the day, women died around the menopausal years, thus escaping the brutal decline of these hormones. In other words, women are not biologically programmed to live without female hormones. Nature did not plan it that way. Because of our modern advances we are living much longer than we used to. In other words, woman are outliving their hormones.

Check out the many reasons why women need their estrogen and progesterone beyond the childbearing years: (explained by Chat GPT):

• Bone Health: Estrogen helps to maintain bone density by promoting the activity of osteoblasts (cells that build bone) and inhibiting osteoclasts (cells that break down bone). This helps protect against osteoporosis.

• Cardiovascular Health: Estrogen has a protective effect on the heart and blood vessels, promoting healthy cholesterol levels, supporting blood flow, and maintaining vascular health.

• Skin Health: Estrogen helps maintain skin thickness, elasticity, and moisture. It's why skin often looks more youthful in premenopausal years.

• Mood and Mental Health: Estrogen influences serotonin levels, which is why fluctuating estrogen levels during menopause can contribute to mood swings, anxiety, and depression.

• Cognitive Function: Estrogen supports cognitive function, including memory, learning, and overall brain health. It’s one of the reasons why some women experience "brain fog" during perimenopause and menopause.

• Libido: Estrogen can improve sexual desire and arousal, which is why many women notice changes in libido during menopause when estrogen drops.

• Metabolism: Estrogen helps regulate fat distribution, so a drop in estrogen can contribute to weight gain, particularly around the abdomen.

• Sleep: Estrogen plays a role in regulating the body’s circadian rhythms, which affects sleep patterns.

Here’s why women need their progesterone:

• Mood Regulation: Progesterone has a calming effect on the nervous system. It can promote relaxation and reduce anxiety, which is why it’s sometimes referred to as a "feel-good" hormone.

• Bone Health: Like estrogen, progesterone also plays a role in bone health, although its influence is more about balancing estrogen’s effect on bone resorption (breakdown).

• Cervical Health: Progesterone influences the cervical mucus, making it thicker and more resistant to infections.

• Cognitive Health: Progesterone has a role in protecting the brain from neurodegenerative diseases and is thought to support brain function in ways similar to estrogen, though in a less direct way.

• Supports Sleep: Progesterone has a sedative effect, which can aid in better quality sleep.

• Immune System: Progesterone can help modulate immune responses, which is why fluctuations in progesterone can sometimes make the body more prone to certain inflammatory conditions.

I really appreciated this podcast by Dr. Mary Claire Haver (being interviewed by badass Dr. Andrew Huberman.) It touches on how fear-based narratives surrounding HRT have led to unnecessary suffering for many women experiencing menopausal symptoms (and also re-frames/de-bunks the cancer scare debate.)

I felt for many years that I could “detox” myself out of menopause symptoms- when in fact I simply just needed my amazing female hormones back! It’s a glorious thing to know my body isn’t failing me, I just needed to slap a patch on my ass.

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