Menopause Talks
Could Hormones Be Part of What You’re Missing?
What if the changes you’ve been trying to manage for years have more to do with menopause than you realized?
Maybe it’s anxiety that seems to have appeared out of nowhere. Maybe you’re waking up at 2 or 3 a.m. and can’t get back to sleep. Your concentration isn’t what it used to be. Your mood has changed. Or you simply don’t feel quite like yourself anymore.
And when you ask about it, you’re told your labs are normal or that these changes are simply part of getting older.
But sometimes, there is a bigger conversation worth having.
When Anxiety Starts Changing Your Life
A 61-year-old woman recently came to me with a question I think many women can relate to: Could hormones help me?
She had undergone a hysterectomy about 20 years earlier because of fibroids and endometriosis. She had not used systemic hormone therapy and had been told that hormones caused cancer. A few years ago, she had been prescribed vaginal estradiol, but her larger health picture had never really been explored through the lens of hormones and menopause.
In recent years, her anxiety had become severe.
She found herself repeatedly checking the doors and stove before leaving the house. What might have once been a simple part of getting ready to go somewhere had become a source of worry. It was affecting her freedom, her relationships, and her everyday life.
Naturally, she wanted to know: Could hormones be part of the reason I feel this way?
It’s an important question. But it’s also one that deserves a thoughtful answer.
Menopause Is About More Than Hot Flashes
One of the biggest misconceptions I see is that menopause is primarily about periods and hot flashes.
It isn’t.
Estrogen receptors are found throughout the body, including in the brain. Changes in estrogen can interact with systems involved in mood, sleep, cognition, temperature regulation, and emotional regulation.
That doesn’t mean every symptom a woman experiences in midlife is caused by hormones.
But it does mean we shouldn’t automatically dismiss changes in anxiety, sleep, mood, or concentration as simply “getting older.”
For some women, hormonal changes may be one piece of a much bigger picture.
A Hysterectomy Doesn’t Always Mean the Same Thing
There is another important detail many women don’t realize.
Having a hysterectomy does not necessarily mean the ovaries were removed. If the ovaries remain, they may continue producing hormones until menopause occurs naturally.
If the ovaries are removed during surgery, however, estrogen levels can fall much more abruptly. This can create a very different experience from the gradual hormonal transition that happens with natural menopause.
That’s why when I talk with a woman who has had a hysterectomy, I want to understand exactly what happened, not simply see the word “hysterectomy” in her medical history.
Her age, symptoms, surgical history, and overall health all matter.
So, Could Hormones Help?
Maybe.
And that’s exactly why I don’t believe this should be reduced to a simple yes-or-no answer.
Hormone therapy can be an important option for some women, but it isn’t appropriate for every woman or every situation.
A woman who is 61 and has been menopausal for many years is having a different conversation from a woman in her early 50s who is just entering menopause.
When I evaluate whether hormone therapy may make sense, I want to understand the whole woman: her cardiovascular health, blood pressure, cholesterol, bone health, personal and family history, medications, lifestyle, symptoms, and how long she has been without ovarian hormones.
The goal isn’t simply to ask, “Can we give her hormones?”
The better question is:
“What does this particular woman need, and where might hormones fit into her care?”
Don’t Let Fear Make the Decision
For years, many women were told that hormone therapy was dangerous. I understand why that created fear.
But fear shouldn’t be the only thing driving a woman’s decision, and neither should excitement about newer conversations around hormone therapy.
Hormone therapy isn’t a magic fix.
It isn’t a Band-Aid.
And it isn’t something I believe should be started and forgotten.
Even when hormones are appropriate, I want to know how a woman is responding, whether her symptoms are changing, what else is happening with her health, and whether the treatment continues to make sense for her.
More hormones don’t necessarily mean better care.
What Can You Do If You’re Experiencing These Changes?
Before your next appointment, start paying attention to your patterns.
Write down when your symptoms started and what has changed. Track your sleep, anxiety, mood, energy, concentration, hot flashes or night sweats, appetite, and other symptoms that seem different.
Also make a list of your medications and supplements and review your personal and family health history.
If you’ve had a hysterectomy, find out whether your ovaries were removed. That detail can be important when discussing your menopause history.
And don’t overlook the basics that support health at every stage of life: regular movement, strength training, nutritious meals, adequate protein and fiber, consistent sleep habits, stress management, and limiting excess alcohol.
If anxiety has become severe or is interfering with your daily life, it deserves attention in its own right. Hormones may be one consideration, but they shouldn’t be assumed to be the only one.
You Deserve a Bigger Conversation
You don’t have to choose between being terrified of hormones and taking them without careful consideration.
There is another option: understanding your own health well enough to make an informed decision.
If you’re in your 40s, 50s, or 60s and you’re noticing changes in your mood, sleep, energy, memory, weight, or overall well-being, don’t assume you simply have to live with them.
And don’t assume one hormone level can explain everything, either.
After more than 20 years of caring for women, I’ve learned that good menopause care starts by looking at the woman—not just the symptom, not just the lab result, and certainly not just one hormone.
Your health history matters. Your concerns matter. Your goals for the next 20 years matter.
And sometimes, the most important first step is simply having a deeper conversation.
Want a clearer understanding of the changes that can happen during perimenopause and menopause?
📘Download my Free Perimenopause Power Guide for practical information you can use to better understand your symptoms and prepare for a more informed conversation about your health.
Ready for a Deeper Conversation?
📅If you’re ready to look beyond individual symptoms and explore your health history, concerns, and options more personally, I invite you to schedule a Free Discovery Call.
Let’s look beyond the symptoms and take the time to understand the whole woman because your health deserves more than a one-size-fits-all answer.
