Should Every Woman Be on Hormone Therapy?
How a hormone therapy trial revealed why one size never fits all.
🧠 Inside the Playbook: September Edition
Welcome to My Health & Fitness Playbook - a private log of what I’m testing, noticing, and learning in real time. This is my space to document the shifts no one prepares you for, and the protocols I’m using to stay grounded, sharp, and fully present in midlife.
If you are reading this, you are part of the most engaged corner of this community and I’m deeply grateful to share this space with you.
Last month I promised I’d share what happened when I finally tried hormone therapy for myself.
It wasn’t the first hot flush. It was the first of a cluster that day. I was in the boardroom presenting slides I’d spent days preparing when suddenly my body turned into a furnace. In what felt like seconds, my back damp with sweat and my forehead was on fire. I sat still, counting the seconds, a sitting duck in heels.
By the next morning after losing the battle to insomnia, I’d had enough.
I had a bottle of prescribed transdermal Estrogel sitting in my bathroom cabinet. I pressed a small pump onto my fingertips, smoothed it across my outer arms, watched it dry and thought: “This will fix me.”
But within minutes, my body had other plans.
Why this post is behind the paywall
Most of my writing is free, because I believe knowledge especially about the business of women’s health should be shared widely. But this series - My Health & Fitness Playbook - is different.
It’s deeply personal. I’m sharing what I’m actually trying in my own body: the shifts I’m noticing, what I’m experimenting with, and what I’m tracking in real time. That kind of honesty requires a more intentional space.
And it’s built for trust, not scale. It’s a living record of what it means to stay sharp, grounded, and clear through a high-functioning midlife and that’s something I want to share with the most engaged part of this community.
If you’re not ready to upgrade, no pressure. The rest of my writing will always be free. But if this work resonates and helps you feel more seen in your own journey, thank you for supporting it.
First, a note: Hormone therapy is a lifeline for many women, and for some it works beautifully. I just happen to be one of the women where it didn’t work out, at least not yet. And because there are many who cannot or will not use hormone therapy, I wanted to share not just my reaction but also what I uncovered and where I’ve turned my focus now.
The Estrogel hit me almost immediately. My nerve endings started tingling. One side of my face throbbed, even the touch of my own fingers felt like an electric shock. Then came the migraine, which lasted at least twelve hours before migrating into my shoulders and upper back. For a week, the same pattern repeated each time I applied the gel.
It rattled me. I had expected relief, not another layer of symptoms.
I’d gone in thinking hormones worked like topping up a tank: low means symptoms, add more and you’re fine. But biology doesn’t behave that neatly. Hormones don’t sit still. They move through pathways, they rise and fall, they’re influenced by how we eat, sleep, metabolize.
Blood tests can’t capture that. They only catch what’s floating in your blood at the moment the needle goes in, not how your body is processing it, not how it’s being cleared. That’s why you can look “low” on paper but still feel flooded.
And that, I realized, was me.
If one pump of Estrogel sent me into overdrive, maybe low estrogen wasn’t my problem. Maybe it was clearance. That gave me a place to start: my gut.
So I reset.
I cut animal protein back to twice a week, making room for more fiber which is crucial for estrogen clearance.
I brought back kimchi as a regular in my food rota to feed my gut microbiome. And I have leaned more heavily into plant-based meals (basically going vegan 4x a week or more), adding diversity without restriction.
Alongside that gut-first reset, I have kept my broader supports steady:
Magnesium glycinate, which I have used for years to help with sleep and metabolism.
2.5L - 3L of water a day, a baseline for me that’s even more important now.
And regular exercise - this is unchanged, because strength training and yoga have been a constant part of my life for 15+ years.
This pared-down stack feels sustainable. And for now, the early signals are encouraging. Will keep you posted!
But this whole experience got me thinking. Despite the rise of services for midlife women, many going through menopause or pre-menopause are still trying to figure things out on their own or in group chats.
A friend recently told me about her frustration with one of the many new telehealth providers aimed at midlife women. She paid for an intake, only to face a rigid questionnaire and a short call that barely scratched the surface. Her symptoms didn’t fit their boxes. Her history wasn’t considered. She left feeling dismissed, despite all the work she’d already done to understand her body.
Like so many of us, she ended up experimenting on her own, adjusting supplements and considering hormone changes while searching for a provider who would truly listen.
Her story echoes what I hear often: the gap between what women know about their bodies and what the healthcare system is prepared to engage with.
Menopause isn’t a one-hormone equation. It’s a whole system. But sometimes, it is presented as a one-note problem: “Low estrogen? Replace it.”
But what about the rest? Gut health, nutrition, lifestyle, metabolism? Could it be that these don’t get the same attention because they can’t be patented and scaled so they’re treated as side notes?
My experiment with Estrogel didn’t “fail.” It revealed something my lab results couldn’t: that my body needed a different kind of support.
Every woman’s hormone journey is personal. In midlife, the real lesson is that no single approach works for all of us. And the sooner we honor that complexity, the sooner we can find approaches that actually fit us individually.
Next Month in the PlayBook
This month I’ve shared the trial and the reset. But there’s more to the story. Next month in the PlayBook, I’ll share the week-by-week journal I kept during my hormone therapy trial. The reactions I logged, the adjustments I tried, and the patterns I started to see.
As always, thank you for being here. This space exists because of you. See you next month, inside the Playbook.
Disclaimer & Disclosure
This content is for informational and educational purposes only. It does not constitute financial, investment, legal, or medical advice, or an offer to buy or sell any securities. Opinions expressed are those of the author and may not reflect the views of affiliated organisations. Readers should seek professional advice tailored to their individual circumstances before making investment decisions. Investing involves risk, including potential loss of principal. Past performance does not guarantee future results.