HRT The Missing Link For Midlife Women
When Everything Shifted After 44
After 44, something shifted in my body in a way I could no longer push through, explain away, or “fix” with more discipline. My metabolism slowed down, and I found myself chasing weight gain with cleanses every few months, trying to “reset” something I did not fully understand. I was exhausted all the time, disconnected from myself, emotionally drained, and struggling in ways I could not fully explain. Something felt physically off.
At one point, my primary doctor told me to cut carbs, even though I had already been eating extremely clean because of years of gut issues. My labs looked “normal,” so nobody really knew how to help me. To my practitioners, I looked textbook healthy. But the reality was, the signs had started much earlier than I realized.
My Hormone Story, What I Wish I Knew Sooner
In my teens, I was put on birth control, introducing synthetic estrogen into my system during a formative stage of development. At the time, it felt routine, but now I cannot help but wonder how that early hormonal influence may have shaped what came later.
Back then, my body never did well with synthetic hormones. My moods were intense, my brain would spin out, and I gained weight very easily. Looking back now, I think my body was trying to tell me something long before I knew how to listen.
In my late 20s, life intensified. My mom was in the ICU, my stress and anxiety were through the roof, and I was living in a constant heightened state. I did not think about hormones then, but now I understand how chronic stress and elevated cortisol can disrupt hormonal balance in a major way.
Nearing the end of my 20s, everything felt off. My moods were unpredictable, high highs, low lows. I had trouble sleeping, constant anxiety, and a short fuse. I was working in commercial real estate, a high pressure, male dominated industry where I was constantly trying to prove myself and hold my ground. There was even a point where my boss had to pull me aside after a tense interaction with a building owner. Looking back now, I realize how emotionally reactive and constantly activated my nervous system had become during that period of my life.
For years, I had been operating in survival mode, constantly stuck in fight or flight and never allowing my nervous system to fully calm down. After one too many moments of feeling emotionally overwhelmed, a girlfriend at work said something that really stayed with me, “life doesn’t have to be so hard.” Once I truly let that sink in, I decided to consult with a doctor because I knew this was no way to keep living.
I was evaluated for ADHD and prescribed antidepressants, anti-anxiety medication, and medication to help with focus. They helped temporarily, but they never addressed what was actually driving the symptoms. Looking back, I can see how long I had been operating in a prolonged state of fight or flight, which can significantly impact cortisol, mood regulation, sleep, and cognitive function. I also suspect my hormones were already fluctuating, with estrogen shifts and lower progesterone potentially contributing to my anxiety, insomnia, and mood changes.
At that time, and honestly even now in many cases, there was very little understanding around hormonal imbalance in women. Antidepressants, ADHD medications, and anti anxiety medications often become the default solution for symptoms that may also have hormonal roots. For me, those medications ultimately felt more like symptom management than true root cause support, while also making it harder for me to fall asleep at night.
I became dependent on my anxiety medication to get through the night. Every evening, anxiety would build because I knew I needed sleep, but could not get there on my own. At the same time, I was also in an unhealthy relationship, which only added to the emotional and physical stress.
I want to be clear that I am absolutely not against pharmacological treatments when they are needed. Those medications helped me through an incredibly difficult period in my life, and at that time, they truly served a purpose. They helped calm my mind enough to get through a very difficult chapter. But I also wonder if some of my symptoms may not have become as severe had hormones and hormonal imbalance been part of the conversation earlier on. I think both things can be true at the same time.
Early Attempts at “Fixing” It
In the early 2000s, there was very little conversation around supplemental hormone therapy, so being told I had hormonal imbalances and was already in perimenopause was both unexpected and honestly shocking at the time. The bioidentical thyroid medication was the part that immediately resonated with me the most because it matched the story my body had been telling me for years: slower metabolism, low energy, and persistent fatigue.
That was my first real ah-ha moment. I was eager to get on something that would finally make me feel better. But at that stage of my life, I viewed the hormones more casually than I probably should have. I was young, life felt exciting, and there was just so much to manage at the time, multiple creams, application schedules, supplements, and routines. I did not yet fully grasp how life changing hormonal stabilization could actually be long term, or how going off those hormones later on might affect me.
The unfortunate reality at that time was that this company essentially held a monopoly on bioidentical HRT, and it was incredibly expensive. Between yearly memberships, mandatory doctor visits, hormone prescriptions, and shipping costs across the country, it added up quickly, and of course, none of it was covered by insurance.
I was prescribed progesterone cream, testosterone cream, DHEA, and thyroid medication. It was expensive, inconvenient, and overwhelming to manage. I had just started dating my soon to be husband, life was exciting, and honestly, after about a year, managing all of this felt excessive. So I did what many young adults do when they think they know everything, I stopped.
I leaned toward only addressing the one issue that felt the most urgent at the time, my thyroid. Little did I know it was the combination of everything working together that had been helping me.
Later on, I struggled to get pregnant and eventually revisited the hormone specialist with my husband. At the same time, I stepped away from conventional medications and completed a 30 day Standard Process cleanse protocol recommended by the specialist as part of a broader effort to support my system and overall balance. My friends jokingly called it “the pregnancy cleanse,” because shortly afterward, I became pregnant. I fully believe that the hormone support and thyroid treatment I was on played a key role in helping my body regulate and prepare during that time, along with the lifestyle changes I was making.
The Physical Toll Pregnancy Took on My Body
During pregnancy, I started noticing physical changes that did not make sense. My skin healed slowly, even small cuts would scar. I later learned this can sometimes be linked to nutrient depletion, including low zinc and other essential minerals, which may have already been present before pregnancy and then amplified while my body supported growing babies.
Both deliveries were extremely hard on my body. I later came to realize my adrenals were likely completely depleted, and those tiny glands play a huge role in stress response, energy production, and the demands pregnancy places on the body.
With my first child, I went a week past my due date. During a routine checkup, they discovered a leak in my amniotic sac and rushed me to the hospital. I was told I would need a Foley balloon to force my cervix open so I could dilate. What nobody explained to me was how excruciatingly painful this would be. It felt medieval.
The contractions would hit while the balloon physically forced my cervix open, and eventually I gave in and took pain medication because I had absolutely nothing left. The epidural barely worked, only one side of my body went numb. At one point, because my hips were already tight and unstable, I tore my hip labrum during delivery. Birth injuries in women are far more common than people talk about, but that is another conversation entirely. The bigger issue was that my body simply would not initiate labor naturally. Everything had to be medically forced, physically and chemically.
With my son, history repeated itself. Again, my body would not dilate properly. After almost 30 hours of labor, I had absolutely nothing left physically. I remember laying there saying, “I cannot do this anymore.” They eventually had to use a vacuum assisted delivery because my body simply could not push any longer. At one point, I remember thinking I could understand how women do not make it through childbirth, because I was so completely physically drained. At the time, I thought I was weak or just exhausted. Looking back now, I believe there may have been a much deeper hormonal and adrenal component to all of it.
The Years After Pregnancy
After delivering my second child, my body changed dramatically.
My son had severe allergies, which forced me to eliminate almost every trigger food from my diet while breastfeeding. At the same time, my mom had recently passed away, and my body simply could not sustain the emotional and physical toll.
That stress eventually showed up in my gut. I developed gastritis and SIBO, which completely changed my digestion, body composition, and overall health. I was surviving on little sleep, breastfeeding, grieving, caring for children, and trying to keep functioning.
As the years passed, and cycling through mulitple doctors, searching for answers, my body slowly adapted to this “new normal,” but underneath it all, things were still shifting. I was working at Equinox in a fast-paced, high-performance environment, constantly teaching sessions, selling, and pitching, while also coming home to two toddlers who needed me nonstop. Anxiety and insomnia were constant, and I attributed all of it to stress.
But during Covid, things really started unraveling. I noticed muscle loss, more injuries, and slower recovery, and it felt like something deeper was shifting in my body. At the same time, I was living in a way that so many women can relate to, running on coffee, unwinding with wine, exercising hard, dieting, not sleeping enough, and staying in a constant state of stress. What I didn’t realize at the time was how much that sustained stress response was affecting my body’s ability to recover and regulate. It wasn’t until later that I understood just how deeply hormones influence muscle mass, fat distribution, metabolism, connective tissue, sleep, cognition, motivation, and overall brain function.
The Turning Point
It was not until last year, when I truly optimized my hormones, that everything finally clicked. What I experienced in my late 30’s and early 40’s felt like a second wave of perimenopause, more intense, more rapid, and much harder to ignore. This time, the symptoms were no longer subtle. Everything I had been navigating for years suddenly came into focus. The conversations around symptoms were suddenly everywhere in my inner circle, and one of my friends suggested I look into Midi Health.
That company genuinely changed my life, mentally and physically. It helped save my relationship with myself, my kids, my friends, and my family because at that point, I barely recognized who I was anymore. I had zero motivation, zero drive, and I was white knuckling my way through life.
My first consult with Midi was incredible. For the first time, I felt like someone was truly listening to me. Instead of being lectured for what felt like hours by multiple practitioners over the years and told what my body was doing wrong, or dismissed and told everything was “fine,” I felt heard, understood, and taken seriously. After years of trying to piece things together on my own, things finally started to make sense. My Midi practitioner immediately started me on estradiol patches and progesterone to help support my symptoms, which had become significant issues for me. This approach felt far more manageable, especially because it was covered by insurance and much easier to maintain in daily life, with the patches requiring little effort and only the progesterone being a daily step.
At the same time, I was also dealing with deeper inflammatory concerns. For over 10 years, I had struggled with gut issues, autoimmune-like symptoms, chronic pain, and elevated inflammatory markers. This had been an ongoing conversation with my primary care doctor and ultimately led me down a long path of specialists, each focusing on individual symptoms rather than the bigger picture.
After my Midi visit, I felt something shift. For the first time in a long time, I felt like there was a coordinated approach to what I was experiencing. Instead of looking at each symptom in isolation, we were looking at the bigger picture, and that gave me hope that I could start feeling like myself again. The best part is, they also take most insurance which was a huge relive as I had paid out of pocket for this type of care in the past.
One of my biggest concerns at the time was the rapid weight gain around my midsection. Combined with elevated inflammatory markers and constant joint pain, it became clear that something more was going on than simple changes in metabolism. Based on my symptoms and lab work, they started me on a GLP-1 medication, and that became a major turning point for me. My inflammation dropped dramatically, my joint pain improved, and my labs normalized.
Yes, there was an adjustment period. I experienced hair loss initially, which was scary, but I was already somewhat prone to that. I started supplementing more aggressively, increased my protein intake, prioritized strength training, and used products like Vegamour and Minoxidil to support regrowth. I also took a couple of months off the medication to see if the hair loss would subside. Eventually, I transitioned to Tirzepatide, which my body seemed to respond to even better overall. I experienced no hair loss wich was a huge relief. My inflammation continued improving, recovery felt more consistent, and I finally started feeling more comfortable in my body again.
The Missing Piece, Testosterone
Balancing estrogen and progesterone helped tremendously, but something still felt missing. I knew I should not be this tired, and building muscle should not be this difficult. I was consistent with Pilates and strength training, but my results still did not match my effort. That is when I started pushing harder for testosterone testing and support, and I had to advocate for it.
Once I added testosterone, everything shifted again. My energy improved, my strength came back, my motivation returned, and I finally started feeling like myself again. For me, testosterone was the missing piece.
This hormone deserves far more attention in women’s health conversations. It impacts energy, sleep, motivation, cognition, muscle preservation, mood, libido, confidence, and overall quality of life. The frustrating part is that women still have to jump through hoops to access it because there is no FDA approved testosterone dose specifically for women, even though testosterone has been prescribed off label for women for decades. Meanwhile, men received approval for testosterone therapies with far less scrutiny. The double standard is hard to ignore.
I also understand that hormone therapy is not one size fits all. Some women are not candidates for certain types of hormone treatment, and others may need a more tailored or cautious approach depending on their medical history. What works for one person may not work for another, and finding the right balance can take time. This blog is not medical advice, it is simply my personal experience navigating symptoms that were deeply affecting my quality of life.
The Inflammation Piece No One Talks About
My experience with GLP-1 therapy sparked a deeper curiosity about inflammation, recovery, and the body's ability to heal and adapt. As I learned more about how these medications work, I became interested in the broader world of peptide therapy and how certain signaling molecules are being studied for their potential roles in metabolism, tissue repair, recovery, and healthy aging.
One peptide I was prescribed through Midi was sermorelin, which supports natural growth hormone production. For me, this became helpful for sleep, recovery, muscle maintenance, and overall physical resilience. It was one of the first times I felt like my strength training and Pilates were finally translating into how my body felt and performed. Along with the other changes I had made to support my health, I also noticed a reduction in the stubborn excess body fat around my midsection that had previously been difficult to lose despite consistent exercise and a healthy lifestyle.
From there, I also began reading more on my own about other peptides being discussed in the wellness and medical space. Research is still evolving, and I've approached it with curiosity rather than certainty, always under medical guidance.
The Skin and Tissue Wake Up Call
After 47, I noticed another shift, this time in my skin. It felt thinner, duller, and less resilient. That led me to start paying closer attention to skin and connective tissue health, and how closely it seemed tied to everything else I was experiencing hormonally and physically.
Through my work with Midi, I was introduced to estriol-based face and eye creams as part of my hormone support plan. These became a meaningful part of my daily routine. One of my long-standing concerns had been how tired and puffy my under eyes looked, and over time I noticed a visible improvement in hydration, softness, and overall firmness.
Beyond my clinical care, I also became interested in how skin health connects to deeper structural repair in the body. Through this ongoing curiosity, I came across GHK-Cu, a peptide being studied for its potential role in skin regeneration, collagen production, hair growth, and connective tissue support. What stood out to me was less the cosmetic angle and more the connection to how the body repairs and maintains structure at a deeper level.
By this point in my journey, I had already seen how interconnected everything is, hormones, inflammation, skin quality, connective tissue, metabolism, and recovery all working within the same system. I am still early in learning about this area, and I approach it as curiosity rather than certainty, with the understanding that research is still evolving.
What I Wish More Women Knew
If you are experiencing symptoms, do not wait. Get your hormones tested early and establish a baseline. Be your own advocate and do not let fear or dismissal stop you from asking questions and pushing for answers. It is important to understand your hormone levels, establish baselines in your 30s and 40s, track changes over time, and monitor symptoms closely.
If your primary doctor is not willing to run labs, there are still options available to order testing independently. This is not about going against your doctor, it is about becoming informed and actively involved in your own healthcare.
For me personally, it took years to find care that looked at the bigger picture of my symptoms instead of treating them in isolation. Working with Midi was one of the first times I felt like everything started to connect—my symptoms, my labs, and my lived experience were finally being looked at together.
Because treating symptoms without understanding the root cause is like placing a Band-Aid over something that needs deeper attention. Most importantly, do not brush your symptoms off as “just aging.” Hormonal shifts are real, and for many women symptoms continue progressing if they are ignored.
Why I’m Sharing This
I have been having these conversations within my inner circle for years, which is exactly why I started writing. I want to reach women who may be silently struggling the way I was. I want to bridge the gap between hormonal health, strength, muscle, mobility, longevity, recovery, and confidence because they are all connected. I spent years thinking I needed more discipline, more willpower, a stricter diet, harder workouts, better routines. What I actually needed was support, information, and a better understanding of what my body was trying to communicate. The more women I talk to, the more I realize how many of us have been silently carrying symptoms we were taught to normalize. That needs to change.
Closing
Midlife hormonal changes are real, and they can affect every part of life, including energy, sleep, mood, weight, strength, recovery, motivation, and confidence. Seeking support is not a weakness, it is taking ownership of your health.
I want women to feel seen, heard, and supported, not dismissed. Because I know what it feels like to be told everything is “normal” when it absolutely does not feel normal. With the right support and guidance, women can regain clarity, resilience, confidence, and quality of life. So many women are doing everything “right” and still struggling with symptoms they cannot explain.
You are not alone, and you do not have to figure it out on your own.
These are a few of the resources and companies I personally explored during my own journey f0r hormonal health and peptide therapy. I encourage everyone to do their own research, ask questions, and work with qualified practitioners to determine what is right for them.
* EllieMD
* Life Extension