HRT is not about chasing lab numbers. It is about how you feel.
If you are 70 to 80 percent better and not having side effects, you are likely in a good range. Labs can add context, but symptoms guide treatment.
💗 Save this for your next appointment.
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02/26/2026
Starting HRT is just the beginning.
What actually matters? Support. Follow-up. Adjustments. Someone who listens when something feels off. You should have care that doesn’t disappear after the prescription.
Check out jointhecollaborative.com and get matched with a Collaborative clinician who can walk you through your symptoms and your options.💗
Migraines in perimenopause are not just headaches. Hormone shifts can make them worse, more frequent, or completely new in midlife.
Did your migraines change in your 40s?
💖 Click here for The Perimenopause Survival Guide https://amzn.to/3KIsBKz
02/25/2026
What is more effective: vaginal estrogen cream or suppositories? We do not have head to head trials, but here is what we do know.
Creams can cover more surface area and many women like that they can rub a little on the external tissues, but they can be a bit messy. Suppositories are less messy and easy to insert, but they do not absorb as well when they sit too far back, so they are usually best for mild dryness.
To be honest, the best option is the one you will actually use.
Check out jointhecollaborative.com if you want to be seen at The Collaborative.
Check out heatherhirschacademy.com if you are a clinician who wants more education.
02/24/2026
So many women in perimenopause are told “your labs are normal” or “it’s just stress.” And they leave feeling dismissed, confused, and stuck.
You are not imagining your symptoms. Hormone changes in perimenopause are real, complex, and often missed.
If you feel unheard, get a second opinion. You deserve care that takes your symptoms seriously.
💖 Need a second opinion? Check out jointhecollaborative.com
02/24/2026
More migraines during perimenopause? Hormone changes can play a role.
If HRT seems to worsen headaches, your clinician may adjust your dose, reassess your regimen, or coordinate care with a neurologist. Treatment should always be personalized.
💖 Click here for The Perimenopause Survival Guide https://amzn.to/3KIsBKz
02/23/2026
Hormones explained with my ice cream cone theory 🍦 Estrogen is the scoop, progesterone is the cone, and testosterone is the sprinkles. And just like your favorite order, the base matters most. Get estrogen right first and everything else builds on top.
🩷 Check out jointhecollaborative.com to be seen by a clinician trained in midlife and menopause care!
02/23/2026
My sister suddenly developed severe anxiety and couldn’t sleep. She thought something was wrong with her. It turned out to be perimenopause.
Hormones can dramatically impact mood and sleep. If you’ve experienced sudden anxiety or insomnia in midlife, you’re not alone.
Save or share with someone who needs this.
02/22/2026
If you knew your symptoms could last 7 to 10 years, would you just sit and suffer? Probably not. And you shouldn’t have to.
Too many women are told to push through perimenopause and menopause symptoms, but suffering is not a treatment plan. You deserve answers, options, and care that helps you feel like yourself again.
Check out jointhecollaborative.com and get matched with a Collaborative clinician who can walk you through your symptoms and your options.
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I am Board certified in Internal Medicine and completed advanced fellowship training in Women’s Health at the Cleveland Clinic. My specialty practice includes internal medicine and office gynecology with a focus on menopausal hormone therapy, contraception and family planning, breast health, sexual dysfunction, and urinary incontinence. Fellowship training included an emphasis on scholarly activity, development of women’s health curriculum, clinical research and leadership. My clinical work and research centers on inequalities or unanswered questions in the field of women’s health, specifically in menopause and its role in chronic disease development and in evaluating the harms of over-screening for chronic diseases. My Academic work centers on enhancing women’s health curriculum for the fellow, resident, and medical student.
