Felice Gersh MD

11/22/2025

My latest talk is available!
The Gut–Hormone Connection: What happens to the gut microbiome in menopause
https://youtu.be/jLFIM19CJTc

In this talk, I explain how menopause impacts the gut microbiome and why it’s one of the most overlooked aspects of women’s health.

Estradiol and progesterone are vital for maintaining gut integrity, microbial diversity, and immune balance. When these hormones decline, gut permeability (aka “leaky gut”) increases, inflammation rises, and the microbiome shifts toward a less diverse, male-like pattern. This disruption contributes to everything from brain fog and osteoporosis to autoimmune disease.

I also discuss the estrobolome—the group of gut bacteria that help recycle estrogen—and how lifestyle, phytoestrogen-rich foods, fiber, and circadian-friendly eating patterns can support gut and hormone health through menopause and beyond.

In this talk, I explain how menopause impacts the gut microbiome and why it’s one of the most overlooked aspects of women’s health.Estradiol and progesterone...

11/20/2025

How menopause changes the gut microbiome
Why it matters.
And what you can do about it.

Reproductive hormones shape the gut microbiome, which in turn affects your hormone levels.

In today’s talk, I’ll explain how the hormone changes in menopause affect the tiny microbes living in your gut. And then I’ll share ways to stay healthy through the transition and beyond.

⏰ Live Thursday, tune in for my talk.

Thurs, 11/20 at 7:30 PM Pacific
Watch live on Instagram.
Or check YouTube for the recording in a few days.

I’ll be checking Instagram for questions so if you have any additional questions that you’d like me to address, please add them to the comments of this post.

Let me know what questions you have! And tune in for this upcoming talk!

11/15/2025

In perimenopause, estradiol swings can lead to symptoms including...

When you enter perimenopause, your hormones may fluctuate dramatically — especially your estradiol levels.

When estradiol shoots up suddenly, you might feel breast tenderness, fluid retention, bloating, and that uncomfortable “puffy” feeling. And then when estradiol falls, you can get migraines. They often appear or worsen in perimenopause, triggered by those excessive estradiol drops after a big surge.

You can also get erratic and sometimes very heavy bleeding.

More Than Hot Flashes:
Common perimenopause symptoms & what to do about them
https://youtu.be/JOeuPqbTyOE

11/15/2025

In perimenopause, estradiol swings can lead to symptoms including...

When you enter perimenopause, your hormones may fluctuate dramatically — especially your estradiol levels.

When estradiol shoots up suddenly, you might feel breast tenderness, fluid retention, bloating, and that uncomfortable “puffy” feeling. And then when estradiol falls, you can get migraines. They often appear or worsen in perimenopause, triggered by those excessive estradiol drops after a big surge.

The hormonal rollercoaster can make you feel like you’re on edge — because, well, your hormones truly are.

More Than Hot Flashes:
Common perimenopause symptoms & what to do about them
https://youtu.be/JOeuPqbTyOE

11/14/2025

On Monday, the FDA announced that it was removing the black box warning on all estrogen products. You’d think I’d be happy. And on one level, I am. And yet...

11/14/2025

“Isn’t it abnormal to bleed after menopause?” I get asked this question all the time.

It depends on your hormone therapy.

If you’re not on hormones, then yes, postmenopausal bleeding absolutely should be investigated because it could signal uterine cancer.

But when we use cyclic hormones to restore physiologic balance, predictable monthly bleeding that mimics your natural period is actually a sign of health. It means your body is responding appropriately to rhythmic hormone support, growing and repairing tissues throughout your body as it did when you had naturally cycling levels of estrogen and progesterone in your youth.

So don’t fear it. Celebrate it. We can’t stop aging—but we can slow it gracefully.

To learn more, watch my full talk,
Top 5 HRT Questions Answered:
Most common questions from doctors & patients
https://youtu.be/5Si9w7ONJzE

11/13/2025

I had an incredible time at the Women’s Wellness Expo 2025 at the UCLA campus in Palos Verdes. It was an honor to share the stage with and .kudzai to talk about women’s health, hormones, and menopause.

And a special thanks to our amazing host for bringing everyone together.

11/13/2025

🚨 7:45PM Pacific, Thursday
Perimenopause Hormone Swings

Hormone swings in the perimenopausal years can cause a wide range of symptoms, including erratic bleeding, mood disorders, headaches, and breast tenderness. Stabilizing hormone levels and supporting natural rhythms of estradiol and progesterone can dramatically improve symptoms, quality of life, and long term wellness.

In today’s talk, I’ll explain my approach to perimenopause, including how I use birth control, hormone supplementation, and other interventions to optimize both short term and long term symptoms. It’s definitely not a one-size fits all regimen, so it needs to be individualized to each woman and then evolve as she moves through the menopause transition.

⏰ Live Thursday, tune in for my talk.

Thurs, 11/13 at 7:45 PM Pacific
Watch live on Instagram.
Or check YouTube for the recording in a few days.

I’ll be checking Instagram for questions so if you have any additional questions that you’d like me to address, please add them to the comments of this post.

Let me know what questions you have! And tune in for this upcoming talk!

11/10/2025

Does cycling hormones in HRT increase risk of uterine cancer for menopausal women?

One of the most common questions I hear is this — “if I’m cycling hormones and I’m bleeding, does that increase my risk of uterine cancer?”
The answer is a clear and confident no.

When you’re giving progesterone in physiologic, healthy levels—similar to what a woman produces naturally in her 20s—and maintaining estradiol in a normal range, you’re actually supporting balance, not risk.

By allowing the uterine lining to grow and then shed, you’re helping to cleanse the uterus, purging potentially abnormal cells and preventing unopposed estrogen exposure. This rhythmic cycling is protective, not harmful.

To learn more, watch my full talk,
Top 5 HRT Questions Answered:
Most common questions from doctors & patients https://youtu.be/5Si9w7ONJzE

11/08/2025

My latest talk!
Pellets for Menopause?
The dangers of estradiol & testosterone pellets
https://youtu.be/OxLAU6ySJbI

What I see in my practice and why I never recommend them...

In this talk, I share what I see in my practice with patients who have received pellets from another provider. And I explain why I don’t recommend hormone pellets for menopausal hormone therapy and why I don't insert them.

Many women are told that pellets are a simple, convenient way to balance hormones, but in reality, they can cause extremely high, erratic hormone levels, unpredictable bleeding, androgenic side effects, and even unnecessary hysterectomies. Once inserted, a pellet can’t be removed—it must fully dissolve, which can take months.

I explain how testosterone does not decline at menopause, why pellets can’t mimic physiologic hormone rhythms, and how safer, evidence-based methods—like transdermal estradiol with cyclic progesterone—can restore hormonal balance without the risks.

What I see in my practice and why I never recommend them...In this talk, I share what I see in my practice with patients who have received pellets from anoth...