02/05/2026
Dosing Guidelines provide a base to start from, but optimal menopausal hormone care is more nuanced.
Recent research now shows what you and I have experienced first hand — that dose alone does not always predict the level of hormone in your blood, and more importantly levels don’t always predict how you’ll feel. PMID: 41529140
Here’s a checklist for when you might want to be curious with your provider about nuance on your hormone dosing:
🎯Persistent Symptoms: You are on a “standard” dose of HRT but still experiencing hot flashes, night sweats, or mood disruptions.
🎯The “Poor Absorber” Check: You’ve increased your dose, but your symptoms haven’t improved—this might signal that your skin isn’t absorbing effectively.
🎯Bone Health Priority: You are using HRT specifically for osteoporosis prevention but have no symptoms to guide your dosing.
🎯Early Menopause: You reached menopause before age 45 (or 40). Younger women typically require higher levels to protect long-term brain, heart, and bone health.
🎯Symptom vs. Side Effect: You’re unsure if your headaches or bloating are a side effect of the medicine or a sign that your hormone levels are still too low.
If you check one or more of these, it’s a sign that standardized dosing — without curiosity or further testing has reached its limit, and individualized care needs to begin.
Please send this to a woman you know who is struggling to find her footing in menopause hormone therapy. Let her know she isn’t “difficult”—she’s just an individual who needs a tailored approach!!!
