259: Ask Me Anything: Hormone Therapy Q&A

This is a special Ask Me Anything episode where I answer real questions from my followers and subscribers about Hormone Replacement Therapy.If you’ve ever wondered:• Why isn’t my HRT working?• Should I adjust my estrogen dose?• Is progesterone causing side effects?• Why are my symptoms still here?• What should I ask my doctor?This episode is for you.Hormone therapy is never one-size-fits-all. Dose, timing, formulation, and your unique biology all matter. In this AMA, I break down common HRT concerns and explain how I think through adjustments in my clinical practice.This content is for medical education only and does not replace personal medical advice. I'm a Dr, but not your Dr. unless you would like to be a patient of my practice, The Collaborative💖 Click here for The Perimenopause Survival Guide: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠More about Dr. Hirsch: Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠⁠

Why I Finally Wrote a Book About Perimenopause // In this video, I share the real reason I wrote my perimenopause book and why women in their 30s and 40s deserve better information about what’s happening to their bodies. After years of treating patients with hot flashes, night sweats, brain fog, anxiety, sleep issues, and hormone imbalances, I saw how often perimenopause is missed or dismissed. This book was written to provide clear, evidence-based guidance on perimenopause, menopause symptoms, and hormone replacement therapy (HRT).If you’re still having periods but feel “off,” exhausted, foggy, or not like yourself, this conversation is for you. We talk about hormonal changes, midlife health, estrogen and progesterone, symptom relief, and why understanding perimenopause is key to thriving, not just surviving.💖 Click here for The Perimenopause Survival Guide: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠More about Dr. Hirsch: Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠⁠

HRT in Your 60s, 70s, or 80s? Yes, It’s Still an Option //This podcast is sponsored by Cozy Earth, products that I have lived in this winter! Use CODE: CozyDrHeather for a discount at Cozy Earth:cozyearth.comHormone replacement therapy (HRT), menopausal hormone therapy, estrogen therapy, and progesterone are often discussed in relation to the “10-year window.” Still, many women ask if they can start HRT in their 60s, 70s, or 80s for menopause symptoms. Women who went through menopause between 2002 and 2022 were frequently denied hormone therapy due to fear, misinformation, and outdated medical guidance about menopause treatment and women’s health. In this video, we explain HRT timing, late-start hormone therapy options, menopause care for older women, and what the latest research says about who may still benefit.More about Dr. Hirsch: Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠⁠

Longevity 101 with Dr. Poonam Desai // This podcast is sponsored by Cozy Earth, products that I have lived in this winter! Use Code " CozyDrHeather" at https://cozyearth.com/Longevity medicine for women, hormones, sleep, menopause, perimenopause, and preventative care are the focus of this episode with Dr. Poonam Desai. We break down what actually matters for long-term health, midlife symptoms, and disease prevention.This conversation covers evidence-based lifestyle changes around coffee quality, sleep timing, toxin and microplastic exposure, air quality, and processed foods, while avoiding expensive wellness trends that don’t move the needle. If you’re interested in women’s health, longevity, and preventative medicine, this episode focuses on what truly supports long-term health.More about Dr. Hirsch: Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠

Changing bodies, changing identities with Dr. Salas-Whalen// In this episode, Dr. Hirsch sits down with Dr. Rocio Salas-Whalen, author of the new book "Weightless," to discuss how medications can result in not just a different body, but a new identity. More about Dr. Hirsch: Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠

The case for testosterone with Dr Kelly Casperson // joined again by the testosterone GOAT, Dr. Casperson breaks down how we think about testosterone and the differences between prescribing testosterone to men and women. Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in the Practice Accelerator Course: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://the-menopause-course.teachable.com/p/acceleratorjuly2025⁠⁠

Perimenopause anxiety with Psychiatrist Dr. Allie Sharma // Thoughts are passing and not a conclusion, but when do you know if your anxiety is getting out of control? Tune in to this episode where Dr. Allie Sharma breaks down the difference between feeling hard emotions and anxiety that may need treatment. Find Dr. Sharma on Instagram here: https://www.instagram.com/alliesharmamd/Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in the Practice Accelerator Course: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://the-menopause-course.teachable.com/p/acceleratorjuly2025⁠⁠

What the "black-box-removal' announcement from the FDA really means/ [UPDATE: Yes, I mixed up relative risk and absolute risk on this recording. Can we blame the perimenopause brain fog? Thanks to everyone for pointing that out! ]A great deal has occurred since the FDA's press release regarding the box warnings on menopausal hormone therapy. Lets dig in!Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠⁠Enroll in the Practice Accelerator Course: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://the-menopause-course.teachable.com/p/acceleratorjuly2025⁠⁠

Your Vaginal Estrogen Cheat Sheet // Here is your "everything-you-need-to-know about local vaginal estrogen, from what it does to what you can use, in this episode, the most frequently asked questions are answered. Order My New Book: The Perimenopause Survival Guide: https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠Enroll in the Practice Accelerator Course: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://the-menopause-course.teachable.com/p/acceleratorjuly2025⁠⁠

The New Era of Weight Loss Medications With Dr. Alexandra Sowa // Wondering about the impacts of GLP-1 agonists and your health? In this episode, Dr. Sowa breaks down the different reasons for taking a GLP-1 agonists, and their many benefits for those who are good candidates. Order The Ozempic Revolution: Ehttps://amzn.to/4okd2HEOrder My New Book: The Perimenopause Survival Guide: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/3SYALze⁠⁠⁠⁠⁠⁠⁠⁠⁠Join The Collaborative Medical Practice: ⁠⁠⁠⁠⁠⁠⁠⁠https://thecollaborative.kit.com/11e9825fb5⁠⁠⁠⁠⁠⁠⁠⁠Enroll in my course on HRT management: ⁠⁠⁠⁠⁠⁠⁠⁠https://heatherhirschmd.myflodesk.com/prescribehrt⁠⁠⁠⁠⁠⁠⁠⁠Enroll in the Practice Accelerator Course: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://the-menopause-course.teachable.com/p/acceleratorjuly2025⁠⁠