Hormone Replacement Therapy, Nutrition & The Future of Women’s Health

There is so much positive momentum happening in the world of women’s health. Recently a group of OBGYNs and other experts contributed to the FDA Expert Panel on Menopause and Hormone Replacement Therapy for women. 

In Episode 3 of The BeingBrigid Show, which will be available on Tuesday, I dive into some of the most overlooked yet life-altering transitions in women’s lives: perimenopause and menopause. These are seasons filled with hormonal shifts, rising risks of chronic disease, and symptoms that can disrupt everything from your sleep to your brain function to your bone health. Yet too many women are dismissed, under-educated, or simply told to “wait it out.”

Ten years ago when I was doing my board certification training in functional medicine, there was a huge emphasis on hormone replacement therapy, something that I have witnessed massive improvements in for women during this phase. 

Today I’m sharing a recap of what happened at the FDA meeting, why it’s so important to address the changes in women’s hormones and decrease the stigma around hormone replacement therapy while also accepting that no amount of HRT will replace the need to also do the work when it comes to nutrition and lifestyle. Here’s a sneak peak into this topic.

The Hormone Replacement Therapy Debate

In 2002, the Women’s Health Initiative study caused widespread fear about hormone replacement therapy (HRT), linking it to breast cancer, stroke, and heart disease. But what was often overlooked was that the average age of women in that study was 63—not reflective of women beginning HRT after menopause.

Newer evidence—and a recent FDA roundtable featuring OBGYNs, urologists, and other experts—has showed the opposite for many women:

• Before age 60, rates of heart events, blood clots, and stroke related to HRT are very low.
  
• HRT can lower risk of breast cancer, fractures, diabetes, and even all-cause mortality in the right candidates.
  
• Vaginal estrogen creams, which carry a black box warning, actually show no evidence of causing cancer and may drastically reduce recurrent UTIs.
  

The problem? Most doctors still receive little to no training in menopause care and don’t proactively recommend or prescribe hormones to their patients. On average, women see five to seven physicians before getting meaningful help with their symptoms.

The Reality of Perimenopause & Menopause

Symptoms during this transition can include:

• Hot flashes and night sweats
  
• Anxiety, depression, and mood swings
  
• Cognitive decline and memory changes
  
• Vaginal dryness and painful sex
  
• Rising cholesterol and blood sugar as insulin sensitivity drops
  

These can be debilitating symptoms but they’re also markers of bigger shifts in long-term health risks. For example:

• Alzheimer’s: Two-thirds of cases are in women. The disease often begins during menopause when the brain loses its ability to use glucose efficiently. Early HRT may lower risk of Alzheimer’s, Parkinson’s, ALS, and dementia.
  
• Bone health: Women lose 15–20% of bone density in the 5–7 years around menopause. Half of women will experience an osteoporotic fracture, and hip fractures carry a 30% chance of death within a year.

These statistics were shared in the FDA hearing by prominent experts who shared that hormones play a huge role. And at the same time, so does nutrition and lifestyle. 

The Power of Nutrition & Lifestyle

This is where food-as-medicine comes in. Research continues to confirm what I’ve seen in over a decade of practice: nutrition and lifestyle interventions can be game-changing during perimenopause and menopause. Underlying issues that were happening prior to these shifts become louder and more pronounced as your hormones fluctuate. A few aspects to focus on:

• Fiber supports satiety, blood sugar balance, and gut health, fueling beneficial microbes that help modulate estrogen metabolism.
  
• Adequate protein and micronutrients (like vitamin D, calcium, magnesium, and omega-3s) are essential for bone, muscle, and brain health.
  
• Sleep and stress management are critical, as sleep deprivation skews hunger hormones and worsens insulin resistance.
  
• Reducing toxic exposure helps minimize endocrine disruption that fuels hormonal imbalance.

The goal isn’t perfection. It’s about building sustainable, consistent habits that support your biology at each stage.

A Holistic Future for Women’s Health

Imagine a generation of women in their 50s and beyond—cognitively sharp, strong, energized, confident, and thriving. That future is possible. But it requires us to both demand better medical care and take proactive ownership of our health through nutrition and lifestyle.

That’s exactly what we’ll be exploring each week on The BeingBrigid Show: evidence-based conversations, practical strategies, and the real talk women deserve.

If this resonated with you, I’d love for you to:

• Subscribe to the podcast so you never miss an episode.
  
• Leave a review to help more women find the show.
  
• Share this post with a friend, sister, or colleague who needs to know she doesn’t have to settle for being dismissed.
  

Together, we can change the story of women’s health.