I Begged My Ob-Gyn for Hormone Therapy—Even Though I Never Had a Hot Flash

My friends described it as a “fountain of youth,” and I wanted in.

December 8, 2025

Around the time I turned 50, my periods started to become sporadic. They’d disappear for a few months, then return with a vengeance. Occasionally, they were so heavy I found myself having accidents again like I was a teenager. At the same time, the conversation around menopause hormone therapy (HT) was shifting. Experts said that the infamous study linking hormone replacement to an increased risk of blood clots, stroke, and breast cancer was flawed. (Most recently, the FDA stripped HT of its "black box" warning.) Suddenly, women were discussing HT as a real option to treat perimenopause symptoms.

Hormone therapy is known for treating symptoms such as hot flashes and night sweats, but I actually wasn’t experiencing those. What I was dealing with (on top of my unpredictable bleeding) was a crisis with the pants in my closet, thanks to the extra padding I suddenly had around my abdomen. At a recent checkup, my primary care physician assured me that this was a normal part of perimenopause.

As a person who works hard to maintain my weight and health through a nutritious diet and regular exercise, I was not ready to accept that this was my new figure. My PCP encouraged me to make an appointment with my ob-gyn to discuss hormone therapy, cautioning that HT would not help with weight loss but that it might aid with weight “redistribution.”

Beyond this, I’d heard friends say that estrogen replacement was like a “fountain of youth.” They talked about improvements in their skin, hair, and nails after they started taking it. So although I didn’t have any classic menopause symptoms yet, I loved the idea of using it proactively to get out ahead of the changes that are inevitable as natural hormone production winds down. Also, being petite, I’m at higher risk of osteoporosis, and HT has been shown to prevent bone loss after menopause. I decided to ask my ob-gyn for it.

I quickly learned that HT wouldn’t freeze time. But it could support a healthier version of me in my 50s and beyond.

When I met with my ob-gyn, she agreed that I could start on progesterone and estrogen. Other than asking me if I preferred a patch or a pill, we didn’t get into too much detail, and in retrospect I realized that this doctor (who I’d only seen once or twice before) was likely more focused on obstetrics versus specializing in perimenopause.

On New Year’s Day 2025, I took my first dose of HT. At first, the biggest change I noticed was that I was getting a regular period again. I felt less bloated around my middle and overall, better in my body. Turns out, these improvements are pretty standard. “[Hormone therapy] is not a youth elixir, but for many women, it restores health, energy, and vibrancy that felt lost. And that’s powerful,” Heather Hirsch, MD, a physician and author of The Perimenopause Survival Guide, tells SELF.

While HT isn’t going to stop the hands of time, Dr. Hirsch does believe it’s one of the most effective therapies available in women’s health. “It is FDA-approved for four indications: hot flashes, night sweats, Genitourinary Syndrome of Menopause (symptoms like dryness, pain during sex, and urinary issues) and osteopenia, which is a condition of low bone mineral density that can increase the risk of osteoporosis,” she explains.

Hormone therapy may also improve a few menopause-related health concerns, Jessica Shepherd, MD, a board-certified ob-gyn, author of Generation M: Living Well in Perimenopause and Menopause, and chief medical officer at telehealth service Hers, tells SELF. Studies have shown that hormone therapy can help improve heart health, bone health, and muscle mass, ultimately reducing the risk of heart disease and osteoporosis, Dr. Shepherd says.

Finding a doctor who specialized in HT was a gamechanger for me.

About four months into using HT, I had breakthrough bleeding. Since the doctor who had prescribed my medications was out on maternity leave, I took it as an opportunity to finally find an ob-gyn who specialized in perimenopause.

My new doctor told me that breakthrough bleeding is typical as the body adjusts to HT. At the time, I was taking oral estrogen and progesterone. She reevaluated my meds and put me on a progesterone-only birth control pill that she said would also help to control my endometriosis. She also suggested switching to the estradiol patch and prescribed me estradiol cream. Finally, I felt like I was receiving medication that was tailored specifically to me, and most importantly, that my doctor was really listening.

“It’s extraordinarily important to see a clinician who specializes in menopause care,” says Dr. Hirsch. “While many ob-gyns are phenomenal physicians, menopause is a subspecialty. It’s not deeply covered in medical training, and many clinicians lack continuing education and the experience needed to prescribe confidently.”

If you need help finding a practitioner who understands the unique challenges of this time, and is up to speed on the latest evidence-based treatments, visit The Menopause Society.

While HT hasn’t been a cure-all, it's helped me feel more like myself again.

These days, I still feel a little “extra” around my middle, but I’ve accepted that HT isn’t the quick fix I thought it might be. For me, it's just part of the picture when it comes to looking and feeling my best in this new life stage—along with pushing myself to lift heavier and focusing on eating healthy. I’m also hopeful I’m getting the protective health benefits, and that it’s keeping my endometriosis in check. And if it happens to give my skin a boost too, I’ll happily take it.

So how can you decide if HT is right for you? Dr. Shepherd recommends having an in-depth conversation with your ob-gyn about why you want to start, the benefits, and any potential risks. (Your doctor may still recommend against taking systemic estrogen if you’ve had certain health issues, including breast cancer or a history of blood clots.)

After navigating this myself, my best advice is to go into that convo knowing what you want out of HT, and to make sure you’re speaking with someone who is knowledgeable and experienced in peri/menopause.

“A good clinician won’t be threatened by your curiosity or desire for more personalized care,” says Dr. Hirsch. And if they are? “That’s your sign to find someone who is aligned with your health goals.”