The Art and Science of Boosting Your Health with Hormones and HRT
My conversation with Dr. Carla Manly on the Imperfect Love Podcast
I recently joined Dr. Carla Manly on her Imperfect Love podcast for a conversation about hormones—why they matter, why they’re often misunderstood, and why the conversation around HRT is finally becoming more nuanced (and more honest).
We framed the episode around a real-life question from a listener in her late 50s: mild depression, weight gain, interrupted sleep, and low libido—wondering if it’s worth investing in hormone therapy or psychotherapy. It’s a question I hear often, and it speaks to something very real: limited resources, real symptoms, and a desire to feel like yourself again.
What I want you to know about hormones
Hormones are tiny molecules with an outsized impact—on bones, heart, muscles, brain, mood, metabolism, and libido. And yet many clinicians were never trained to truly understand them, which leaves women feeling dismissed, confused, or told to “wait it out.” This episode is one step toward clearer, kinder education.
A few takeaways from the conversation
1) Hormone therapy is about support, not perfection
You may hear HRT called menopause hormone therapy now, and I appreciate the shift. The goal isn’t necessarily to restore your hormones to what they were at 30—it’s to support your body as you age well and reduce unnecessary suffering.
2) It’s not either/or — it’s “which first?”
For many women, symptoms like depression, low libido, sleep disruption, and weight changes are both biochemical and psychological. Sometimes hormone therapy helps “take the edge off” enough that you can sleep and function better—so lifestyle changes and therapy actually become possible. Sometimes psychotherapy is the first lever. Often, it’s a synergy.
3) Stress changes hormones (and hormones change resilience)
We talk about the HPATG axis (hypothalamus–pituitary–thyroid–adrenal–gonadal) because it explains what so many women feel: when stress is high, hormones get wobbly. Breath, boundaries, nourishment, movement, sleep—these aren’t extras. They’re part of the physiology.
4) The details matter
We cover why one-size-fits-all hormone prescribing created so much fear in the first place—and why bioidentical options, delivery route, dosing, and follow-up matter. Hormone work is often as much art as science: track response, adjust thoughtfully, and individualize.
If you’re wondering whether HRT is right for you
The most important takeaway is this: there is no one-size-fits-all answer. The right decision depends on your symptoms, history, goals, and resources—and on having a clinician who will treat you as an individual, not a protocol.