“They Told Me to Just Suffer Through Menopause. I Refused”
Dawn Gallagher, 63
Former model and beauty wellness expert
About 10 years ago, when I began experiencing menopausal symptoms like hot flashes, I asked my gynecologist what I could do to feel better. Her answer was, “Open a window.” That was it. Every gynecologist I consulted at the time dismissed hormone replacement therapy as too risky without offering alternatives. The message was the same everywhere: there’s nothing to do—just suffer through it. I felt stuck, frustrated, and dismissed.
I’m 63 now and still dealing with night sweats, problems staying asleep at night, and fatigue. As I age, keeping my hormones balanced and preventing osteoporosis—since I have osteopenia—are my top priorities. I want to feel great, stay fit, and enjoy life fully with my teenage daughter.
But as I got older, I noticed dips in energy and slower recovery, especially after long trips or stacked work days. My sleep started to suffer, too. I could fall asleep easily, but I’d often wake up around 3 or 4 a.m. and struggle to get back to sleep.
I wasn’t feeling bad, but I wanted to get ahead of any downward trend before it became a real issue that might prevent me from being fully present for my family, managing my work, and keeping my physical and mental energy steady.
Symptoms
Insomnia Hot flashes & night sweats Brain fog Irritability ExhaustionInsomnia
Before Hone
MildAfter Hone
MildHot flashes & night sweats
Before Hone
MildAfter Hone
MildBrain fog
Before Hone
MildAfter Hone
MildIrritability
Before Hone
MildAfter Hone
MildExhaustion
Before Hone
MildAfter Hone
MildClinical Notes
We extensively reviewed the risks and benefits of starting HRT after age 60, including a slightly increased risk of cardiovascular disease and breast cancer. We agreed to proceed with low-dose transdermal estrogen (0.025 mg) and oral micronized progesterone (100 mg). We’ll recheck in a few months to track symptom improvement.
After an initial improvement in menopause symptoms, some of Dawn’s symptoms, including fatigue and insomnia, were starting to return. We increased the dose of transdermal estrogen to 0.037mg at 6 months, and increased it again at 9 months to 0.05mg).
We discussed adding testosterone, since Dawn’s levels are low. Because testosterone can influence overall cardiovascular health, she’ll complete a full cardiac workup—including a coronary calcium scan—to screen for any signs of atherosclerosis (the buildup of plaque in the arteries that can restrict blood flow and increase heart disease risk) before starting therapy.
Her cholesterol is slowly improving with increased exercise and lifestyle modifications; I have every confidence that this will come down as she continues to make improvements to her diet and exercise habits.
Amanda Simone-Belin, M.D., Board-certified internal medicine physician
Timeline
Get Started—Initial Test
Purchase your advanced lab test and go to a partner lab or we’ll send someone out to your place for free (if available in your area).5 days—Physician Consult
Your licensed physician will review your labs & health history to diagnose your symptoms and create a personalized plan.10 days—Medication Arrives
Your medication and supplement arrive with instructions, and Hone is there for as much or little support as you need.30 Days—Start Feeling Better
Depending on which medications you purchase you may start to feel the impacts on your sleep, energy levels, strength, and mood. It’s usually very subtle at this point.60 Days—Improvements
You’ll wake up one morning and realize you’re starting to feel more like yourself again.90 Days—Retest
At this point you’ll see some real differences in your mood, energy, sleep, cognition, and more.
Initial Labs
Estradiol is the primary form of estrogen in women and plays a role in regulating temperature, mood, sleep, and vaginal health. In post-menopausal women, estradiol levels drop to less than 15 pg/ml. Levels as low as Dawn’s are associated with classic vasomotor symptoms (night sweats, hot flashes) and sleep disturbances. For women in menopause who are on HRT, an estradiol level between 40.0 – 200.0 pg/ml is optimal.
Sex hormone binding globulin is a protein that binds to sex hormones like estradiol and testosterone, making them inactive. High SHBG means less free, bioavailable testosterone and estrogen are circulating, which appears to be contributing to Dawn’s symptoms. An ideal range for women is between 70.0 – 90.0 nmol/L.
While often overlooked in women, testosterone supports muscle strength, energy, mood, and more. Women’s testosterone declines with age; by 40, total testosterone is about 50 percent of what it was at 21. Optimal range for women is 40–80 ng/dL.
Cholesterol is essential for hormone production and cell function, but levels often rise by ~11% during menopause, raising heart disease risk. Total cholesterol should ideally be under 200 mg/dL for women.
LDL (low-density lipoprotein) is often called “bad” cholesterol because high levels can contribute to plaque buildup in arteries, raising your risk for heart attack and stroke. An optimal LDL level for women is below 100 mg/dL.
9-Month Follow Up
Estradiol is the primary form of estrogen in women and plays a role in regulating temperature, mood, sleep, and vaginal health. In post-menopausal women, estradiol levels drop to less than 15 pg/ml. Levels as low as Dawn’s are associated with classic vasomotor symptoms (night sweats, hot flashes) and sleep disturbances. For women in menopause who are on HRT, an estradiol level between 40.0 – 200.0 pg/ml is optimal.
Sex hormone binding globulin is a protein that binds to sex hormones like estradiol and testosterone, making them inactive. High SHBG means less free, bioavailable testosterone and estrogen are circulating, which appears to be contributing to Dawn’s symptoms. An ideal range for women is between 70.0 – 90.0 nmol/L.
While often overlooked in women, testosterone supports muscle strength, energy, mood, and more. Women’s testosterone declines with age; by 40, total testosterone is about 50 percent of what it was at 21. Optimal range for women is 40–80 ng/dL.
Cholesterol is a waxy substance your body uses to make hormones, vitamin D, and support cell function—but too much can increase your risk of heart disease. Total cholesterol ideally should be under 200 mg/dL in women, with regular testing recommended to track changes over time.
LDL (low-density lipoprotein) is often called “bad” cholesterol because high levels can contribute to plaque buildup in arteries, raising your risk for heart attack and stroke. An optimal LDL level for women is below 100 mg/dL.
Treatment Plan
Medications
Estrogen patch
Steady-dose estradiol patches address estrogen declines linked to hot flashes, night sweats, fatigue, and irritability.
Micronized progesterone
By menopause, progesterone levels fall by nearly 80 percent. Supplemental progesterone can improve sleep and reduce hot flashes and night sweats. Progesterone is often taken daily after menopause but some women have better symptom reduction taking it cyclically (two-weeks-on, two-weeks-off).
Supplements
Vitamin D3 (5,000 IU)
Vitamin D supports mood and recovery; may also support hormone production.
Lifestyle Changes
Stress reduction
Chronic stress elevates cortisol and disrupts the hypothalamic–pituitary–gonadal (HPG) axis, suppressing hormone production. Meditation, time in nature, and gratitude practices can ease stress.
Exercise
Add resistance training 3x/week to support bone density and metabolism.
Diet
Increase water intake and follow a mostly Mediterranean-style diet, emphasizing colorful fruits, veggies, legumes, nuts, seeds, and lean protein and limiting sugar, alcohol, and processed foods. This type of diet can help with hot flashes, while positively impacting blood pressure and cholesterol levels and reducing inflammation.
Sleep
Progesterone stimulates the brain to produce GABA, an amino acid that helps to calm the mind and body, making it easier to fall asleep and stay asleep. A consistent bedtime (around 10:30 p.m.), turning off electronics at least an hour before bed, and avoiding late-night eating also help.
At 3 months, my energy, sleep, and mood were dramatically better. At 6 months, some symptoms crept back, which can happen, so I was glad the doctor was open to increasing my HRT dose.
Since osteoporosis is a concern, she suggested getting an updated bone scan, since it had been about five years since my last one. I just completed the scan and am currently awaiting the results. Once they come in, we’ll schedule a follow-up to reassess and adjust my medications accordingly.
Physically and mentally, I feel so much better—like I have my life back. I’m dancing again, swimming, and walking 5-7 miles a day without the exhaustion I used to feel.
Uncover What’s Possible with Hone
Our tailored plans uncover the root causes behind your symptoms and deliver lasting relief.
Mentioned in This Article:
Estradiol Patch
Estradiol patches can help alleviate symptoms of menopause, including hot flashes, vaginal dryness, and osteoporosis, by supplementing reduced estrogen levels.
Progesterone
Prescription progesterone tablets help balance and regulate the body’s natural hormone levels to benefit women undergoing menopause or experiencing menstrual conditions.
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The Edge upholds the highest standards of health journalism. We source research from peer-reviewed medical journals, top government agencies, leading academic institutions, and respected advocacy groups. We also go beyond the research, interviewing top experts in their fields to bring you the most informed insights. Every article is rigorously reviewed by medical experts to ensure accuracy. Contact us at support@honehealth.com if you see an error.
About the author
Tracy Middleton is the Senior Editorial Director at Hone and an award-winning health journalist and editor with more than 20 years’ experience. She is the former Editor in Chief and Brand Director of Yoga Journal and former Health Director of Women’s Health, and a member of the Association of Health Care Journalists.
