The Midlife Hormone Guide: HRT, Libido, Brain Fog & How to Feel Like You Again

Feeling foggy, flat, or just not yourself? You’re not alone — and your hormones could be the reason. In this insightful episode, Dr Sunita Chelva, Dr Aoife O’Sullivan, and Dr Rachel Rubin explain how hormonal changes in perimenopause affect your brain, mood, sleep, libido, and energy — and how HRT, testosterone, and vaginal hormones can help restore balance and wellbeing.

In this episode, you’ll learn:

• Why there’s no “too young” age to explore HRT when symptoms impact life.
• How the pill differs from HRT and when body-identical hormones matter.
• What testosterone can (and can’t) do for libido, focus, and fatigue.
• The role of estrogen and progesterone in brain, bones, sleep, and heart.
• How to balance benefits and risks when deciding how long to stay on HRT.
• Why vaginal hormones (estrogen, DHEA, testosterone) support comfort, continence, and sex at any age.
• Practical guidance for monitoring and dosing without over-testing.
• A fresh look at what “natural menopause” means today.

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Disclaimer: This podcast and any information, advice, opinions or statements within it do not constitute medical, health care or other professional advice. Information is provided for educational and entertainment purposes only.

00:00 – Introduction & “Too young for HRT?”

02:19 – Pill vs HRT: what’s the difference?

04:26 – Testosterone for women: why and when

05:23 – How to use testosterone cream & what to expect

11:52 – Blood tests, PCOS cautions & prescribing

14:16 – How long should you stay on HRT?

15:23 – Brain health, dementia risk & estrogen

16:18 – Personalising HRT: continue, pause, or stop?

17:56 – “Menopause is natural”—but is modern life?

19:55 – Vaginal hormones: comfort, UTIs & continence

25:18 – Rediscover You: program overview

26:22 – Hormone basics & perimenopause physiology

29:54 – Testosterone reality check (levels vs estrogen)

30:33 – Why body shape & fat distribution change

31:34 – Estrogen’s systemic roles (vessels, joints, brain)

33:20 – Progesterone’s role: balance, bones, GABA, sleep

35:05 – HRT: making the decision with evidence

35:24 – Progesterone for sleep: who benefits?

36:23 – Contraception during perimenopause on HRT

37:54 – Estrogen + progesterone: tailoring treatment

39:18 – Dosing: treat symptoms, not numbers

41:43 – Bloods & monitoring: limits of testing

42:57 – HRT & breast cancer: context and nuance

45:42 – WHI, media, and risk communication

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