HRT: What the Evidence Actually Says
A generation of women stopped treatment because of a study that mostly didn't apply to them.
Mary Leonard
MD
Dr. Mary Leonard is a board-certified obstetrician-gynecologist with over 15 years of clinical practice experience. She graduated from Johns Hopkins School of Medicine and completed her residency in Obstetrics and Gynecology at Massachusetts General Hospital. Education and Certification MD — Johns Hopkins School of Medicine (2008) Residency — Massachusetts General Hospital (2008–2012) American Board of Obstetricians and Gynecologists Certification (FACOG)
Medically reviewed
Do You Need a Blood Test?
Usually not the one you're thinking of — and often one you weren't.
Eight Minutes: Making Them Count
Walk in with a pattern, not a feeling.
Reading a Study Without a PhD
Five questions will tell you more than any headline.
What Doesn't Have Evidence (Yet, or Ever)
Menopause is a large and lightly regulated market, and you are the customer.
Non-Hormonal Options That Have Evidence
Not everyone can take estrogen. The alternatives are better than they used to be.
The Menu: Types, Routes, and What They're For
"HRT" is not one thing. The differences between versions are not cosmetic.
What to Tell the Younger Women in Your Life
The thing your mother didn't tell you is the thing worth telling.
Telling Work — Or Not
There is no universally right answer. There is a right answer for your workplace.
The Partner Conversation
The silence costs more than the conversation ever will.
Who Am I When the Rules Change?
You are not losing yourself. You are losing a set of arrangements you made a long time ago.
Desire, and What Changes
Before you conclude it's the relationship, rule out the tissue.
The Window of Vulnerability
Perimenopause carries a genuinely elevated risk of depression. Knowing that is protective.
Brain Fog: What the Research Actually Shows
It's measurable, it's temporary, and it isn't the beginning of dementia.
The Rage Is Real — and It Has a Reason
It isn't that you've become an angry person. It's that the gap between feeling and reacting has closed.
Weight and Body Composition: What Actually Changes
The weight gain is mostly age. The redistribution is mostly menopause.
Heavy, Erratic, Unpredictable: What's Normal and What Isn't
Irregular is expected. There are still limits, and they're worth knowing.
The Symptom Nobody Names
It affects most women eventually, and unlike hot flushes, it does not pass.
Joint Aches: The Symptom Nobody Warned You About
Half of women report it. Almost none were told it was coming.
Why Sleep Breaks in Ways That Have Nothing to Do With Heat
You can fix the temperature and still not sleep.
Night Sweats and the 3 a.m. Wake
You may be waking before the sweat, not because of it.
Hot Flushes: What's Happening in the Brain
It starts in a cluster of neurons the size of a grain of rice.
When It Happens Before 45
Early menopause is not just menopause sooner. It's a different medical situation.
How Long Does This Last?
The honest answer is longer than you were told, and shorter than it feels.
Estrogen Isn't Declining. It's Swinging.
The problem in perimenopause isn't low. It's unpredictable.
Your Cycle Changed Before Anything Else Did
The first signal wasn't a hot flush. It was a calendar.
The 12-Month Rule, Explained
Menopause is a single day. You only ever identify it looking backwards.
Perimenopause Has a Beginning. Here's How It Actually Starts
The transition has a shape. Most women were never shown it.
Talking About Mood Without Being Dismissed
There's a specific reason mood gets handled badly in these appointments, and a specific way around it.
Anxiety That Arrives Without a Cause
A body-first anxiety, arriving before there's anything to be anxious about.