1) Libido: Reproductive hormones play a direct role in sexual desire, arousal, and pleasure. As estrogen drops, vaginal tissues can become thinner and drier. Changes in testosterone levels can also influence sexual interest.
Supplemental hormones can be used to treat all these symptoms. “Some women respond better to estrogen for libido, and others respond better to testosterone,” says Karen Kaufman, MD, a board-certified obstetrician and gynecologist, and the medical director of MIORA in Colorado, stressing the need for individualized treatment.
Libido isn’t purely hormonal, though. Sexual interest is also affected by stress, sleep, relationship dynamics, and overall health. For some women, restoring hormone levels can improve comfort and desire; for others, addressing lifestyle or emotional factors may be just as important.
2) Bone health: Estrogen, progesterone, and testosterone all help stimulate and maintain bone tissue. When they decline, bone loss can accelerate. According to the Bone Health & Osteoporosis Foundation, half of women over 50 will break a bone because of osteoporosis.
“The hormone drop-off is absolutely one of the reasons for bone-health issues like osteopenia and osteoporosis postmenopause,” Kaufman says. “Without estrogen, progesterone, and testosterone, we start to lose bone density.”
She adds that supplementing with these three hormones can have profound effects on bone strength.
3) Brain health: Estrogen plays a role in glucose metabolism in the brain. Low levels can lead to brain fog, including concentration and memory problems. These issues are common enough to have their own nickname: menopause brain.
“Women in particular really need estrogen for their brain health.”
“Women in particular really need estrogen for their brain health,” Kaufman says, noting that the hormone can help prevent cognitive decline by protecting the brain from the plaque associated with Alzheimer’s.
Studies have found that menopause may lead to reductions in the brain’s gray-matter volume. Yet there’s also evidence that this volume may partially recover after menopause — and there’s no evidence that menopausal brain fog is associated with a subsequent risk of dementia.
4) Joint health: Some women experience joint pain for the first time during perimenopause and menopause. Because estrogen can act as a natural anti-inflammatory and lubricant for the body, declining levels can lead to systemic inflammation, thinning cartilage, and reduced collagen production in the joints.
Activity level, prior injuries, muscle loss, and inflammatory conditions each play their own role in joint health. Yet when joint symptoms appear or worsen alongside other menopausal changes, hormone therapy may help relieve discomfort, especially when combined with strength training and anti-inflammatory nutrition.
5) Mental and emotional well-being: Estrogen and progesterone help regulate mood, stress, and sleep. When these hormones decline, many women experience more anxiety, irritability, and emotional volatility. Still others experience a loss of emotional range, says Kaufman. “People will say, ‘I just feel flat. I can’t explain it. I’m just not myself.’”
Antidepressants are often prescribed for these symptoms, but Kaufman says hormonal changes are frequently at play and that it can be more effective to address them first.
Understanding HRT
If you’re considering hormone replacement therapy (HRT), you probably have questions. We asked clinicians and hormone specialists for answers about how HRT works, what its real risks and benefits are, and how to decide whether it’s right for you at “A Balanced Approach to Hormone Replacement Therapy,” from which this article was excerpted.
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