TL;DR - Perimenopause and menopause can make women feel like their bodies suddenly shifted into a different gear, but modern hormone therapy is safer, more effective, and far more accessible than most women have ever been told. You do not have to suffer through it, and this week’s episode explains why. If you’re a woman or have a woman in your in life, I’m not kidding when I say that this episode could be life changing. Click to listen

Hi everyone,

This week’s episode of The Dr Kumar Discovery focuses on a major transition in women’s health: perimenopause, menopause, and modern hormone replacement therapy. I sat down with two outstanding OB-GYNs, Dr. Diana Kumar and Dr. Theresa Walsh, who work with women every day to help them understand and navigate these changes with confidence. The conversation was clarifying in a way I think many women have been waiting for.

Perimenopause often begins earlier than expected, sometimes as early as the late thirties. The symptoms rarely announce themselves as hormonal issues. Instead, life simply starts to feel heavier. Thoughts are less sharp, sleep becomes inconsistent, moods swing unpredictably, energy fades, and sex can become uncomfortable. Many women assume they are falling behind or losing control, when in reality they are trying to function through unpredictable hormonal spikes and crashes.

What makes this even more confusing is that hormone labs during perimenopause often look completely normal. Estrogen can be very high one day and very low the next. If a lab is drawn on a stable day, the results may look perfect, and women are told everything is fine even when their symptoms say otherwise.

Once menopause arrives, estrogen levels settle at a consistently low level and the symptoms often become more steady and more noticeable. Sleep problems, irritability, joint pain, vaginal dryness, lower libido, difficulty building muscle, and changes in cholesterol and blood sugar all become more common. Bone loss accelerates at this stage, which is one of the reasons this transition matters so much for long term health.

The surprising part is how treatable all of this can be. Today’s hormone therapy uses bioidentical estrogen and micronized progesterone, which behave the same way as the hormones a woman’s ovaries used to make. These are not the same medications used in the early 2000s that created fear and confusion. The evidence is much clearer now. When started at the right time, hormone therapy can improve sleep, settle mood, restore clarity, protect bone density, support cardiovascular health, and improve both urinary and vaginal symptoms.

One of the most helpful points from our conversation is the role of vaginal estrogen. It is extremely safe, highly effective for preventing recurrent UTIs, and very helpful for vaginal and pelvic comfort as women age. It barely enters the bloodstream, and almost every woman eventually benefits from it.

If a woman’s doctor is not comfortable prescribing hormone therapy, that does not mean she is out of options. The Menopause Society maintains a directory of clinicians who specialize in menopause care and who understand the current evidence and treatment options.

The bigger message is simple. Women should not feel obligated to suffer through years of symptoms that are completely treatable. Our mothers and grandmothers often did not have access to this information. Today we know better, and women deserve better. You do not need to wait until life feels unmanageable. You do not need to accept feeling unlike yourself. And you should not be dismissed simply because your labs look normal.

This episode may help you understand what is happening in your own body, or it might help you support someone you care about. Either way, it is a conversation worth hearing.