Why Hormones Can Sometimes Make Menopause Symptoms Worse
There’s more to hormone balance than hormones alone.
Bio-identical hormones can be an incredibly helpful tool for many women moving through perimenopause and menopause.
I’ve experienced this personally. For me, bioidentical progesterone was a game changer for my sleep during perimenopause.
But here’s the part that doesn’t get talked about nearly enough:
Hormones aren’t always the first thing that needs to be addressed — and in some cases, adding them too early can actually make symptoms worse.
Let me explain…
Hormones don’t work in isolation
When women come to see me struggling with hot flashes, poor sleep, weight gain, mood changes, or heavy periods, hormones are often the first thing they’re thinking about—and understandably so.
But hormones don’t function in a vacuum.
They rely on several foundational systems in the body to be working well in order to be used and cleared properly. One of the most important—and often overlooked areas—is digestion.
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Why digestion matters more than you think
Your digestive tract does far more than break down food.
It’s where nutrients are absorbed.
It’s home to a large portion of your immune system.
And it plays a critical role in hormone metabolism and elimination.
When your body breaks down hormones like estrogen, the by-products need to leave your body—primarily through urine and stool.
Here’s the problem I see all the time in practice:
Many women are constipated… even if they don’t think they are.
Having a daily bowel movement doesn’t always mean you’re fully eliminating. Years of sluggish digestion can leave waste sitting in the colon longer than it should.
When that happens, bacteria in the gut can break hormone byproducts down in a way that allows them to be reabsorbed into circulation.
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How this can affect estrogen — and your symptoms
Estrogen is a good example.
We have three main forms of estrogen in the body, each with different effects. When digestion and elimination are sluggish, there can be a shift toward a more inflammatory, less favourable estrogen pattern.
This can contribute to:
• heavier or more painful periods
• breast tenderness
• worsening PMS
• stubborn weight gain around the middle
So if we add hormones on top of this—without first improving elimination—it can feel like adding fuel to the fire.
Instead of improving, symptoms may stay the same… or even intensify.
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The first pillar of my Midlife Hormone Blueprint
Over the years, I’ve realized that supporting women through perimenopause and menopause works best when we follow a clear, thoughtful framework — not a one-size-fits-all approach.
That’s why I use what I call my Midlife Hormone Blueprint, which focuses on four key areas that need to be addressed for hormones to work with your body instead of against it:
Digestion and elimination
Nervous system and stress response
Blood sugar and metabolic support
Hormones (when appropriate)
Today, I’m starting with the first — and often most overlooked — pillar: digestion and elimination.
Whether hormones are introduced or not, we want to make sure the body can absorb nutrients, metabolize hormones efficiently, and eliminate hormone byproducts fully.
Improving digestion doesn’t require extreme cleanses or aggressive protocols. It’s a gradual, supportive process, and how someone responds tells me a lot about how long this area needs attention.
What still amazes me, even after years in practice, is how much can improve just by optimizing digestion:
Energy.
Bloating.
Mood.
Sleep.
Hormone symptoms.
Even when hormones are part of the plan, this step helps everything work better.
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A simple place to start: fiber
There are many ways to support digestion, but one of the most basic is fiber.
Almost every woman I work with is eating far less fiber than her body needs when we take a look at her intake.
If you’d like a simple place to start, I’ve created a fiber cheat sheet with food ideas that support digestion and hormone balance (without extremes).
You can download it here: https://drjenniferhaessler.myflodesk.com/fibre
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Next time, I’ll share a second pillar of my Midlife Hormone Blueprint and how it supports hormone balance in a completely different—but equally important—way.
Because hormones can be powerful tools…
they just work best when the foundation is solid.