The Truth About Taking Hormones for Menopause

Welcome Back to the Libido Lounge

Dr. Diane: Welcome to the Libido Lounge, where we focus on all things love, lust, and libido. We believe that fabulous sex is as important to health as exercise and good food.

Hi everybody! Welcome back to the Lounge. Today we are circling back to a topic I introduced several months ago: hormones—and whether or not they are safe.

A while ago, I talked about the top myths commonly seen when it comes to sexuality and understanding your libido. I gave you nine out of ten, and I said, “Stay tuned—number ten is coming.” Well, that teaser leads us to today.

The Hormone Safety Myth

Dr. Diane: The myth is that hormone therapy is unsafe. This belief stems from research done in the 1990s, and I want to explain what that research actually said—and didn’t say—so you can feel more empowered when talking to your doctor or clinician.

My hope is that, after listening, you’ll feel more confident discussing hormone replacement therapy, if it might be a good idea for you. And remember, if you need help from my team, you can always join our masterclass or online programs—links are in the show notes.

A Look at the Women’s Health Initiative Study

Dr. Diane: Back in the 1950s and 60s, hormone replacement therapy (HRT) became popular because it was clearly helping women feel better as they hit menopause. But there wasn’t much long-term research on its effects.

So in the 1990s, the Women’s Health Initiative launched a study focused on the long-term risks—particularly mortality. A very noble and important goal.

In the study, women were either given a placebo, estrogen only (if they didn’t have a uterus), or estrogen plus progesterone (if they did).

The results were communicated poorly. The headlines said hormone therapy increased the risk of death by 25%—but let’s break that down.

The Real Numbers

Dr. Diane: In the placebo group, 4 out of 1,000 women died early. In the estrogen + progesterone group, it was 5 out of 1,000. That’s one extra person. Yes, it’s technically a 25% increase—but only relative to the placebo, and that’s misleading.

In real numbers, the increase was just 0.001%. And the study didn’t account for other health risks like obesity or diabetes. It also didn’t test women who actually had menopausal symptoms. They studied older women to track death rates more quickly—so right from the start, the design was flawed.

Synthetic vs. Bioidentical Hormones

Dr. Diane: Another major issue: the study used synthetic hormones—horse-derived estrogen (conjugated equine estrogens) and synthetic progesterone—not bioidentical hormones, which are molecularly similar to those we produce naturally.

So we can’t really say the study proves anything about the safety of bioidentical hormones. Yet, this flawed study has heavily influenced how hormones are prescribed today.

How One Study Changed Everything

Dr. Diane: This isn’t the first time bad science went mainstream. Remember the 1980s fat scare? “Fat is bad,” they said. Suddenly everything was low-fat, and we got margarine instead of butter.

Now, we know fat is essential. It fuels our brain, supports hormone production, and has many health benefits—so long as it’s balanced. But again, one misleading study had huge ripple effects.

The same is true with hormone replacement therapy. One poorly communicated study made everyone afraid.

Hormones Have Benefits

Dr. Diane: I’ve seen countless women get better on hormone therapy. We now know estrogen has cardiovascular benefits. Estrogen, testosterone, and progesterone all support bone health. Even progesterone—though maybe less so—has been linked to improved bone density.

And then there’s DHEA—a precursor hormone that helps us make estrogen and testosterone. It supports energy, muscle, anti-aging, and more. For many people, DHEA is a very safe supplement.

Of course, there are exceptions. For someone with an active cancer, hormone therapy would not be appropriate. But after cancer is in remission, more and more doctors are re-evaluating whether hormones can safely be reintroduced.

Headlines Can Be Misleading

Dr. Diane: I once saw a headline that said, “Pizza helps fight cancer.” That stuck with me—not because pizza is a health food (it’s not!), but because it showed how easily one detail can be taken out of context and turned into a myth.

Maybe the tomato sauce had lycopene with anti-cancer properties—but suddenly, people think pizza is part of a wellness routine. This is how misinformation spreads.

Take Home Points on Hormones

Dr. Diane: My personal and professional opinion? Most women at menopausal or perimenopausal age do extremely well on bioidentical hormones.

I’m in that age range, and I take hormones myself—I love them. Symptoms go away, weight is easier to maintain, and mood and energy improve.

DHEA is also very well tolerated for most people—both women and men.

And of course, don’t forget about diet, lifestyle, sleep, and stress—all of those still matter.

Libido is More Than Hormones

Dr. Diane: On this channel, we talk about all the factors that affect libido. Hormones are a huge one—but they’re just one spoke on the wheel.

If your hormones are off, that spoke needs fixing. But maybe it’s not the only one. What about gut health? Inflammation? Thyroid or adrenal function?

And then there’s the mind: are you present? Do you feel safe with your partner? Are you enjoying sex? Do you like the positions? Do you even want to be touched?

So many layers go into this. And when I support people clinically, they’re often looking for “the one thing.” But libido is rarely fixed by just one thing.

Wrapping It Up

Dr. Diane: Hormones are important—but they’re part of a bigger picture. You deserve to feel strong, healthy, vibrant, and sexy. And that often means having these bigger conversations about what’s right for your body, your health, and your libido.

Thanks again for another great episode. And always remember:

Stay classy, be sexy, and stay a little badassy.

See you on the next one!

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