Hormone Health Hub: Expert Insights on Testing, Balance & Better Living — menopause hormone therapy

Hot flushes, night sweats, anxiety, insomnia and brain fog — menopause can feel overwhelming. But what is actually happening biochemically? In this case study, Dr. Kate Placzek and Dr. Allison Smith walk through the test results of Julia, a newly postmenopausal woman, showing exactly how hormone and neurotransmitter imbalances drive menopausal symptoms — and what can be done about it.

The Women’s Health Initiative (WHI) trial cast a long shadow over hormone replacement therapy — but it enrolled women well over a decade past menopause. Two newer trials, ELITE and KEEPS, specifically studied HRT started early in the postmenopausal period. Their findings on cardiovascular health, sexual function, sleep, mood and cognition paint a more nuanced and encouraging picture. Here is what the latest research shows.

When sex hormone test results show both oestradiol (E2) and progesterone (Pg) within normal ranges, yet symptoms persist, the Pg/E2 ratio provides a critical additional layer of clinical insight. A low ratio points to oestrogen dominance; a high ratio to progesterone dominance — each requiring a different therapeutic response. This article explains how the ratio is calculated, when it is clinically relevant, and how a real-world case illustrates its practical value.

Over 25 million women enter menopause each year and face decisions about hormone replacement therapy. But HRT dosing is far from standardised — and the testing method used makes all the difference. This article explores why doses vary so widely and how saliva, blood spot and urine testing can help optimise outcomes.