menopause, mature woman touching sweater and having hot flash

Navigating menopause can be a minefield. Many women are determined to go the “natural” route but end up with such life limiting symptoms they find themselves in front of their GP being given HRT.

For some, HRT is a life saver. For others however it is just a continuation of the misery that led them to taking it in the first place. Here we discuss what is happening in the body during menopause and the main 3 signs that your HRT isn’t working for you.

During menopause or peri to post menopause massive changes occur in the levels of our three hormones: Oestrogen, Progesterone and Testosterone.

  • Oestrogen is an exciter hormone. It gives us energy and promotes healthy weight, boosts libido, ensures ovulation, boosts mood and protects our heart.
  • Progesterone is a calming hormone. It lines the uterus to hold a pregnancy, it is important in fertility, it regulates our cycle and helps with mood.
  • Testosterone is also an exciter hormone. It is responsible for libido, energy, and also lovely thick hair!

The first real symptoms start in peri menopause when progesterone drops, and oestrogen levels are “higher” than progesterone. This is called “oestrogen dominance”.

These symptoms can be difficult to spot and anything from disturbed sleep, lack of libido, lack of energy, weight gain and mood swings to name but a few.

As peri menopause progresses the symptoms start to increase including itchy scalps, confusion, memory loss, lack of confidence, increased food intolerances, headaches and period irregularities until some of the more tangible symptoms occur such as insomnia, hot flushes, night sweats and vaginal dryness.

It is usually these symptoms make life difficult that women end up seeking help from the GP, and are prescribed one of the current HRT offerings such as the Mirena coil, the oestrogen patch or gel or a combination pill.

What are the signs your HRT isn’t working for you?

1)   You are tired ALL the time. 

And not just tired, you are exhausted and feel like you are dragging yourself around.

This is often because the oestrogen used in HRT is the most active form of oestrogen and it’s also a pretty big dose of it. This oestrogen is very stimulating. If we have already been dealing with quite a lot of stress, our nervous system can struggle to deal with this much stimulation.

This is compounded with the fact that during menopause our liver begins to struggle to remove the unused hormones in our body and we start to get a build-up. With the high doses of this very active oestrogen that can happen quickly, and our body can become overwhelmed.

This toxicity is also seen by the body as a “stressor”. In response to any stress our body produces the hormone cortisol. Cortisol is designed to get us out of danger by switching on our “flight or fight” mode but being in this mode 24/7 leads us to becoming utterly exhausted.

2)   You are experiencing problems with your sleep 

For some women this is a huge issue. It usually has three causes.

The first cause is that we are in that “fight or flight” mode mentioned above which hugely affects our sleep.

The second cause is because our blood sugars are imbalanced which in turn creates more stress hormone to be produced.

The third cause is really important to know because it’s actually the cause of MANY issues with synthetic HRT. Not only do we have the oestrogen dominance issue mentioned above we are also having to deal with pretend progesterone in most HRT at a time when we need real progesterone. But why is this a problem?

Pretend progesterone

The progesterone in most HRT isn’t really progesterone. It’s a synthetic called Progestin. (also called drospirenone, levonorgestrel, or medroxyprogesteron).

Chemically these are totally different. Levonorgestrel is actually more similar to testosterone than progesterone, which means we end up overstimulated and “tired but wired”.

This “pretend progesterone” also affects the body differently.


  • beneficial for cardiovascular health
  • stimulates hair growth
  • calms mood and promotes sleep
  • prevents breast cancer


  • increases the risk of fatal blood clots
  • can cause hair loss (due to its similarity to testosterone)
  • may cause anxiety and depression
  • increases the risk of breast cancer

There is however a natural (body-identical) progesterone available from your GP.

3)   You are struggling with your weight despite doing everything “right”

The problem with most mainstream thoughts around diet is that “calories in/calories out” is the answer, this is really flawed science.

Today’s diets are very carb heavy leading to unstable blood sugars. Even if your diet is ideal, most of us are navigating stressful lives so we are overproducing the stress hormone cortisol which combined with overstimulation from the wrong HRT leads to major hormone imbalances which can lead to weight gain.

So, what can I do?

  1. Work with an experienced practitioner 
  2. Speak to your GP
  3. Find a specialist Doctor

Claire Snowdon-DarlingAbout the author

Claire Snowdon-Darling – menopause and hormones expert, Head of The College of Functional Wellness and founder of kinesiology clinic, Balanced Wellness. 

Claire is deeply passionate about educating people about the flaws that are inherent in the NHS approach to chronic conditions and what they can do themselves to get their health back. Her unique work offers cutting edge solutions to menopause and hormonal imbalances, adrenal issues, chronic fatigue, and emotional issues such as anxiety, by bringing together modern advances in nutritional science with highly effective, specialist kinesiology techniques.

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