Inside Job:
Reversing Signs of Aging From the Inside Out


By the age of 40, most women have invested in at least one skin care regimen to prevent the signs of aging. In fact, you’d be hard-pressed to find a woman over the age of 30 who hasn’t put their trust (and hard-earned funds) in the latest creams, moisturizers, and serums to prevent wrinkles.

Though most women put all their focus on exterior treatments, the truth is that slowing the aging process is actually an inside job. Younger women are increasingly learning that there’s more to aging gracefully than just slathering expensive lotions on the skin. For most women, the aging process actually begins internally, years before the first wrinkle makes its appearance. In fact, many of the symptoms associated with menopause, like fine lines, hot flashes, and weight gain, begin to show up long before middle age. The truth is, it’s quite common for younger women to be caught completely off guard by any one of the many unpleasant symptoms associated with one common cause—hormonal imbalance.

What is hormonal imbalance?


A broad term used to describe a variety of conditions, a hormonal imbalance occurs when there is either too much or too little of one or more hormones. In fact, even the slightest imbalance in certain hormones can cause major changes in the way you look and feel. While some hormonal imbalances are temporary and go away on their own, others are chronic and longer-lasting, requiring some form of intervention.  

Common Causes of Hormonal Imbalances



Perimenopause, the transitional phase before menopause, when the ovaries begin producing less hormones, causing a woman’s menstrual cycle to become erratic, is one of the more common causes of hormonal imbalance.  As a woman’s body moves toward the end of its reproductive years, levels of estrogen start to decrease, bringing on menopause-like symptoms, such as hot flashes, dry skin, and irregular periods. Perimenopause can begin as early as the mid-30s and can either pass quickly or last as many as eight years. Menopause is confirmed once a woman goes 12 consecutive months without a period.

During this transitional time, physical changes and symptoms begin to occur as the body adjusts to decreasing hormone levels. Most of these changes are caused by declining estrogen levels. Produced inside of the ovaries, estrogen plays a vital role in maintaining a woman’s reproductive system. Progesterone levels also fluctuate, often resulting in hormonal imbalance. For most women, the first sign of perimenopause is unpredictable menstrual cycles. Other common signs of menopause, like hot flashes and vaginal dryness, begin to surface in the early stages of the menopause transition.

Symptoms of Perimenopause


A woman’s body begins producing estrogen during puberty and continues throughout her reproductive years. This is why the body goes through a major adjustment period when levels begin to decline.

Though symptoms vary from woman-to-woman, most people experience at least one of the following:

  • Erratic or skipped periods

  • Heavier or lighter periods

  • Hot flashes

  • Dry skin

  • Fine lines and wrinkles

  • Vaginal dryness

  • Frequent urination

  • Sleep problems 

  • Mood swings

  • Irritability

  • Depression

  • Bone thinning

  • Changes in cholesterol levels

  • Hair loss

NOTE: While periods may be irregular, it’s still possible for a woman to become pregnant during perimenopause.

Though one of the most common, perimenopause isn’t the only cause of a hormonal imbalance in younger women. Other causes can include: 

  • Lifestyle triggers

  • Infection

  • Medications

  • Carcinoid tumor

  • Medullary thyroid cancer

  • Endocrine gland damage

  • Head trauma 

  • Autoimmune conditions like Hashimoto’s and Graves’ Disease

  • Type 1 diabetes

Common Symptoms of Hormonal Imbalance


Of the many signs of hormonal imbalance, the most common are tied to estrogen deficiency. Estrogen is responsible for a wide range of functions in the body, from regulating metabolism to sexual health, and when the body stops making enough estrogen, it can affect just about every aspect of a woman’s life. 

  • Hot flashes

  • Slow or rapid heartbeat

  • Fatigue

  • Constipation

  • Numbness or tingling in the hands

  • Inability to tolerate cold or warm temperatures

  • High blood cholesterol levels

  • Acne

  • Irregular menstrual periods 

  • Infertility

  • Muscle mass loss

  • Vaginal dryness

  • Loss of interest in sex 

  • Unexplained weight fluctuations (either gain or loss)

  • Diarrhea

  • Depression

  • Anxiety 

  • Dry, coarse skin

  • Dry, brittle hair 

  • Hair loss

  • Thin, warm and moist skin

  • Irregular body fat distribution

  • Darkened skin in your armpit or the back and sides of your neck 

  • Skin tags 

  • Extreme thirst

  • Frequent urination

  • Frequent UTIs

  • Breast tenderness

The Winona Solution


Winona is a telehealth company, created to advise, educate, and empower women and offer medical solutions throughout the perimenopause and menopause journey. By debunking the myths, removing the stigma, and eliminating the confusion, Winona helps women to embrace this stage of life and see it in a positive light.

Because we know that symptoms of hormone imbalance can adversely impact our patients’ lives, we offer customized, effective, and physician-prescribed remedies like hormone replacement therapy (HRT) shipped directly to your door. Hormone replacement is a safe and natural way to restore proper hormone levels using substances that are bioidentical to those produced by the body. 

What is HRT?

The spiking and waning of hormone levels is part of every woman’s life, from puberty to menopause. As women enter perimenopause in their late 30s and early 40s, estrogen, progesterone, and testosterone begin to steadily become imbalanced, creating challenging symptoms. 

By boosting hormone levels that naturally diminish with age, HRT is a prescription treatment that addresses the 100+ symptoms associated with this transitional stage of life. Our treatments only use molecularly-identical and plant-based hormones that effectively mimic those produced naturally in the body. 

One size does not fit all.


If you’re like most women who feel perplexed, confused, and overwhelmed by the symptoms of hormone imbalance, you’re not alone. 

Because every woman’s experience is unique, we believe that a one-size-fits-all approach is not efficacious. At Winona, we are committed to offering comprehensive and personalized HRT, driven by each patient’s individual symptom profile. Using a targeted, symptomatic approach, Winona’s team of board-certified physicians trained in menopause determine treatment plans and dosages specifically tailored to each patient’s needs.  

Benefits of Hormone Replacement Therapy 

When hormones are out-of-balance, your entire being can feel off-balance as well. You may feel bloated, tired, unmotivated, unattractive, and just not like yourself. Once you start treating the imbalance, you’ll begin to feel healthier and happier. Hormone replacement therapy (HRT) is a customizable treatment that restores hormone levels, taking aim at the core issue to help improve symptoms. In fact, HRT can even reduce the risk of heart disease, bone loss, breast cancer, and future hormonal imbalances.

Risks of Hormone Replacement Therapy

Many experts agree that hormone replacement therapy is safe for healthy women under the age of 60 experiencing menopause symptoms. There may be potentially serious risks, however, for certain groups. 

Participants in a 2022 research study found that certain women taking HRT faced higher risks of breast cancer, heart disease, stroke, blood clots, urinary incontinence, gallbladder disease, and dementia.   

Potential risks may be more likely for people falling into the following categories:

  • Women starting HRT 10 years after the start of menopause

  • People with personal or family history of cancer and heart disease

Hormone replacement therapy is not recommended for women who fall into these categories:

  • Currently pregnant

  • Issues with abnormal vaginal bleeding

  • Family history of breast cancer, gallbladder disease, heart disease, stroke, blood clots, or liver disease

  • Allergy to estrogen or progesterone

Though the benefits of HRT far outweigh the risks for healthy women, it’s important to understand that there is no one-size-fits-all treatment, so working with a medical professional is imperative.

Woman Holding Product

Winona’s HRT effectively manages 100+ symptoms associated with perimenopause and menopause, including:

  • Hot flashes

  • Night sweats

  • Mood swings

  • Brain fog

  • Vaginal dryness

  • Low libido

  • Urinary incontinence

  • Palpitations

  • Sleep disruptions

  • Weight gain

  • Breast sensitivity

  • Irregular heartbeat

  • Electric shocks

  • Tingling sensation in extremities 

  • Headaches

  • Dizziness

  • Allergies

  • Dry, itchy skin

  • Anxiety and depression

  • Decreased mental capacity

  • Thinning hair

  • Body odor

  • Joint and muscle aches

  • Digestive issues

  • Burning tongue

To discover where you are in the


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Types of HRT

Estrogen Therapy

When estrogen decreases and begins to create symptoms, your doctor may suggest estrogen therapy to help replace it. If you have had your uterus removed, your doctor may prescribe estrogen alone, whereas with a uterus, it’s necessary to take estrogen and progesterone together. Prescribed both orally and vaginally, depending on symptoms, estrogen therapy treats vasomotor symptoms (hot flashes and night sweats) and urogenital atrophy (itching, dryness, and irritation).

Progesterone Therapy

Like estrogen, progesterone is a female sex hormone that is produced in the ovaries. Progesterone therapy works by replenishing this hormone as it declines during menopause transition. As with estrogen therapy, progesterone helps regulate the growth of uterine cells. It can also address sleep issues, alleviate stress and anxiety, improve mood, support memory, and curb hot flashes. 

Testosterone Therapy

Traditionally thought to be a male hormone, women also produce - and need - testosterone. Like estrogen and progesterone, testosterone also decreases during menopause, causing symptoms like low libido, brain fog, painful sex, fatigue, and weight gain.

Combination Therapy

Consisting of a blend of estrogen and progesterone, combination therapy is a common therapy for women prescribed HRT for menopause symptoms. Using estrogen alone, for example, can cause an overgrowth of cells in the uterus, which may lead to cancer. The addition of progesterone reduces this risk by thinning the endometrium cells and keeping estrogen in check.

Where Empathy Meets Expertise


Rooted in empathy, our aim is to not only help our patients find innovative, research-driven medical solutions, but to provide a safe place to ask questions without embarrassment or judgment. We provide the opportunity to connect with our team of compassionate, knowledgeable, board-certified physicians trained in menopause, who are available right now to address your concerns and design a personalized HRT plan, just for you!

7 Ways We Support Our Patients


Patient Portal 

  • View your physician visits and treatment timeline

  • Sign up for webinars

  • Chat with board-certified physicians trained in menopause.


Real-Time Chat Support

  • Ask questions

  • Share feedback

  • Real-time messaging


Winona Women Facebook Community

  • Community for women going through the menopause transition

  • Educational resources

  • Weekly discussions  

  • Information about Winona products

  • Personal menopause stories 


The Winona Patient Care Team + FAQs

  • View previous conversations

  • Peruse our FAQs

  • Schedule a support chat callback

  • Ask questions about HRT or the Winona process

  • Schedule a call with a member of the Winona Patient Care team 


Symptoms Guide Download 

  • Learn about 100+ symptoms of menopause

  • Learn how changes in your hormone levels during menopause can cause symptoms like weight gain, fatigue, brain fog, painful sex, and poor sleep

  • Learn what you can do to treat symptoms and feel your very best


Live Q&A Sessions

  • Live sessions with the opportunity to ask questions

  • View any of our past sessions.

  • Learn more about hormone replacement therapy (HRT) and the different treatment options.



Winona Medical Journal

  • Educational information on menopause topics from hot flashes and mood swings to weight gain and more

  • Read the latest articles.

  • Stay informed and empowered on your menopause journey. 

By erasing the stigma, removing the uncertainty, and clearing the confusion surrounding menopause, our aim is to help our patients embrace the changes, nurture their bodies and minds, and greet this phase of life with confidence, grace, and vitality. 

Still not sure about hormone replacement therapy?


Our free ebook, Navigating Menopause: Your Complete Guide to Hormone Replacement Therapy, answers all of your questions and addresses common concerns about HRT.

This free resource includes everything you need to know to make informed decisions during the menopause transition and beyond. 

Discover the many benefits of HRT, educate yourself about menopause, and empower yourself with knowledge from leading experts.


How Changing Hormones Cause 100+ Menopause Symptoms

Download Now



As women in the prime of life, you take care of your families, your work, and your friends, but all too often, you forget to care for yourselves. From painful sex and unwanted weight gain to wrinkled skin and bothersome hot flashes, imbalanced hormone levels can leave you feeling lethargic, apathetic, listless, and unmotivated. Hormone replacement therapy is effective for re-calibrating your system, treating the symptoms that come with the menopause transition. 

While there is no magic cure to growing older, adding hormone replacement therapy (HRT) to a self-care regime can help you regain your energy, bring back your motivation, and boost your confidence from the inside out.


How Changing Hormones Cause 100+ Menopause Symptoms

Download Now


Can HRT help you look younger?

HRT helps to restore health holistically, including improving the appearance and health of skin and hair. This can result in you both feeling and looking more youthful.

What is the difference between perimenopause and menopause?

Perimenopause is a transitional time that ends in menopause. Menopause means your periods have ended. When you have no menstrual cycle for a full 12 months, you have officially reached menopause.

Why does perimenopause happen?

As we age, the ovaries begin to produce less estrogen. Perimenopause happens when the body begins to react to these changes in hormone levels in preparing to transition to menopause.

At what age does perimenopause begin?

Perimenopause begins about 8 to 10 years before menopause, usually starting in a woman’s mid-40s. Entering menopause before age 40 is called premature menopause.

How long does perimenopause last?

The average length of perimenopause is about four years. Some people may only be in this stage for a few months, while others will be in this transition phase for as long as eight years. Once you’ve gone 12 consecutive months without having a period, you have entered menopause.

Can you  get pregnant during perimenopause?

If you’re still getting a period, even an irregular one, you're still ovulating. Until you haven't menstruated for 12 consecutive months, you should assume your body is still ovulating (releasing eggs) and you can still get pregnant.

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