Key Takeaways
Dr. Brown encourages women to keep a running log of symptoms rather than waiting until they can clearly name what's happening. She notes that early perimenopause signs — like brain fog, mood shifts, or subtle sleep changes — are often vague enough to explain away, and a documented pattern gives both patient and provider much more to work with.
HRT Is Often a Better Fit Than Birth Control or Antidepressants
Dr. Brown explains that antidepressants only address a fraction of perimenopause symptoms, while birth control pills use a much higher, synthetic hormone dose than HRT and may carry a higher risk of complications like blood clots and stroke. She points out that HRT from Winona uses lower, bioidentical doses designed to support the body rather than override it.
The Breast Cancer Fear Around HRT Has Been Misinterpreted
According to Dr. Brown, breast cancer is the most common concern she hears from women considering HRT. She ties much of this fear back to older research linked to the Women's Health Initiative study. She points out that, overall, more women die each year from heart disease than breast cancer, and emphasizes that breast cancer has more significant risk factors, including alcohol consumption, rather than HRT itself.
Hormone Testing Isn't Always Necessary — Except for Testosterone
Dr. Brown explains that most hormone treatment decisions are symptom-based rather than lab-based, since hormone levels can fluctuate too quickly to be reliably useful. Testosterone is the exception, she says, because its narrow therapeutic range and controlled-substance status make in-person monitoring important.
Self-Advocacy Is Essential When Providers Dismiss Symptoms
Dr. Brown urges women not to accept being dismissed by a provider who isn't comfortable discussing or treating perimenopause. She suggests directly asking a provider if they're comfortable treating these symptoms, and if not, asking for a referral or seeking care elsewhere.
