Oprah Daily - When Menopause Treatments Aren't Working - What Next?

Have you tried the recommended treatments, and you still feel absolutely rubbish? I have, and it’s frustrating AF.

You've read the articles, followed the advice, maybe even started hormone therapy (HT), and yet here you are, still dealing with hot flashes, brain fog, or whatever delightful symptom decided to stick around. First things first: you're not broken, your not alone and you're definitely not a failure. The issue is likely that what you were offered didn't quite hit the mark for your specific situation.

Here's what many women don't realise about hormone therapy - it's not one-size-fits-all. There are three main reasons HT might not be working: the formulation (the mix of hormones), the dosage (too high or too low), or the route (how you're taking it). About one-third of women get irritated by progesterone; some people don't absorb hormones properly through patches, and dosage is a proper balancing act. One woman's blood work showed she wasn't absorbing anything from her patch after two years of increasing doses. Two years!

Then there's the testosterone conversation. If HT has sorted your hot flashes, but you still feel flat, unmotivated, or your libido has done a runner, testosterone might be worth discussing. It's not just about sex drive - it can help with energy, cognitive function, and muscle health. There's no FDA-approved version for women yet, so you'll likely pay out of pocket, but many women find it makes a significant difference.

Sometimes the problem isn't even hormonal. Gut health changes with age, regardless of menopause - your microbiome shifts, digestion becomes less efficient, and suddenly you're bloated after foods that never bothered you before. Other medications can muddy the waters, too. Statins cause fatigue and sleep problems. Ironically, SSRIs and SNRIs prescribed for anxiety can actually cause hot flashes and night sweats - the very symptoms they're sometimes used to treat.

The key message? Don't give up. If something isn't working, there are alternatives. Finding the right combination might take patience, but relief is possible.

A friendly reminder: I'm sharing what I've learned, not prescribing what you should do. Always chat with your GP about what's right for your unique situation!

‍