Empower Lifestyle Medicine

Time to get your levels checked!!

If you are post-menopausal and on hormone therapy, here are your estradiol target numbers:

> 60 pg/ml for bone density maintenance and cardiovascular protection ❤️
> 110 pg/ml to increase bone density 🦴

What if you're pre-menopausal? Well that's a lot more complicated since your ovaries are still producing estrogen, and your natural estradiol levels during perimenopause can be very chaotic.

💚Need help navigating your menopausal hormone therapy? Come see us!!

References:
Piette, P. C. M., & Simon, J. A. (2026). Optimizing estradiol serum levels for optimal skeletal and cardiovascular health during transdermal menopausal hormone therapy. Gynecological Endocrinology, 42(1).

Glynne SJ, Simon JA. Tailoring transdermal estradiol dose to maximize benefits and minimize risks. Menopause. 2026 Jun 1;33(6):743-753. doi: 10.1097/GME.0000000000002723. PMID: 41529140.

GLP-1 Medications: What's New in 2026?

If you've been trying to keep up with all the new weight-loss medications, you're not alone. Here are three of the biggest updates this year:

✅ Higher-dose Wegovy (7.2 mg) is now FDA-approved. In clinical trials, participants lost an average of about 19% of their body weight, and about 1 in 3 lost 25% or more. The trade-off? More gastrointestinal side effects.

💊 Oral Wegovy is now available, giving patients another option besides weekly injections.

🆕 Foundayo (orforglipron) is the first approved oral, non-peptide GLP-1 receptor agonist. It doesn't require refrigeration or fasting before taking it, making it a convenient option for many people. Average weight loss in clinical trials was about 9%.

👀 Coming soon: CagriSema combines semaglutide with an amylin analog and has shown approximately 20% average weight loss in clinical trials—approaching the results seen with bariatric surgery.

No medication is a magic solution. The best results still come from combining medication with healthy nutrition, regular physical activity, quality sleep, stress management, and long-term lifestyle habits.

Try making your own sourdough bread at home this summer if you have a little extra time. There is something satisfying about baking a loaf from scratch—and your kitchen will smell amazing.

Sourdough starter: Vine Sourdough Bakery
Bread recipe: Alexandra's Kitchen

Homemade Hummus
Ingredients:�
1 can (15 oz) chickpeas, rinsed and drained�
¼ cup lemon juice (from 1½–2 lemons), plus more to taste�
1 medium-to-large garlic clove, roughly chopped�
½ teaspoon fine sea salt, or to taste�
½ cup tahini�
2–4 tablespoons ice water, more if needed (especially if the tahini is very thick)�
½ teaspoon ground cumin�
Fresh parsley, chopped, for garnish

Fresh sourdough, homemade hummus, and crisp vegetables—one of my favorite simple summer meals.

Why your metabolism shifts in menopause — and what can actually help. 🧬

Estrogen isn't just a reproductive hormone. It's a metabolic regulator — and when it declines, your body composition changes, resulting in increased abdominal and visceral fat.

That's why replacing estrogen, when appropriate, can do more than relieve hot flashes. Menopausal hormone therapy (MHT) has measurable metabolic benefits backed by research: A study using DEXA scans in 1000 post-menopausal women show that women on hormone therapy accumulate less visceral and abdominal fat over time compared to those not using it.

Is MHT right for everyone? No. It's a highly individualized decision based on your medical history, risk factors, and goals. But for many women, it's one of the most powerful tools available for protecting both how you feel and your long-term metabolic health.

If you've been told menopause weight gain is just "part of aging" — this is your sign to ask better questions. 💬

👇 Drop your questions below, or book a free Discovery Call at the link in bio.

References:
Papadakis, J Clin Endocrinol Metab 2018
Castaneda R, The Lancet Obstetrics, Gynaecology, & Women’s Health, 2026

Birth control pills or menopause hormone therapy (MHT) during perimenopause—how do you choose?

Both can be highly effective for symptom relief, but they serve different purposes.

💊 Birth control pills:
Symptom relief
Reliable contraception
Better bleeding control
Higher hormone doses

🌿 MHT:
Symptom relief
Body-identical hormones
Favorable side-effect profile
❌ Not birth control
❌ May not control bleeding

The best choice depends on your symptoms, goals, and stage of the menopause transition.

How do we know if someone is in perimenopause?�
And which blood test confirms it?
Surprisingly, there’s no single blood test that can diagnose perimenopause.
Hormones don’t decline in a straight line.�They fluctuate.

Research from the Study of Women's Health Across the Nation ( SWAN) showed several estrogen trajectory patterns during perimenopause:�
• Roller coaster ups and downs�
• Slow, gradual decline�
• Stable until a sudden drop�
• Late drop levels rise and stay up, then fall after the last period.
A hormone test is only a snapshot of a moving target.

So how do we diagnose perimenopause?�
-We listen to our patients. We review symptoms, menstrual changes, sleep, mood, and overall health.
-Testing is still important to rule out other conditions like thyroid disease, iron deficiency, vitamin deficiencies, sleep apnea, or rheumatologic conditions.

References:
El Khoudary SR et al. “Menopause Transition and Cardiovascular Disease Risk.” Circulation. 2020;142:506–532.
Tepper PG et al. J Clin Endocrinol Metab. 2012;97(8):2872–2880.