Fix What They Missed | Women’s Hormone Care

COMPLEX HORMONE CARE FOR
Women WHO ARE DONE SETTLING FOR ONE-SIZE-FITS-ALL ANSWERS.

If something in your body has changed and the usual answers aren’t cutting it, I look at the whole clinical picture, not one symptom or one lab at a time, because that’s how the things everyone keeps treating separately finally start to make sense.

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Medical Professional? Contact Me Here

MEDIA APPEARANCES & ADVANCED TRAINING

“Normal” lab ranges weren’t designed to define what optimal health feels like.

Most women don’t end up here because of one random symptom. It’s usually a collection of things that started changing around the same time. Maybe you’re sleeping like shit, forgetting words you absolutely know, noticing changes in your mood or sex drive, dealing with bladder symptoms you never had before, or just feeling like your body is behaving differently and nobody has given you a decent explanation for why.

Too often those changes get filed under stress, ageing, lifestyle, or “everything looks normal” before anyone stops to look at the bigger hormonal picture.

That’s what I want to help you understand.

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I'VE SPENT MORE THAN 20 YEARS UNDERSTANDING THE SYMPTOMS WOMEN ARE TOLD ARE “IN THEIR HEAD” SO I CAN HELP YOU MAKE SENSE OF WHAT YOUR BODY IS Actually TELLING YOU.

I’m Holly Warner, founder and Chief Medical Officer of Holly Warner Health and the person behind Fix What They Missed.

I’ve worked in hormone therapy for more than two decades, with more than 16 years in clinical practice. My advanced training includes Levels I through IV with Worldlink Medical, continuing education through Harvard Medical School’s 2026 WHAM program, and I’m an Affiliate of the TruBalance Healthcare Network in Canada for Bioidentical Hormones.

Menopause, perimenopause, thyroid disease, sexual health and complex hormone cases are what I spend my days looking at, and if there’s one thing I’ve learned, it’s that symptoms rarely show up in neat little boxes.

I see women all the time who have been given one explanation for their sleep, another for their mood, another for their libido, another for their bladder, and nobody has stopped to ask whether some of those things might actually be connected.

That’s why I created Fix What They Missed.

I want to help you understand what may be happening, what the research actually says, and what questions are worth asking when something still doesn’t add up.

MEET HOLLY

How Care Works at
Holly Warner Health

Holly Warner Health is a multidisciplinary, hormone-focused practice built around collaborative care. As team lead, I provide clinical oversight, chart review, lab interpretation, treatment strategy and case-based guidance throughout the patient journey.

Our nurse practitioners and physicians provide prescribing care within their respective scopes of practice. We work from the same clinical picture, looking at your symptoms, health history, lab results and response to treatment together rather than treating each piece in isolation.

When something needs a closer look, the case is reviewed as a team so the appropriate licensed clinician can make informed decisions about next steps.

The goal is thoughtful, evidence-informed care that considers the whole patient rather than relying on a one-size-fits-all approach.

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We are a proud member of the TruBalance Healthcare Inc., Canadian Physician and Nurse Practitioner Network for Bioidentical Hormones, Testosterone, LDN and custom Thyroid, established in 2009

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YOU PROBABLY ALREADY HAVE A QUESTION.
Let's Start There

You don’t need to understand all of this at once. Start with the thing that brought you here and we’ll work outward from there.

Bone, Cardiovascular
& Metabolic Health

Looking beyond symptom relief to the broader role hormones can play across bone, cardiovascular and metabolic health.

Thyroid & Complex Hormone Care

Thyroid disease, Hashimoto’s, hormone sensitivity, autoimmune overlap and cases where multiple factors need to be considered together.

Brain, Mood
& Cognition

The relationship between hormones and memory, cognition, mood and neurological health.

Sexual &
Urogenital Health

GSM, vulvovaginal health, desire, arousal, pain, bladder symptoms and the hormone-sensitive tissues that are too often left out of the conversation.

Hormone Therapy

Estradiol, progesterone, testosterone and DHEA, including the evidence, dosing considerations, formulations, monitoring and the nuance that gets lost in one-size-fits-all conversations.

Perimenopause
& Menopause

Understanding the hormonal transition, changing symptoms and the bigger health picture before, during and after menopause.

Hormones rarely work in isolation. In just 2 minutes, this clinical screen can help identify whether your symptoms look more like a sex hormone, thyroid, stress and cortisol, metabolic, or more complex overlapping pattern.

Get a clearer picture of what may be worth exploring next.

TAKE THE 2-MINUTE CLINICAL SCREEN

Your results are designed to guide your next steps and are not a medical diagnosis.

YOUR SYMPTOMS ARE TELLING YOU
Something

WONDERFUL EXPERIENCE

"Working with Holly, her team and doctor has been wonderful. I feel very well taken care of and listened to. Getting a full battery of blood work done and having people to take their time and explain the results in a very detailed manner is worth every penny."

— Karen

ABSOLUTELY THRILLED

"I am thrilled to have found Holly Warner Health. Holly's knowledge and wealth of information is an asset when it came to my BHRT journey. My overall wellness extremely improved while on BHRT. I highly recommend Holly Warner Health to anyone considering HRT."

— Lynn

HIGHLY RECOMMEND

"I feel like I’ve finally found a team that understands my needs. Not only does Holly understand my needs, but she explains everything in detail. The best part, I can always reach out and someone will answer my questions! Highly recommend Holly and her team. Very grateful!"

— Sharon

STRAIGHTFORWARD APPROACH

“I’ve known Holly for several years as a patient and an enthusiastic follower of her social media. What I truly appreciate about her is her straightforward approach; she always validates my feelings and backs her protocols with solid information.”

— Maxime

AMAZING EXPERIENCE

“I reached out to Holly desperate for relief from menopause related concerns, felt like I was losing myself. The professional advice and care received has made a tremendous improvement. Only regret is not starting sooner.”

— K.

WHEN WOMEN FEEL HEARD, THINGS
Change

Start with a 15-minute clarity call

If you’re not sure what makes sense next, this is the easiest place to begin. We’ll talk about what brought you here, what you’re looking for and whether a more in-depth clinical assessment may be appropriate.

This is not a medical consultation or diagnosis. It’s a first conversation to help determine the right next step.

BOOK A 15-MINUTE CLARITY CALL

Looking for clinical care?

Holly Warner Health is my multidisciplinary medical practice, where I lead the clinical team and work collaboratively with our nurse practitioners and physicians on hormone-focused care.

If you’re considering becoming a patient, start with the 15-minute clarity call and we’ll determine whether the practice is the right fit for what you need.

BOOK A 15-MINUTE CLARITY CALL

COMING SOON

Prefer to dig into the research first?

I’m building an education hub for the women who want to understand the science before they do anything else. You’ll find research breakdowns, patient education and deeper conversations about hormones, menopause, thyroid health, sexual health and the areas where the answer is rarely as simple as one headline makes it sound.

EDUCATION HUB COMING SOON

You don’t need
to have it all figured out before you start.

Some women come here with a specific question. Others have years of symptoms, labs and half-answers they’re trying to make sense of. And some already know they’re ready to explore clinical care.

MORE OF THE CONVERSATION IS HAPPENING ON Instagram

It’s the weekend, you’re getting ready to head out for dinner with friends…in your 40’s

Except, alcohol hits a little different after 40 doesn’t it?

Yet another thing we can blame on our hormones (no, seriously!)

Estradiol helps regulate how our liver handles alcohol, and when it drops, alcohol clearance slows, which means acetaldehyde (the toxic byproduct), hangs around longer.

That’s where the flushing, headaches, nausea, and the whole“why did one glass feel like five?” feeling comes from.

Then there’s progesterone, which is part of your GABA system (our calming neurotransmitter pathway). Alcohol gives a temporary GABA boost, but when progesterone is already low (as it tends to be in perimenopause), the crash can be pretty brutal.

Hello 3 a.m. anxiety, irritability, and absolute garbage sleep.

Testosterone should probably also get a mention since it supports mitochondrial function, glucose regulation, and metabolic resilience. Lower testosterone can mean bigger blood sugar swings after drinking.

Oh and DHEA helps regulate cortisol and inflammation! When DHEA drops, alcohol can become a way bigger inflammatory trigger.

Both perimenopause and menopause change liver metabolism, brain chemistry, blood sugar stability, inflammation, and sleep.

The wine didn’t get stronger, our physiology changed.

Personally I maximize and optimize when it comes to my personal hormone therapy strategy. I make sure not to miss a dose of my testosterone therapy. I take DHEA orally (daily). My estradiol gets a little boost and I pop a progesterone TROCHE before I go out. Not the kind that makes you sleepy. The kind that helps you process the negative effects of alcohol a little bit better.

That doesn’t mean I go out and abuse alcohol like a 20 year-old university student. It simply means that I support my body in ways that allow me to enjoy one glass of wine without it feeling like I’ve been hit by a truck the next day.

#fixwhattheymissed

Why is it always the ones who can’t prescribe? Someone needs to teach her about the timing hypothesis.

The WHI found real benefits when estradiol was started in the 50 to 59 age range. Women in that group had fewer heart attacks, fewer hip fractures, and a lower rate of the trial’s combined disease outcomes across 13 years of follow up.For every 76 women started on estrogen at 50 to 59, one less heart attack occurred over 13 years, and outcomes for MI and the global index were both significantly better in that age group compared to older women.

The ELITE trial tested this directly. Estradiol slowed the progression of artery thickening in women within six years of menopause, but had no effect when treatment started ten or more years after menopause. That’s the actual window the data supports, and going into menopause after 45 doesn’t put most women outside it. The average age of natural menopause is around 51, so someone starting HRT in her early to mid fifties is usually still inside those first six to ten years, not past them.

Bone protection isn’t a maybe either. Women randomized to hormone therapy in the WHI had about a 50% lower risk of fracture, including hip fracture, compared to placebo, and this held true regardless of their starting estradiol levels. Calling that unproven doesn’t match the trial data. It’s one of the most consistent findings to come out of WHI.

The claim that primary prevention benefit isn’t proven for women who reach menopause in their late 40s or 50s doesn’t hold up against the RCTs we actually have. #fixwhattheymissed

Because for some of us, living began at midlife.

Isn’t the 2nd act worth feeling incredible and thriving? I am privileged to watch patients within my practice age not just with grace and dignity, but also with vibrancy. Our sparkle doesn’t need to dull simply because midlife knocked.

Our muscles can stay strong, our bones don’t need to become brittle.
Our heart can beat as strong as it did in our 20s, and our brains be just as sharp.

Facts over feelings. Evidence over fear.

Women deserve to know what the data is saying without all the rest of the noise.

https://activatefit.ca/activate-her/

I knew great things would happen when I attended this event in 2009….

I just had no idea how great.

Menopause doesn’t suddenly make men the problem.

It often makes women less willing to carry problems they were taught to normalize.

Yes, there are biological shifts across perimenopause and menopause. Hormones affect sleep, mood, stress tolerance, desire, cognition, pain sensitivity, and emotional regulation.

Can’t deny biology, but biology doesn’t erase sociology.

A woman may have wanted children. She may have wanted partnership. She may have built a family. That doesn’t mean she was biologically programmed to tolerate emotional neglect, unequal labour, poor communication, weaponized incompetence, or being treated like the household manager with benefits.

And no, “the patriarchy” doesn’t mean “all men are bad.” Just like #MeToo didn’t mean ALL men. But it is unfortunately most.

I said what I said

Social structure where women have historically been expected to sacrifice, accommodate, soothe, mother, organize, forgive, manage, absorb, and stay quiet while being told this was love, maturity, or “just how men are” is shifting.

Menopause didn’t create the problem, it removed the patience we once had for the performance.

It’s decades of adaptation finally meeting a nervous system that has run out of free labour.

Tiny inconvenient detail: women also have more financial independence now, marriage rates have declined, and more women can choose NOT to stay in relationships that drain them.

That’s not a hormonal issue, it’s called options.

In Canada, the probability of ever marrying dropped from 74% in 1991 to less than 44% in 2020, and 4.4 million Canadians were living alone in 2021, the highest share on record. In the U.S., 42% of adults were unpartnered in 2023, and women were more likely than men to be unpartnered, 44% versus 40%. Sources: Justice Canada⁠, Statistics Canada⁠, Pew Research Center⁠.

So maybe the issue isn’t that women changed.

Maybe the issue is that women finally stopped negotiating with nonsense.

Websites can either be fun or a nightmare.

Back in July I experienced the nightmare part, and do I mean absolute fkn nightmare.

Big promises, deadlines missed, consistent mistakes and excuses…and nothing delivered.

Dropped like a sack of potatoes (out of nowhere) with trash that couldn’t be used.

Lesson learned.

Fast forward to this week and the project feels exciting again, not stressful at all.

Working with the right team makes all the difference. Website design isn’t the same as website development (who knew?!).

So beyond happy to have found an incredible team, local AND all female. The copy, the design, and the implementation has been above and beyond. So professional.

What a difference working with professionals makes!

I won’t name names…..but when it’s all done I will 1000% sing praises to the ones who took on a severely botched project, had to start from scratch with a serious project timeline and are actually pulling it off.

I was recently sent a video by Dr Susan Davis, someone you would think is qualified to speak on the ins and outs of testosterone therapy.

And yet, there I was watching this reel thinking to myself…what the actual *&#$

I would have commented in her video but shocker…she’s limited who can comment. We can’t drop incorrect info and simultaneously shut down discussion, that should be the first red flag 🚩

She makes some interesting statements without filling in the gaps for accuracy. Not to mention her claim that “low testosterone doesn’t predict if a patient will have low sexual desire, low mood, low cognition, low bone density, weak muscles or anything”.

I am so sick of hearing clinicians say there is “insufficient evidence” as though not enough data is the same as no data at all. Luckily there are those of us, like Rachel S. Rubin MD - Urologist and Sexual Medicine Specialist and Dr Kelly Casperson, who are quite vocal about the use and benefits of testosterone therapy.

@kellycaspersonmd
@drrachelrubin

Just google cl*t🤫ral atrophy (those aren’t fun images). It’s the decrease in size, sensitivity, or responsiveness, tied to declining estradiol AND testosterone during and after menopause. It falls under the broader umbrella of genitourinary syndrome of menopause (GSM).

It disappears ladies. Bet no one mentioned that tidbit in health class.

It’s an underrecognized companion to v*gin*l atrophy, since most clinical attention historically goes to v@gin*l symptoms.

We have data on mood, energy, bone health and cognition. There’s more research being done but we aren’t waiting for that to eventually roll out and prove what we already know.

So saying it doesn’t exist is dishonest.

Read more (studies and facts) 👇🏼 🔗 in comments

Shoutout to @kellycaspersonmd for sharing this large Swedish population based cohort study on menopausal hormone therapy and liver cancer risk.

I was asked for a breakdown of what it all means, so here it is. #hormonehacker

Taking a look at ENDO-250, the investigational non hormonal ~p🤫pt🥼de~ giving hope to women suffering with endometriosis.

Anyone who suffers from endometriosis (either diagnosed or suspected) knows what it’s like to feel like we are constantly left out of the research. We have always treated it like a manage it and survive it condition. We hear the same story on repeat…Pain management + Hormonal suppression, then maybe surgery and repeat.

Endo 205 doesn’t amplify a hormonal signal, it’s designed to be taken up by the affected tissue where it acts locally at the lesion sites = localized.

Dig a little deeper over in my 🆓 Substack…see pinned comment (copy and paste into your browser).

So we’re selling Moneris?
One of the biggest payment processing platforms in Canada is being sold to the US, and it raises red flags 🚩 all over the place. Catherine Landry

Why are we not talking about DHEA more often? I absolutely love it and so do a majority of my patients (not all).

In Canada it’s available by prescription only. In the United States it’s OTC, but that’s usually garbage. Get it compounded and watch the difference.

Can it lower HDL? Yes in some cases but not usually when prescribed appropriately.

Acne, yes for some (it converts to estradiol and testosterone so it’s always a possibility)

Hair loss? Only for those who would also have issues with testosterone conversion into DHT. It’s not the testosterone or the DHEA.

Hair growth…maybe a chin hair or two in SOME women (same deal with testosterone)

Insomnia, if you take too much or too late in the day.

Headaches….on occasion for some women yes. Not all and not the majority.

Menstrual irregularities….not usually but we list it anyway just in case.

Now look at all the benefits…they far outweigh the negatives that MIGHT happen.

My 30mg DHEA is a game changer.
For some it’s 5 mg, 10mg, 15mg or even 20mg… Every dose is based off YOU the individual patient as it should be.

Stop calling estradiol “estrogen”

Stop assuming the risk with one format goes for them all when it comes to estrogen therapies (especially oral ones).

For healthy women without major VTE risk factors, the absolute risk of a blood clot with oral estradiol is very low.

Compared with conjugated equine estrogen, women taking oral estradiol had about a 15% to 17% lower risk of developing a blood clot, depending on whether they were taking estrogen alone or with a progestogen (micronized progesterone wasn’t studied in this one).

In other words, if you’re choosing between these two oral options, oral estradiol appeared to be the safer choice in this study.

Vinogradova et al. published in 2019

The study included 80,396 women with VTE and 391,494 matched controls from the QResearch and CPRD databases.

It’s not the only study to show this either.

Now weight out risk vs reward, the protection you loose by opting for a transdermal option (because someone told you it was “safer”) and THEN make your decision.

Informed decisions can only be made with all the evidence (aka evidence based medicine).

Oral estradiol has a SMALL increase in VTE risk in appropriately selected women compared with transdermal therapy. But calling it a “problem” ignores the fact that the first pass is also responsible for many of the physiological effects that make oral oestradiol a reasonable, and beneficial option for many women.

The liver isn’t an obstacle we should be avoiding, it’s part of the intended physiology of oral therapy. It’s like when they told us for 2 decades that hormones cause cancer and then whoopsy…they were wrong.

“9 extra clots per 10,000 women per year” sounds alarming until you actually do the math. If you look at the numbers they’re actually pooled across ALL oral formulations, including conjugated equine estrogen (CEE). In fact oral CEE + medroxyprogesterone (the synthetic progestin) has DOUBLE the VTE risk, but estradiol with dydrogesterone has a much smaller risk (non significant 18% increase).

Within that same study we see that oral estradiol performed way better than the pooled average, meaning the actual risk of oral estradiol was actually lower than 9 out of 10,000 (not equal to it). Oral estradiol specifically was 4 out of 10,000 women, that’s less than half.

A healthy 52 year old, normal BMI, non smoker, no thrombophilia, no prior VTE, no active cancer, no major cardiovascular disease is not the same patient as someone with multiple risk factors. So why treat her like she is?

We’re treating 0.09% absolute increase as though it’s a catastrophic danger while completely ignoring what the first pass through the liver is actually doing physiologically.

Risk isn’t binary, there should be a proper benefit versus risk assessment. Your decision should be evidence based/informed.

I break it down in detail over on my Substack if you’re interested. It’s a free post, no paywall so that everyone can access the info.

#clotrisk #riskassessment #menopause #fixwhattheymissed #hormonehacker

It’s shameful seeing MD’s, worse yet GYNs who refuse care to patients because they haven’t bothered to seek out additional training for hormone prescribing.

Seeing someone who has attended a medical conference where literature was reviewed, over and over again, where MHT has been reviewed by a hematologist who clarified that transdermal estradiol doesn’t increase clotting risk…yet the same medical providers will deny care because they won’t bother to look at the literature.

Stop telling patients there isn’t enough data when we have a plethora of it.

Stop denying care to patients.

Start properly treating them.

Start sitting down and having actual conversations where you review risk versus reward.

If you are unaware of the literature how will you ever going to educate and inform your patients.

It’s beyond exhausting, seeing patients to denied testosterone therapy, denied appropriate estradiol therapy, and even progesterone based off of a lack of understanding of the literature, and sheer ignorance.

Shared decision making is important.

Once again I find myself being sent information that has been put out by “The Menopause Revival” lady whose latest claim is that we have “misunderstood menopause” and supposedly “IGNORED the Science of Intracrinology”

She claims that menopause is a story we’re told, that our ovaries stop producing estrogen, that hormones decline, and that’s where our symptoms begin.

I’m not sure how it’s a story when it’s in the literature…over, and over… and over again.

But who cares about science when you can sell an online program right?

She also claims that if your menopause specialist doesn’t know what intracrinology is then they aren’t a menopause specialist, and thousands of women are falling for her BS.

Please don’t be one of them.

When someone with no clue is given a platform it can be a dangerous thing.

https://open.substack.com/pub/hollywarnerhealth/p/compensation-isnt-restoration-lets?r=ogr32&utm_medium=ios&shareImageVariant=card

Today I had a friend text me, she had just gotten out of the hospital with a broken bone. Her doctor informed her she likely had the beginning stages of osteoporosis or maybe osteopenia, pending more tests. She just turned 50 last year, and the news surprised her.

Another friend broke a bone last week, it’s becoming an all too common trend I’m starting to see with friends in their 50s, who thought they had time before the onset of deterioration from the loss of their hormones.

One of these women had a hysterectomy and no hormones added, she kept her ovaries and figured she was probably fine.

The other one hit menopause and one other from last month wasn’t quite there yet (she gets a period every 6 or 7 months.

We’re telling women that they need to wait for 12 months to signify menopause and then maybe we start to do something about it. But we aren’t talking about is the bone loss that is happening prior to menopause starting.

We have a window of opportunity and we are missing it.

Photo cause it’s pretty….

There’s a post circulating in women’s health groups claiming menopause has been “misunderstood” and that your body makes all the hormones it needs after your ovaries stop through a process called intracrinology.

It sounds scientific and it’s convincing women to question whether they actually need hormone therapy.

Here’s the deets.

Intracrinology is real and the data cited exists. After menopause, peripheral tissues can convert DHEA into small amounts of estradiol and testosterone locally. That parts accurate.

But here’s what they left out.

DHEA also declines with age, so the raw material for local production is shrinking at the same time your ovaries shut down. Postmenopausal intracrine estradiol is a fraction of what your ovaries produced. Enough to explain why you’re not in a complete hormonal vacuum, not enough to prevent bone loss, cardiovascular changes, genitourinary atrophy, or the brain metabolism changes we consistently see on imaging.

If intracrinology were sufficient, menopause wouldn’t exist as a clinical syndrome. Women wouldn’t get hot flashes, osteoporosis, vaginal atrophy, or the brain energy changes we now measure on FDG PET imaging in otherwise healthy women. They happen despite local hormone production continuing. 🤔

The idea that symptomatic women are less metabolically healthy is ridiculous btw. Plenty of women with excellent metabolic health, normal weight, healthy insulin sensitivity, and regular exercise still develop bone loss, cardiovascular changes, and cognitive symptoms after menopause. The brain imaging studies showing reduced cerebral glucose metabolism included otherwise healthy women, not just those with obesity or metabolic syndrome.

Metabolic health matters and I work on it with every patient. It modifies your resilience. It doesn’t replace ovarian estradiol or prevent the biological consequences of losing it.

Compensation isn’t restoration ladies.

As a clinician in this space for over two decades, if this were the case we could prescribe WAY LESS and that wouldn’t be something I’d be opposed to. #fixwhattheymissed

A Facebook page with 45,000 followers is telling women that menopause isn’t a hormone issue and that HRT “gags the messenger.”

The person behind it isn’t a doctor, she isn’t a nurse, she holds no regulated clinical credential of any kind.

And yet women are sharing her content, cancelling appointments, and walking away from a treatment that could protect their bones, their heart, and their brain.

This week’s Substack breaks down exactly who she is, what “neuro metabolic dysfunction” actually means (spoiler, it’s not in any peer-reviewed literature), and why the credential soup on her bio page means a lot less than it’s designed to look like.

I’m not a fan of tearing another woman down, but when that woman is positioning herself in a way that is harming the women I have spent my entire career trying to protect, game on.

45,000 followers is a lot of women to mislead.
As always, linkity link is in the BIO.
#hormonehacker #fixwhattheymissed #disinformation

My grandmother called it senile, her doctor called it aging, and some of you seem to have accepted it as something that happens to women when they get old.

But I’m calling it what it actually is…a starved brain.

When a woman goes ten years without estradiol, you don’t just feel the difference, you can see it on a scan.

Less tissue, thinner cortex, shrinking in the exact regions that control memory, personality, language, and the ability to think clearly and function day to day.

Hard pass! (No thanks, I don’t want that).

A 2026 study out of the University of Kansas scanned the brains of 459 women between 65 and 80 and found that the ones with more lifetime estradiol exposure had measurably more brain tissue in the regions most vulnerable to Alzheimer’s disease. Women who used birth control earlier in life and hormone therapy later had more brain, in the regions that go first, compared to women who used neither.

This was published in NeuroImage four weeks ago, and your doctor almost certainly has no about it.

As a woman reading this I bet you want to know all the deets (or at least you should!)

Detailed breakdown is on Substack, the linkity link 🔗 is in my bio.

#menopause #brainhealth #hormonehealth #fixwhattheymissed #alzheimersprevention

Just turned down an $8,000 USD speaker gig.

I was specifically told that they wanted all of my expertise, but I wasn’t allowed to demonize MLMs (because some of them had purchased expensive booths), Dutch tests 🧐, homeopathy (hey if you like it use it!), hair mineral analysis 👎🏼or live/dry blood nonsense 🔬

If you want me to speak at an event, it’s going to be an evidence based conversation. If you don’t like what the science has to say about some of these tests being absolute bullshit then I am not the speaker for you. It’s not the topic of my talk, but if I get asked in the Q&A, I’m going to answer honestly. That’s where they took issue.

I won’t dilute my message, and I certainly won’t sell out my morals or ethics for a paycheck.

There is a time in a place to utilize some of these things (not all), however, not in the prescribing space.

As add on testing that is non-diagnostic (because that is what these are considered), there may be a place depending on the test (not Hair mineral analysis and not the “live blood analysis”).

Unfortunately a lot of it is a money grab used by people with little to no training who are trying to look important. There’s enough space for everyone without trying to pretend we are something we aren’t or that we can do something we can’t. 🤷🏼‍♀️

It’s like when I say I’m “not a fan of MLM products” but once in a while one of them will pop up that blows my mind. Most of my skin care happens to be an MLM/affiliate style product (or whatever you wanna call it). The omega supplement that I swear by also happens to be an affiliate marketing model (it’s seriously so freaking good!).

If your products are truly great, I will shout it from the rooftops!

Honestly, moral integrity, and transparency are how I roll.

Progress like this is what I dreamt of 20 years ago, back when those of us working in hormones were few and far between.

The strides we’ve made are incredible.

Access to hormone therapy has improved dramatically, women are asking better questions, and more clinicians are entering the space. Watching that evolution has been incredible. I honestly never thought I would see the day.

I’ve taken course after course, attended advanced trainings, medical conferences, seminars, and CME events. I have binders full of studies, highlighted literature, and years of continuing education that have shaped the way I practice and allowed me to provide care grounded in evidence rather than opinion.

What I see now isn’t an access issue.

The challenge has shifted.

The challenge is ensuring that the clinicians prescribing hormones truly understand what they are prescribing, how to prescribe it appropriately, and how to troubleshoot the more complex cases that don’t fit neatly into a textbook.

Back in March, I had the privilege of meeting @drrachelrubin at the Harvard CME program in Boston. Every lecture she delivered was exceptional, and I left with pages of notes and even more appreciation for the importance of continuing education in this field.

I’m already looking forward to seeing her again in February at the annual ISSWSH (International Society for the Study of Women’s Sexual Health) meeting.

What we need now isn’t simply more access.

We need more clinicians opening the books.

More clinicians reading the literature.

More clinicians understanding what they’re reading.

More clinicians willing to challenge outdated beliefs and continually expand their knowledge.

Understanding when to prescribe, what to prescribe, how to adjust treatment, and how to navigate the nuances of patient care is where expertise lives.

Women deserve access, but they also deserve clinicians who never stop learning.

Special thanks to Melinda Gates (and Pivotal)

For those of us who have been working in this space for years, this is more than a generous donation. It’s recognition that women’s health matters, menopause matters, and the education of healthcare professionals matters.

The question was around the fact that we can’t really “test” vaginal estrogen, but what we can do is test the pH and our pH will tell us if we have adequate estrogen or not.

#precisionmedicine #hormonetruths #chronicuti

I hear it all the time

“My Dr wants me to stop my hormone therapy”.

“My doctor thinks I’ve been on it for long enough and should take a break”.
Both of these statements are horrific advice, especially if you have been on hormone therapy past menopause for any length of time.

https://open.substack.com/pub/hollywarnerhealth/p/stopping-your-hormones-isnt-playing?r=ogr32&utm_medium=ios

Women are often told they’re “aging naturally” when they decline hormone therapy.

But what if what’s actually happening is a swap to eventual pharmaceutical substitutions/interventions?

I’ve seen women enter menopause with minimal symptoms and choose to avoid hormone therapy because they believed it was the safest option.

Fast forward 10-15 years.

They’re taking medications for:

• Sleep
• Anxiety
• Depression
• Hot flashes (yep, those can stick around)
• Pain
• Bone loss
• Blood pressure
• Cholesterol

And nobody ever stopped to ask if hormones had been part of the conversation could those meds have been avoided?

Before anyone gets defensive…

This is not anti-medication.

Many women genuinely need these medications and they can absolutely improve quality of life.

This is about informed consent.

Because here’s something most women aren’t told… some of the medications commonly prescribed to menopausal women can become difficult to discontinue once started.

In fact, entire medical guidelines exist around “deprescribing” certain medications because stopping them often requires careful tapering, dose reductions, liquid formulations, compounding pharmacies, and close monitoring. Yet most of the docs I see prescribing these have ZERO clue how to accomplish that.

Somehow we’ve become more afraid of discussing hormones than discussing medications women might get stuck on for years or even decades.

That doesn’t make sense to me.

The goal should be ensuring every single woman understands ALL of her options.

Hormone therapy.
Lifestyle intervention.
Nutrition.
Strength training.
Sleep optimization.
Stress management.
Medication when appropriate.

Not fear-based medicine.

Not one-size-fits-all medicine.

Honest conversations backed by evidence.

Because women deserve more than symptom management.

They deserve choices.
#evidencebasedcare #hormonehacker

One of the most important pieces of advice that I give every single one of my patients is that vaginal estrogen therapy (of any kind!) is non-negotiable.

And you don’t wait until menopause to start.

https://hollywarnerhealth.substack.com/p/vaginal-estrogen-stays-local-but/comment/267114949?r=ogr32&utm_medium=ios

I’ve seen a lot of commentary on this in medical circles but not one single person has offered a solution. Probably because as much hormone knowledge as these providers have, they don’t have the nuance component for histamine related issues. Luckily, being someone who suffers from MCAS and also just so happens to be a hormone specialist, histamine issues + PMDD were right up my alley.

If you’ve spent any time on women’s health TikTok lately, you’ve probably seen this new-ish trend. Women with PMDD, perimenopause symptoms, or the general hormonal chaos of midlife are stacking Pepcid AC with Allegra or Zyrtec and reporting what sounds like the most incredible relief ever, and they aren’t lying. Brain fog lifted, fatigue gone... A literal feeling of being back in their own bodies.

But are antihistamines actually the answer?

📌 Latest Substack article 🔗 is the pinned comment.

This was a great reminder of how important social media content is, you never know who you will reach.

https://substack.com/@kkbeausmom/note/c-261684195?r=ogr32&utm_medium=ios&utm_source=notes-share-action

Seeing women advocate for better care and access to hormones in a way that works best for their body, is an example of how rewording this type of work is.

https://substack.com/@thelibbiegrant/note/c-259996119?r=ogr32&utm_medium=ios&utm_source=notes-share-action

Systematic reviews on hormone therapy and stroke risk in menopausal women. How can women educate themselves?

Searching terms like “menopausal hormone therapy stroke risk meta analysis” in PubMed or Google Scholar will pull up detailed papers that compare age, timing, dose, route and formulation. But I want to be sure you’re understanding the data, and asking the right questions.

It’s why I reviewed the data for you in today’s post on Substack (and show you how to review the data yourself!)

I’ll pin 📌 the “where” below 👇🏼 (comments)
#stroke #menopause

Sometimes it’s not about the hot flashes, sometimes it’s simply about feeling a little bit more like ourselves in the day-to-day shuffle.

#hormonesupport #fixwhattheymissed

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FOLLOW ME ON INSTAGRAM

COMPLEX HORMONE CARE FOR Women WHO ARE DONE SETTLING FOR ONE-SIZE-FITS-ALL ANSWERS.

“Normal” lab ranges weren’t designed to define what optimal health feels like.

I'VE SPENT MORE THAN 20 YEARS UNDERSTANDING THE SYMPTOMS WOMEN ARE TOLD ARE “IN THEIR HEAD” SO I CAN HELP YOU MAKE SENSE OF WHAT YOUR BODY IS Actually TELLING YOU.

How Care Works at Holly Warner Health

YOU PROBABLY ALREADY HAVE A QUESTION. Let's Start There

Bone, Cardiovascular & Metabolic Health

Thyroid & Complex Hormone Care

Brain, Mood & Cognition

Sexual & Urogenital Health

Hormone Therapy

Perimenopause & Menopause

YOUR SYMPTOMS ARE TELLING YOU Something

WHEN WOMEN FEEL HEARD, THINGS Change

Start with a 15-minute clarity call

Looking for clinical care?

Prefer to dig into the research first?

You don’t need to have it all figured out before you start.

MORE OF THE CONVERSATION IS HAPPENING ON Instagram

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COMPLEX HORMONE CARE FOR
Women WHO ARE DONE SETTLING FOR ONE-SIZE-FITS-ALL ANSWERS.

How Care Works at
Holly Warner Health

YOU PROBABLY ALREADY HAVE A QUESTION.
Let's Start There

Bone, Cardiovascular
& Metabolic Health

Brain, Mood
& Cognition

Sexual &
Urogenital Health

Perimenopause
& Menopause

YOUR SYMPTOMS ARE TELLING YOU
Something

WHEN WOMEN FEEL HEARD, THINGS
Change

You don’t need
to have it all figured out before you start.