HRT — everything After Forty Feel has written.
The hormone replacement therapy conversation, taken seriously. Start with whichever entry point fits your situation — readiness quiz if you're just learning, the post-WHI letter if you've been told to avoid HRT, the bridge letter if you're still cycling.
If you're just starting to research
The HRT readiness quiz
Twelve questions that tell you whether HRT is worth bringing up with your prescriber, and which kind. No email gate. No supplement upsell.
The 2024 research reset
HRT after the 2024 reanalyses
The 2002 Women's Health Initiative scared a generation off HRT. The 2023-2024 reanalyses updated the math. For many women in early menopause without contraindications, the absolute risk numbers are smaller than the headline made them sound — and the benefits compound for years.
The peri-to-menopause bridge
Hormonal birth control in perimenopause — the under-discussed bridge
The years between cycles getting weird and menopause being official have a treatment most women's media skips entirely. Not HRT yet. Not nothing. Low-dose hormonal contraception as the multi-year bridge.
Decision support — what to ask, what to track
Reading your bloodwork at 50 — what to ask for
If you're considering HRT, your prescriber will run FSH + estradiol + progesterone + TSH. But the FULL bloodwork picture (ApoB, fasting insulin, vitamin D, ferritin) tells you how your whole physiology is shifting, not just your reproductive hormones.
Brain effects worth understanding
Brain fog at 47 — the neurometabolic reframe
The "menopause brain fog" framing has a research basis (Maki, Henderson, Mosconi). Cognitive symptoms aren't psychological — they're a neuroenergetic transition. HRT plays a role for some women; the timing window matters.
Sleep + HRT interaction
Why your sleep architecture changed at 47
Sleep stage durations literally change shape in late 40s, independent of cortisol or mood. HRT can preserve slow-wave sleep in some women, but isn't a one-size answer.
For men reading along — TRT
TRT for men 40-60 — the actual decision framework
The hormone conversation for men is more commodified and less honest than for women. What testosterone actually does, who benefits, who shouldn't, and the difference between TRT and a peptide stack.
The pathway for women
HRT pathway — start to clinician-ready
The full pathway from "I'm curious" to "I'm ready to talk to a prescriber" — including how to find a prescriber who's current on the research, what to track ahead of the appointment, and what red flags to watch for.
The Sunday letter
Free. Research-led. One thoughtful letter a week on the decade media gets wrong.