Understanding Hormones, Perimenopause & Hormone Therapy

An Information Letter for Women

Dear Women,

It’s time to take the fear out of hormone therapy. With the right monitoring and an

individualised approach, hormone therapy can be safe, effective, and life-changing.

The Language of Hormones

Hormones don’t just appear out of nowhere. They are written and delivered like important

messages.

• The hypothalamus is the master “author” of hormones.

• The pituitary gland is the messenger, delivering instructions to the rest of the body.

• Other glands (such as the adrenals and ovaries) follow these instructions and produce specific hormones including estrogen, progesterone, testosterone, DHEA, and

  cortisol.

Every hormone acts like a message, and your body’s cells are full of “locks” (receptors)

waiting for the right key. When the right hormone reaches the right receptor, the message is

received.

Perimenopause – A Time of Transition

Perimenopause is the natural transition toward menopause, and it begins when the

communication between your brain and ovaries starts to shift.

• The first hormone to decline is progesterone.

• Next, estrogen begins to fall.

• Testosterone is not tied to your cycle, so it is still made daily.

This changing hormone balance explains many of the physical and emotional changes women notice during these years: mood shifts, irregular cycles, sleep disturbances, hot flushes, low energy, and sometimes reduced sexual desire.

Hormone Therapy – What You Need to Know

Why Consider Hormone Therapy?

Hormone therapy can:

• Reduce vasomotor symptoms (hot flushes and night sweats).

• Improve sleep, energy, and mood.

• Support bone and heart health.

• Improve sexual function and vaginal health.

• Enhance quality of life during and after menopause.

Safety Matters

• Estrogen can be safely used up to age 60 (earlier is better for heart and brain health).

• Transdermal estrogen (through the skin) is safer than oral for women with clotting

risk.

• Risks (such as breast cancer and clotting) are influenced by type, dose, lifestyle, and

whether progestins are used alongside estrogen.

• Each woman’s risk/benefit profile is different — which is why personalised

monitoring is essential.

Symptoms We Can Help With

• Hot flushes & night sweats

• Mood changes & sleep disturbance

• Low sexual desire (Hypoactive Sexual Desire Disorder – HSDD)

• Vaginal dryness, painful intercourse (Genitourinary Syndrome of Menopause – GSM)

• Irregular or heavy bleeding during perimenopause

• Bone and heart health concerns

Treatment Options

Your therapy may include one or more of the following:

1. Progesterone Capsules (compounded, vegetarian)

o Typical dose: 75–150mg orally at night.

o Helps regulate cycles, support sleep, and balance estrogen.

2. Oestradiol Topical Cream

o Compounded in macadamia cream.

o Standard strength: 1mg per gram (0.1%).

o Dose: 1–2 pumps daily (0.5–1.0g).

o Supports bone, heart, brain, and symptom relief.

3. DHEA Capsules

o Typical dose: 5–15mg in the morning.

o Supports energy, mood, and sexual health.

4. Testosterone Topical Cream

o Strength: 1–4mg per gram (0.1–0.4%).

o Dose: ½–1g applied daily to buttocks or thigh.

o Helps restore sexual desire, energy, and muscle health.

Note: Blood tests are used for monitoring. Testosterone is adjusted gradually to match

healthy pre-menopausal levels.

Other Important Points

• Vaginal estrogen is effective for dryness and discomfort — applied only about 2.5cm

(1 inch) inside, and also to the vulva.

• Lifestyle matters: exercise lowers breast cancer risk, while daily alcohol increases it.

• If you’ve had a provoked DVT (clot), transdermal estrogen remains a safe option.

• Symptoms like heavy bleeding in perimenopause should always be investigated with

  ultrasound.

• Hormones should be reduced gradually when ceasing therapy — never stopped

  abruptly.

Final Thoughts

Hormone therapy is not “one-size-fits-all.” With the right formulation, careful monitoring,

and ongoing support, it can transform your quality of life.

Menopause and perimenopause are not the end of vitality, but rather a new chapter — one

you don’t have to navigate alone.

Warm regards,

[Your Clinic / Doctor’s Name]