• 11/1/26

Episode 37: HRT Deep Dive: Estrogen, Progesterone & Testosterone Explained with Karen Martel

Summary

Hormone replacement therapy (HRT) is everywhere right now, but between the types, doses, delivery methods, and conflicting advice, it’s easy to feel more confused after your research than before. In this episode that dives into HRT, Erin sits down with Karen Martel, a Certified Hormone Specialist, Nutrition Coach, and CEO of Midlife Solutions, a women’s health clinic focused on bioidentical hormone therapy and holistic midlife wellness.

Together they cover what’s happening to our hormones as we age and why symptoms look so different from woman to woman. Karen explains what’s most misunderstood about HRT, what to consider with estrogen, progesterone, and testosterone, including delivery forms and the lab markers she looks at, and how and when to testThey also get into whether to go by labs or by how you feel, why timing matters, and how to advocate for yourself with a practitioner.

Every body is different, and what works for a friend can’t simply be copied. This conversation gives you the foundation to understand your options and ask better questions.

What You’ll Learn

  1. When Karen says perimenopause typically begins (the late 30s to early 40s)

  2. Why she says progesterone is usually the first hormone to change

  3. The early signs she links to low progesterone, including heavier periods, longer PMS, anxiety and sleep trouble

  4. How she separates progesterone, estrogen and testosterone symptoms

  5. Why she says "it's natural" does not settle the HRT question

  6. What she says women misunderstand about estrogen and "estrogen dominance"

  7. Why she recommends timing progesterone testing late in the cycle

  8. What FSH is and why some labs test it early in the cycle

  9. Why delivery method comes up so often in hormone therapy, per Karen

  10. How long she says it can take to find the right plan, and her answer on whether it is ever too late to start

Chapters

0:00 When does perimenopause actually start?

2:01 What is happening to our hormones as we age?

7:05 Where do brain fog, muscle loss and a flat mood come from?

9:36 Is the ice cream analogy for estrogen, progesterone and testosterone right?

11:40 If hormone loss is natural, why talk about HRT at all?

18:13 What do women misunderstand about HRT?

23:50 How do you find a practitioner who knows hormones?

28:03 When should you test progesterone?

33:31 What is the Dutch test, and is it worth it?

35:33 What should you look at on testosterone labs?

46:46 What are the options for delivering estrogen?

54:14 Do estrogen and progesterone have to be taken together?

56:05 What does estrogen dominance actually mean?

57:57 Why can't you copy a friend's hormone plan?

59:31 What do light periods mean compared with heavy ones?

1:01:54 Is it ever too late to start HRT?

Resources

Connect with Karen