I tried Bioidentical Hormone Therapy (BHT). Here’s my honest take on BHT: The Good, The Bad & The Ugly.
Here’s the backstory:
Like many of you, I started noticing some early symptoms of perimenopause—nightsweats, headaches, poor sleep, and mood shifts right before my period. But honestly, looking back, it wasn’t anything too extreme. Still, knowing the benefits of starting BHT earlier than later in perimenopause, I decided to give it a try. I found a local practitioner and began using oral progesterone and testosterone cream.
At first, the progesterone felt like magic. I slept better, woke up feeling rested, and my body and mood seemed to really love it. But then, just 17 days in, my period arrived—way earlier than usual (typically I run a 26-29 day cycle). Needless to say, I was panicked. Your cycle is a key indicator of overall health, and I didn’t want to mess with it. Before that, my cycles were regular, with pain-free, easy periods. I want to keep my natural cycle as long as I can to maintain the long-term health benefits, like heart health, bone density, and protection against metabolic disease.
Then, there was the testosterone. At first, things were great—more energy, a stronger libido, better focus, and even building muscle (I put on 2 pounds in just a few months). But then, things went haywire.
My skyrocketing testosterone was completely throwing off my blood sugar regulation, making it nearly impossible to control my cravings. High testosterone can increase insulin resistance, meaning my body wasn’t efficiently using the carbs I was eating—leading to constant (!!) hunger, energy crashes, and an endless cycle of eating just to feel normal. I’d even wake up starving in the middle of the night, needing to eat just to fall back asleep. During the day, my cravings were relentless, even though I was eating plenty of protein, fiber, and balanced meals. Despite doing all the “right” things, I gained 7-9 pounds since starting BHT.
Here’s what I think was happening:
- Testosterone can drive up your metabolism and hunger, making you eat more, while progesterone promotes fat storage—a perfect storm for weight gain.
- Too much testosterone can impair insulin sensitivity—sometimes within just a few weeks or months—leading to blood sugar fluctuations, intense cravings, and increased fat storage, much like what happens with PCOS. And I was living proof of how quickly things could spiral!
- With my body struggling to regulate blood sugar, I was caught in a cycle of eating more just to feel stable, yet still dealing with hunger and fat gain.
On top of the weight gain, I just didn’t feel like myself. I even told my husband, Mal, “I feel like I’m going through a tough time right now, and something has to change ASAP.” I knew something was off, so I ran some bloodwork… and the results were shocking. My testosterone was crazy-high at 441—when normal levels for women in perimenopause are only 20-80. It was a clear sign that my body was out of balance, and I couldn’t ignore it any longer.
So, what’s next?
As I’m writing this, I’ve decided to stop BHT altogether. I’ve been off the testosterone for 2.5 weeks, and already I’m seeing improvements in hunger and cravings. I stopped the progesterone more than a month ago, and I’m happy to report that my last cycle was 28 days and arrived with no symptoms (surprise!). I’m back to focusing on the basics, patience, and consistency. After stopping the progesterone, my sleep hasn’t been great, so I added in some slow-release melatonin before bedtime to help improve it.
Here’s the takeaway:
I love the idea of BHT, but looking back, I realize I may have jumped the gun. This experience made me see that I was already in a really good place with my health. Sure, I had some minor perimenopause symptoms, but I was doing a great job overall of maintaining balance on my own. It really reinforced how powerful the basics can be and that I didn’t need BHT after all.
What I should have done was take a step back and honestly evaluate how I was living—looking at where I could improve my stress management, nutrition, and consistency. Instead of rushing into BHT, I should have focused on making smart, sustainable changes. I’ve learned that when I stick to the basics, they work. And this is exactly the approach we use in Fit + Fueled. We focus on the four pillars of metabolism—mindset, muscle, minerals, and macros—because when you get these right, your body has what it needs to thrive. These fundamentals have served me well, and they’ve helped hundreds of women do the same. Early enrollment opens on 2/27, and you can join the waitlist to be the first to know when doors open!
I’m not against BHT (I actually think it’s amazing for many women), but I know it wasn’t the right time for me. I’ll likely revisit it in my late 40s when it makes more sense for my body. For now, I’m focusing on the foundations, which I know will set me up for long-term success and only make any future interventions more effective when the time comes.
Have you tried BHT? I’d love to hear about your experience. Hit reply and share how it went for you—I’m always interested to learn from others’ journeys!
