HRT & GLP-1 Q&A: Progesterone Problems, Hair Loss, Weight Gain, and More

What do you do when you finally start HRT and instead of feeling amazing, you feel exhausted, puffy, bloated, or like something is just not right? Or you start a GLP-1, lose weight, and suddenly your hair starts falling out?

Today's episode is another listener Q&A, and we are getting into the real-life questions women are asking when hormone therapy, thyroid treatment, weight-loss peptides, and menopause symptoms do not fit neatly into a textbook.

We talk about progesterone intolerance, oral versus topical progesterone, when estradiol may still be too low even though your doctor says your levels are "fine," thyroid-related puffiness and fatigue, HRT after hysterectomy, and what women need to consider when starting hormones later in menopause.

I also answer questions about GLP-1 nutrition, peptide stacking, hair loss during rapid weight loss, muscle and bone concerns, stalled weight loss, and whether it makes sense to start HRT and a GLP-1 together.

This episode is all about troubleshooting instead of assuming there is only one right way to do hormones or weight loss in midlife.

In this episode, we cover:

• Why oral progesterone can make some women extremely tired
• Topical versus oral versus vaginal progesterone
  What to look at when you feel puffy or tired on HRT
• Why estradiol levels should not be interpreted by numbers alone
• Thyroid testing when fatigue, constipation, puffiness, or brain fog persist
• Alternatives to hysterectomy for heavy bleeding and uterine problems
• How to eat while using GLP-1 weight-loss medications
• Protein, fat, and carbohydrate considerations on GLP-1s
• Combining GLP-1s with other peptides
  HRT after a breast scare and questions around route of estrogen
• Starting HRT later in menopause
• Hormone intolerance and why delivery method matters
• Whether tirzepatide works even when appetite suppression fades
• Muscle and bone concerns during GLP-1 weight loss
• Hair loss after rapid weight loss and how to support regrowth

Who This Episode Is For

This episode is for women who are already on HRT or GLP-1 therapy and have questions that are not being answered by the standard advice.
It is especially helpful if progesterone makes you tired or puffy, your HRT does not seem to be working, you are gaining weight despite hormones, you are losing hair on a GLP-1, or you are trying to understand whether your thyroid, estrogen, testosterone, cortisol, or nutrition may be part of the problem.

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Are you in perimenopause or postmenopause and struggling with symptoms—but not getting the support you deserve?

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Your host:

Karen Martel

Certified Hormone Specialist, Transformational Nutrition Coach, & Weight Loss Expert

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