How To Feel Stronger, Sleep Better, & Support Hormones In Midlife

Hot flashes. Mood swings. Brain fog. These are the classic signs we associate with menopause. But for many women, the reality is more complicated and more misunderstood.

Hormone replacement therapy (HRT) is one of the most effective ways to ease symptoms of perimenopause and menopause. But public perception of HRT has been shaped by fear, largely stemming from the 2002 Women’s Health Initiative study that linked HRT to breast cancer.

According to Senemar, that study was deeply flawed. “A lot of the researchers on that study didn’t agree with the headlines that were published,” she says. The trial used different forms of hormones than those used today, and subsequent analysis has shown the original findings were misrepresented.

Even within the WHI study, there were signs of benefit. “In the estrogen-only arm, we actually did notice a decrease in the development of breast cancer,” she adds.

Now, more physicians are turning to bioidentical hormones, formulations that closely match what the body naturally produces. These are typically delivered via transdermal patches, creams, or vaginal rings for estrogen, paired with micronized progesterone in capsule form.

But hormone therapy isn’t one-size-fits-all. Whether or not it’s the right choice depends on a range of factors, like age, symptom severity, personal medical history, and individual goals. It requires a careful, personalized approach that takes the whole picture into account.

Senemar avoids the word “diet” due to its outdated, weight-focused connotation. Instead, she encourages women to focus on nourishment that supports strength and longevity. A well-rounded, whole-foods-based approach, rich in protein, healthy fats, fiber, and complex carbs, is key.

Resistance training is especially important during perimenopause and menopause, when declining estrogen levels accelerate muscle loss and decrease bone density. While cardio still has its place, strength training should be the core of your routine.

Sleep is a foundational piece of hormone balance and mental clarity. While many people assume they’re getting enough, wearable tech like the Oura ring can provide insight into sleep quality. “Some people think they get eight hours of sleep, but was it really quality sleep?” she says.

While often underrated, having a strong support system can make a real difference during hormonal transitions. Meaningful connection helps regulate stress, boost mood, and create a sense of belonging, all of which are essential for mental and emotional well-being.

For Senemar, her fitness community played an important role in staying grounded during the pandemic. She joined virtual workouts through the Tracy Anderson Method and found a global network of like-minded women. 

For many women, consistent lifestyle changes provide meaningful relief. But there’s also a point where symptoms intensify or quality of life suffers, and HRT can be a valuable next step.

Senemar explains that women often assume they’re “not ready” for hormone therapy if they’re still getting their period or not experiencing severe hot flashes. But that’s not the full picture. 

HRT can be especially helpful in perimenopause to ease symptoms like mood swings, brain fog, and fatigue, and to offer protection for long-term health. 

If you are looking for more expert guidance, check out mindbodygreen institute’s peri/menopause+ course. Taught by leading OB-GYNs, sleep scientists, and women’s health experts, this expert-led program goes beyond the basics to give you the clinical insights, integrative tools, and real-world strategies to help you or your clients navigate this transition with confidence.