The Dr. Gabrielle Lyon Show

Hormone Replacement Therapy, What Every Woman Needs to Know in 2026 | Dr. Heather Hirsch

31 snips
Mar 3, 2026
Guest
Heather Hirsch
Dr. Heather Hirsch, a board-certified women’s health and menopause specialist and author of The Perimenopause Survival Guide, debunks myths around hormone replacement therapy. She explains the flawed 2002 study interpretation. Short takes cover timing of therapy, routes and formulations, differences between progestins and bioidentical progesterone, and practical dosing and monitoring for better long-term health.
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ANECDOTE

Nervous Moment Speaking To The FDA Panel

  • Heather Hirsch described nerves before speaking to Commissioner Marnie McCary, because thousands of women watched live during an expert panel on HRT safety.
  • That panel influenced perception and was a pivotal moment in public advocacy for menopausal hormone therapy.
INSIGHT

Estrogen Improves Blood Flow And May Protect The Heart

  • Estrogen is vasodilatory: it increases nitric oxide and improves blood flow, which plausibly reduces coronary events when started near menopause.
  • This vascular mechanism connects estrogen to reduced heart disease seen in women who start MHT earlier.
ADVICE

Start Low Dose Hormones In Perimenopause To Prevent Decline

  • Consider initiating low-dose estrogen, progesterone or testosterone during perimenopause or even while still cycling to prevent symptom progression and long-term loss.
  • Early trialing can skip severe perimenopausal suffering and is supported in individualized care.
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