Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

Ep. 586 The Estrogen Masterclass: The Truth About HRT, Heart Health & Hair Loss | Menopause, Perimenopause & HRT

Apr 29, 2026
Dr. Carrie Jones, clinician expert in hormone testing and detox, explains the DUTCH test and estrogen metabolism. Dr. Sarah Berry, nutrition and microbiome researcher, dives into menopause-driven gut changes and phytoestrogen interactions. Dr. Kellyann Niotis, clinician researching menopause and brain health, discusses estrogen’s role in cognition and dementia risk. They cover HRT timing, lipid and insulin shifts, hair-shedding causes, microbiome links, and personalized testing.
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INSIGHT

Brain Upregulates Estrogen Receptors In Menopause

  • Estrogen receptors in the brain upregulate during perimenopause, suggesting the brain increases sensitivity as circulating estradiol falls.
  • Dr. Kellyann Niotis cites Lisa Mosconi's work showing higher receptor density in Alzheimer-related brain regions, implying the brain 'wants' more estrogen.
ADVICE

Consider HRT For Day to Day Cognitive Symptoms

  • Many women report improved attention, less brain fog, and better concentration after starting hormone therapy.
  • Kellyann Niotis emphasizes these cognitive changes can meaningfully improve daily function even if long-term dementia data remain mixed.
INSIGHT

LDL And Hearing Lead Dementia Risk Modifiers

  • LDL cholesterol (ApoB) and hearing loss are top modifiable contributors to dementia risk per the 2024 Lancet Commission.
  • Dr. Kellyann Niotis highlights addressing LDL/ApoB, and protecting hearing (use hearing aids) as high-impact interventions.
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