Is hormone therapy safe? What women should know about weight loss & hormones
You’re exhausted, gaining weight without explanation, and tired of being told it’s “just part of aging.” Maybe you’ve heard hormone therapy can help, but you’re not sure if it’s the right step—or a risky one. You're not alone.
For many women in perimenopause or menopause, hormone therapy can be life-changing, helping to ease symptoms like fatigue, poor sleep, mood swings, and yes—supporting a metabolism that suddenly feels sluggish and uncooperative. But with that possibility often comes fear: Is it safe? What about cancer? Will it really help?
At Elle MD, we offer personalized hormone replacement therapy in Michigan—never as a one-size-fits-all solution, but as a tool that, when used correctly, can support your energy, mood, weight, and overall quality of life. In this guide, we’ll walk you through what HRT actually does, how it impacts weight loss, what the research says about safety, and how to know whether it’s the right fit for your body.
You deserve real answers—without fear, shame, or pressure. Let’s start there.
In case we haven’t met yet—we’re Dr. Erin Hendriks and Dr. Maricela Castillo MacKenzie, founders of Elle MD, a functional medicine and weight loss clinic based in Royal Oak, Michigan.
We specialize in helping women—especially those navigating perimenopause, menopause, and hormone-related symptoms—understand their bodies, rebalance their systems, and finally feel at home in their skin again.
Let’s talk about what hormone therapy actually is, what it does, and whether it could be the key to helping you feel like
yourself again.
What hormone therapy actually does to a woman’s body
Does HRT actually help with weight loss?
Hormones are the conductors of your metabolism, not just background players. Estrogen helps your cells respond to insulin. Progesterone supports restful sleep. Testosterone fuels energy and muscle mass. Thyroid hormones regulate how your body burns calories at rest.
So when estrogen and progesterone drop during perimenopause and menopause, it’s not just hot flashes you’re noticing. It’s the slowed metabolism. The increased belly fat. The way your cravings seem out of control even when you’re "eating clean."
Hormone therapy isn’t a weight-loss drug. But when your hormones are supported, your body can begin to function more efficiently. You sleep better. Cravings reduce. Your blood sugar stabilizes. You have more energy to move your body and make nourishing choices. Weight loss becomes possible—not from restriction, but from balance.
What does hormone therapy do to a woman’s body?
HRT can:
- Improve insulin sensitivity
- Support lean muscle mass
- Enhance sleep and mood stability
- Reduce hot flashes and night sweats
- Help regulate appetite hormones like leptin and ghrelin
In other words, it helps restore the foundation so that your body isn’t fighting itself anymore.
Is hormone therapy safe? Let’s talk about what the science really says
The fear surrounding hormone therapy didn't arise without cause—but it also didn't present the complete picture. In 2002, the Women’s Health Initiative (WHI) study raised concerns by suggesting a link between combined hormone therapy (estrogen plus progestin) and an increased risk of breast cancer. However, it's crucial to note that this study involved synthetic hormones administered to women well past menopause, and its findings may not be applicable to all.
Fast forward two decades, and research now offers a more nuanced understanding. When prescribed thoughtfully, hormone replacement therapy (HRT) can be both safe and highly effective—particularly when:
- Initiating hormone therapy before age 60 or within 10 years of menopause onset has been shown to provide cardiovascular and metabolic benefits when appropriately prescribed. — The Journal of The North American Menopause Society, Vol. 29, No. 7, pp. 767–794 (PubMed)
- Using the lowest effective dose and conducting regular follow-ups is essential to ensure long-term safety and individualized outcomes. — The Journal of The North American Menopause Society, Vol. 30, No. 6, pp. 573–590 (PubMed)
Testosterone plays a role in muscle mass and metabolic rate. Low levels may contribute to fatigue, low libido, and weight gain.
But here’s the truth: Testosterone therapy is not a go-to treatment for weight loss and should never be used without proper testing and oversight.
At Elle MD, we approach HRT not as a one-size-fits-all solution but as a personalized treatment tailored to your unique timeline, physiology, and health goals—ensuring that the benefits outweigh the risks.
Is hormone therapy really linked to cancer? Let’s talk facts, not fear
This is the question that keeps so many women awake at night: “Will this give me cancer?”
Here’s what the research actually shows: Hormone therapy, when started in women younger than 60 or within 10 years of menopause onset, is associated with a favorable safety profile. While combined estrogen-progestin therapy has been linked to a slight increase in breast cancer risk, the overall absolute risk remains low, especially in the early years of use. For many women, the benefits—such as relief from vasomotor symptoms (hot flashes and night sweats), protection against bone loss, and improved quality of life—clearly outweigh the potential risks in this therapeutic window.
These conclusions are supported by updated clinical recommendations published in
Menopause: The Journal of The North American Menopause Society, Vol. 29, No. 7, pp. 767–794 (PubMed).
When is HRT not the right fit? Here’s when we pause
Hormone therapy isn’t a green light for everyone—and a responsible provider will always tell you that.
There are situations where HRT could do more harm than good. You may need to avoid it if you:
- Have a history of hormone-sensitive cancers (like breast, ovarian, or uterine cancer)
- Have had blood clots or stroke
- Have active liver disease
But here’s the key: this doesn’t mean you’re out of options.
It just means you need a provider who can look at your entire health history and build a plan around what
will support you—not just what’s trending.
That’s why at Elle MD, we never recommend hormones without comprehensive labs, full screening, and honest conversations. You deserve that level of care.
So, what’s the safest kind of hormone therapy?
When we talk about safety, context matters—and so does customization. At Elle MD, we prioritize bioidentical hormone therapy that’s tailored to your specific needs, using only the hormones your body actually needs to feel supported. The three primary hormones we prescribe in our HRT protocols are:
- Estrogen – Typically delivered through a transdermal patch. Estrogen supports everything from insulin sensitivity and fat metabolism to bone density and cognitive function.
- Progesterone – We use micronized progesterone, a gentle, bioidentical form that’s better tolerated and can help with sleep, mood stability, and balancing estrogen levels.
- Testosterone – In select cases where clinically indicated, we may prescribe testosterone to help with fatigue, low libido, and muscle mass maintenance. It’s always based on lab results, symptoms, and careful monitoring—not guesswork.
We don’t prescribe synthetic hormones, and we never default to a standard dose. Your hormone plan at Elle MD is built around your labs, symptoms, and long-term goals—and monitored closely over time to make sure it continues to support your health, not compromise it.
Is bioidentical hormone therapy safe? (And what does "bioidentical" even mean?)
Bioidentical hormones are structurally identical to the hormones your body naturally makes. That means your cells recognize them and respond in a more predictable way.
At Elle MD, we personalize every prescription. There is no "one-size-fits-all" protocol here.
Want natural hormone balance? Here’s where to start
Functional medicine tools that support your hormones—even without HRT
Hormone therapy is just one tool. If you’re not a candidate, or simply not ready, we have plenty of ways to help your body feel better:
- Functional lab testing (cortisol, thyroid, insulin, estrogen pathways)
- Anti-inflammatory nutrition plans
- Supplement protocols (magnesium, B-vitamins, adaptogens)
- Gut healing strategies to support hormone detoxification
Nutrition and movement for estrogen and progesterone support
- Cruciferous veggies help metabolize estrogen safely
- Fiber supports healthy elimination of hormones
- Protein and strength training help preserve muscle mass
- Healthy fats (omega-3s, avocado, nuts) support hormone production
Stress is the hormone disruptor no one talks about enough
When cortisol is chronically high, it disrupts sex hormones. It raises blood sugar. It blocks fat loss. That’s why at Elle MD, we help you calm your nervous system—not just your symptoms.
You deserve more than fear—you deserve clarity and care
Hormone therapy isn’t about reversing time or chasing perfection. It’s about helping your body feel supported, stable, and strong during a phase of life that can feel anything but. Yes, safety matters—and at Elle MD, safety is built into every decision we make. From comprehensive lab work and personalized protocols to ongoing monitoring and real conversations, we treat your health like the full, complex story it is.
Whether you’re navigating perimenopause, menopause, or simply feel like your body’s been out of sync, hormone therapy might be the missing piece. And if it’s not the right path for you, we’ll help you find another—rooted in functional medicine, not fear.
👉 Learn more about how we approach hormone replacement therapy in Michigan and discover what true, personalized support can look like.
Because you don’t just deserve answers. You deserve to feel like yourself again. And we’re here to help you get there—one step, one insight, one hormone at a time.
Book a consultation, explore our Weight Loss Program, or browse our Trusted Products.
Let’s do this together!
*AI Disclosure:
This content may contain sections generated with AI with the purpose of providing you with condensed helpful and relevant content, however all personal opinions are 100% human made as well as the blog post structure, outline and key takeaways.
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Meet the Drs.
Dr. Hendriks and Dr. Castillo MacKenzie are board-certified physicians, female, specialized, with over 10 years of experience.
Elle MD started after practicing in a traditional primary care setting together for over a decade. We grew frustrated with the current healthcare model, which places no emphasis on addressing the root cause of chronic disease. A lot of times, conventional care doesn’t even promote overall wellness!
We founded Elle MD in Royal Oak, MI, with a vision of providing this care in a compassionate and personalized way.
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