For millions of Americans, getting to (and maintaining) an ideal weight is a lifelong struggle. All too often, our “traditional” diet, recommended exercise plans, and even some medications, fail to provide a viable solution that delivers results—especially for women.

Enter the GLP-1 “wonder drug.”

Several of my friends are taking GLP-1s to lose weight in midlife. One friend, in particular, is having great success using GLP-1s to help manage a lifelong weight challenge. She has now lost more than 60 pounds—the same pounds she has attempted to lose (and keep off) most of her teenage and adult life. The GLP-1s are also helping lower her A1C, another issue she has struggled with, and has been taking medication for years.  

Why GLP-1s, but no hormones?

Last time we got together, I remarked on how great she looks, and she told me how wonderful she feels now that she's 60-plus pounds lighter. But, she also sat next to me fanning herself with exasperation and confessed, “These hot flashes are killing me! I can’t even drink a glass of wine without feeling like I’m on fire from the inside out!”

“Well, DUH!” I admonished her, “You’re postmenopausal, right? What are you doing to address your hormone deficiencies?”

My dear, lifelong friend stared blankly at me, blinking her bright, blue-green eyes. “Umm...nothing?” she replied. “I thought I was past that! What do I need to do about my hormones?”  

We had spoken openly about hormones and bioidentical hormone replacement therapy (BHRT) before, but apparently, my mini lecture didn’t stick. I explained again how even after perimenopause and menopause, as women in our fifties, we may deal with hormone deficiencies and fluctuations for the rest of our lives—UNLESS we proactively do something about it, like personalized BHRT.

I told my friend again about my own success with hormone replacement therapy—how I sleep well, haven’t had a hot flash in years, am no longer suffering from vaginal dryness or low sex drive, and about the protective potential of hormones for long-term cardiovascular and bone health.

I asked her if she was sleeping soundly or waking up around 3:00 am most nights. I asked her how her libido was these days. Her response was, “I am waking up around 3:00 am almost every night, and poor Noah! He's been really patient and understanding. He knows I love him, but...ya know.” She held up her hands in an “I give up” gesture. “So, all that’s because of my hormones?”

“It could be,” I responded.  

So many women today are making the mistake of prioritizing their weight-loss journey (successfully using GLP-1s), without hormone replacement therapy, and they’re doing themselves (and perhaps their relationships) a big disservice. When you forego BHRT for GLP-1s, you’re missing a significant piece of the women’s health puzzle. Of course, you’re going to feel better when you shed extra pounds that you’ve been carrying around. But, losing weight doesn’t replace the hormones that are most likely on a steady decline now that you’re in the menopausal/postmenopausal stage of life.

What an Expert Hormone Doctor Says

Angela DeRosa, DO, MBA, CPE, founder of the Hormonal Health Institute, and Medical Director of Belmar Pharma Solutions, wrote about the importance of hormones for women’s overall health and wellness in her article, “Every Woman’s Guide to Understanding the Impact of Hormones from Perimenopause and Menopause to Postmenopause.”

Dr. DeRosa explains the effect each hormone can have on a woman’s body, and the potential health benefits you may be missing when you don’t replenish your declining hormones. For example, estrogen deficiency has been associated with increased risk for certain long-term health issues, such as heart disease, stroke, mood changes, and dementia.

Low testosterone levels over many years may increase a woman’s risk of low bone density, which can lead to osteoporosis. Low testosterone may often be the culprit for low sex drive (in both women and men) and may contribute to relationship problems down the road. And (here’s the kicker when it comes to GLP-1s) testosterone actively regulates glucose metabolism. Testosterone helps move sugar from the bloodstream into muscles to burn it for energy.  

Additionally, testosterone offers many long-term health benefits, like improving:  

• Mental clarity and focus

• Mood stability

• Energy and stamina

• Muscle mass and metabolic health

So, beyond all the symptom relief you may get from personalized BHRT, add in a GLP-1 and you could be reaping the long-term health benefits and the weight management benefits all at the same time. Although there are only a few medical studies regarding hormone therapy and weight management medications, the results are promising.  

One study by the Mayo Clinic found that postmenopausal women using hormone therapy alongside tirzepatide, a GLP-1/GIP medication, lost about 35% more weight than women taking tirzepatide alone. That’s compelling and hopeful information for women who want to lose weight in midlife.

If you’re like my friend—a postmenopausal woman on GLP-1s—or even if you’re in perimenopause, consider how bioidentical hormone replacement therapy could potentially help you find even more success with your weight and your well-being.

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