HORMONES
Hormones - The Past and Present
Women have been misled about hormone therapy for so long that even the name has become confusing.
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-Traditionally hormone therapy, referred to as HRT, includes treatment with estrogen and progesterone only, leaving out testosterone completely. This is outdated thinking and does not work for our Ember Women.
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-TRT, the nomenclature for testosterone replacement therapy, has very masculine undertones, and we now know testosterone is just as an important sex hormone as estrogen and progesterone for women. All hormones should be an included part of comprehensive care. So TRT only, does not work either.
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-You may have seen BHRT - bioidentical hormone therapy - this term became popular about 5 or so years ago, mostly as a marketing ploy. Yes, we use primarily bioidentical hormones at Ember, but this has become common practice to the point that even your local pharmacies are carrying good bioidentical brands. You don't need fancy prescriptions to access bioidenticals. And in some cases, some women still do better on synthetic forms of hormone therapy. That is a fact. So, the term BHRT is not fully honest nor accurate, and therefore does not work for Ember either.
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-MHT, Menopausal Hormone Therapy includes all three hormones because all three play a critical role in the menopausal transition. Unlike terms like HRT, TRT, or BHRT, MHT doesn’t limit a woman to a specific hormone or a specific sequence of care.
MHT is flexible by design. A woman may begin with one hormone, adjust her dose, add another later, or shift her regimen entirely as her symptoms and physiology evolve. Any combination is possible, because her needs change throughout the transition. This is the point: menopause is dynamic, and the care must be dynamic too. MHT mirrors the lived experience of women, adaptable, responsive, and individualized. It offers the comprehensive flexibility every woman deserves.
Barriers to care: Where we were, and the progress we have made
The Data was there, but then, the 2002 WHI Report..
Hormone therapy has been used successfully for a century. (Embryo Project Encyclopedia 2017). As early as the 1920s, clinical research showed that estrogen, progesterone, and even testosterone could meaningfully relieve the symptoms of peri‑ and post‑menopause. Yet today, fewer than one in 10 women are accessing MHT (2024 JAMA Health Forum). The reason traces back to 2002, when the Women’s Health Initiative (WHI) released preliminary data suggesting increased risks of breast cancer, heart disease, stroke, and blood clots. The study was halted early, the media ignited a firestorm, and access to hormone therapy collapsed almost overnight. Years later, deeper analysis revealed that the elevated risks were confined to the synthetic progestin + estrogen arm, that the absolute risk increase was small and not statistically significant, and that the formulations used were not the bioidentical hormones widely used today. But by then, the damage was done, setting women back decades in understanding, access, and confidence. It also raised deeper questions: why did the media apply such vigorous bias to the WHI data, and how does that same bias continue to show up across women's medicine today? Dr. Abdulmaged Traish, former editor-in-chief for the Journal of Andrology has noted that once women move past their child-bearing years, their sexual and hormonal health is often treated as less-relevant. Unfortunately, the women of Ember would agree, this has been all too true.
The Barriers Persist
The fallout from the WHI didn’t end with media bias, it reshaped the entire landscape of women’s health. Hormonal medicine is still barely taught in medical schools, and a 2007 Mayo Clinic survey found that fewer than 7% of providers feel equipped to manage hormone‑related concerns. The gap is even more stark with testosterone: despite decades of research demonstrating its effectiveness for peri‑ and post‑menopausal symptoms, the FDA has yet to approve a single formulation for women, while men have more than a dozen. Testosterone remains a Schedule III controlled substance due to historical misuse, a designation many experts now view as outdated and misaligned with current evidence, yet it continues to restrict access for women. At the same time that MHT prescribing plummeted after the WHI, we saw a sharp rise in non‑hormonal medications like SSRIs used as first‑line treatment for vasomotor symptoms and midlife mood changes. The problem is clear: SSRIs carry a documented risk of bone loss (Scientific Reports, 2021) and often reduce libido, two issues already deeply tied to menopause. This has resulted in typical menopausal "treatment" programs that may be doing more harm than good. Further, we hear story after story from women who finally gather the courage to ask their doctor about their hormones, only to be told it’s unnecessary, they’re too young, too old, or simply to “tough it out.” And for the few who do get labs drawn, there is a 95% chance they’ll be told they’re “in the normal range,” their symptoms minimized or ignored. Dismissed, embarrassed and infantilized. This is the reality too many women still face.
The Women Who Refused to Settle
Despite the setbacks, motivated by the stories of the needless suffering of their patients, brave women refused to accept the status quo. Leaders like Drs. Mary Claire Haver, Kelly Casperson, and Rachel Rubin pushed relentlessly for evidence‑based, compassionate care for women in perimenopause and beyond. In February 2025, Dr. Rubin and Dr. Casperson met with the FDA and successfully advocated for the removal of the black box warning on estradiol patches, a label that had long discouraged clinicians from prescribing and limited access for millions of women. This marked a major turning point. At the same time, a growing body of data, including decades of supratherapeutic MHT use in transgender individuals without increased adverse events, reinforced what early clinicians understood nearly a century ago: hormone therapy is generally safe and effective for treating menopausal symptoms. The WHI’s 2002 conclusions have since been widely challenged, with many experts acknowledging that the data was selectively interpreted at best and incorrect at worst. Long‑term studies now show that testosterone is breast‑protective, that route of estradiol administration matters, and that non‑oral formulations carry no increased clot risk above baseline. And in 2022, the North American Society of Menopause (NAMS) updated its position to affirm MHT as a safe and effective treatment for symptomatic women. Real practitioners stood in the gap, demanded better, and change at long last, is happening.
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At Ember, we have immense respect and gratitude for these titans of menopausal care, who carved the path and widened access for millions of women.
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Where We Are Now
Once your social media algorithm senses you’re a midlife woman, your feed fills with perimenopause and menopause content. The conversation is everywhere. Practitioners are creating content, and most importantly, you are consuming it. Women are following hormone‑health accounts, buying Dr. Haver's books the moment they’re released, and openly discussing topics that were once whispered about.
This progress matters. But it comes with drawbacks.
Knowledge is more available than ever, but so is noise. Women are still forced to sort through mountains of conflicting information. More clinicians are willing to prescribe, yet the nuance of MHT remains elusive. And MHT is not linear, it needs adjustments as hormone levels decline. Doses shift. Routes change. Responses vary. What’s “generally safe for most women” still requires individualized care.
Complications like histamine intolerance or progesterone intolerance can be missed, delaying relief or derailing treatment entirely. The system still expects women to be experts in a topic we never bothered to teach them. How can we expect her to know what no one ever explained?
This is why we created Ember.
Most women want to be treated by women in this phase of life because she “gets it.” They want full access to all three hormones, delivered in a smart, safe, clinically clear way. They want consistent, individualized care: validation when needed, reassurance when concerned, and responsive adjustments when called for. They want clarity, not homework. And most of all, they just want to feel like themselves again.
Clinics are popping up, but many feel generic, diluted by male‑centric messaging, or exorbitantly priced.
Ember is created for access.
Ember is created by women for women.
Ember is created for you.
Where We Are Today
Today, the conversation is finally changing.
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Women are talking openly about menopause. Books are becoming bestsellers. Social media has amplified voices advocating for better education and better care. Providers are becoming more engaged in the conversation than ever before.
This progress matters.
But access to information has also created a new challenge: information overload.
Women are often left sorting through conflicting opinions, contradictory advice, and countless treatment recommendations without the guidance needed to make sense of it all.
Hormone therapy is rarely as simple as a single prescription.
Doses change. Delivery methods change. Symptoms evolve. What works beautifully today may need adjustment six months from now.
This is why individualized care remains so important.
Women deserve more than information.
They deserve partnership, expertise, and ongoing support.
PEPTIDES
The Promise and the Reality of Peptides
Everyone is talking about peptides, but what are they? Peptides are short chains of amino acids, pieces of proteins, that act as powerful messengers in the body. Some bind directly to receptors, others modulate how those receptors respond. Insulin was one of the earliest and most transformative peptides, and since then researchers have developed compounds that influence everything from metabolism and weight regulation to sleep, energy, recovery, and skin quality. Their potential is extraordinary.
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But there is a structural problem. Decades ago, a landmark court ruling determined that peptides identical to those naturally found in the human body cannot be patented. Without patent protection, there is no financial incentive for pharmaceutical companies to fund the tens of millions of dollars required for rigorous safety trials. As a result, we now have an entire class of compounds with promising mechanisms and growing consumer demand but limited formal safety data. Most peptides remain available only for “research use,” meaning they are not legally approved for human prescription.
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In April 2026, the FDA acknowledged the accumulating research and signaled a shift. They announced a formal review of core peptides, with recommendations expected in July, a rare moment of regulatory attention that could expand access responsibly.
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There are other challenges too. Peptides that promise performance, body composition changes, or stamina are overwhelmingly marketed to men, leaving women out of the conversation entirely. GLP‑1s face a different kind of bias: despite their life‑changing impact, women who use them are often questioned about how long they’ll “need” them, a scrutiny rarely applied to any other chronic therapy.
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At Ember, we see peptides, including low‑dose GLP‑1s, as tools, not magic solutions. The foundation will always be lifestyle, nutrition, movement, stress reduction, and hormone balance. From there, thoughtfully selected peptides can make meaningful sense. We are pro‑access, especially when it comes to women’s care, and we approach this emerging field with equal parts optimism and caution. Our priority is safety, clarity, and common‑sense care in a landscape that is still finding its footing.
Low-Dose GLP1 Therapy
We are not hiding it, we love GLP-1s, but it wasn't always that way.
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About 5 years ago, when GLP-1 therapy started to reach fever pitch, we were skeptical.
Rapid weight loss. Muscle and hair loss. Rebound weight gain.
Didn't look good and we kept our distance, opting for purely "all natural" weight management instead.
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But then there was a shift:
#1 New Possibilities with GLP1s
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In April of 2022 the Journal of Aging and Disease put out a comprehensive metanalysis analyzing the roles and mechanisms that GLP-1s play in overall health and aging, not just weight loss.
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THE FINDINGS WERE JAW-DROPPING
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neurodegenerative protection
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improved cardiovascular outcomes
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reduced blood pressure
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improved kidney function
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promotion of bone formation
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promotion of muscular formation
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blood sugar stability
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significant weight loss
and so much more!
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This review highlighted something very important: GLP-1 medications influence far more than just appetite. They positively affect inflammation, insulin signaling, metabolic flexibility, and the body's ability to respond to stress. And for women experiencing metabolic shifts in menopause, those mechanisms matter.
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Smart podcasters like Dr. Tyna was one of the first to take another look at the utility of these meds and asked some interesting questions. What if the maleffects of this medication aren't the drug itself, but perhaps it's the dosage? Mabey people are being dosed to high, too long, too fast, and this is driving muscle loss and poor outcomes. What if we used this medication, but at a lower dose, with a slower titration, and the right lifestyle supports, what could happen?
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There is a clear trend. As women progress along perimenopause, their estrogen fluctuates and declines, and so does insulin sensitivity. Estrogen plays a key role in combatting insulin resistance. Despite keeping their nutrition healthy and balanced and workouts consistent, women start to endure a slow and steady metabolic decline, directly as a result of hormone depravation. Insulin resistance starts to emerge changing the way their body burns fat and stores it. She could be eating the same exact calories she always did, but her body now less metabolic efficient, the weight starts to pack on. She is told by her doctor to eat more salads and walk, and the reality is, the more the poor girl stresses the worse the weight retention becomes. It is a very real complication of menopause. She may not be "obese" but that extra 15 pounds is life-altering to her. It is crushing her confidence, her mobility, her inflammation is soaring, and despair is setting in.
Could GLP1-s be a peri/menopausal girl's best friend?
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What Low Dose GLP1s Actually Means?​
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Low‑dose GLP‑1 isn’t a trend or a loophole, and it's a different clinical philosophy. Instead of chasing rapid weight loss, the goal is to support steadier metabolic function by using the lowest effective dose and increasing it gradually, only when needed. This approach respects the physiology of midlife women, whose bodies are already navigating shifts in estrogen, insulin sensitivity, and metabolic flexibility. Lower doses paired with slower titration tend to be better tolerated, easier to sustain, and more compatible with preserving muscle and long‑term stability while still achieving meaningful fat loss.
Additionally, pairing MHT with GLP-1 therapy has proven to yield better results. Estrogen depravation contributes to insulin resistance, so then replenishing estrogen may improve insulin sensitivity. Further a real hurdle of any weight loss program is loss of lean muscle mass. Testosterone therapy has been shown to positively impact muscle mass. We are excited for the conclusion of the PAMELA study which is investigating the use of testosterone therapy in post-menopausal women for the prevention of muscle loss. At our clinic we often pair testosterone therapy with GLP-1 as an affective agent to target fat loss, while preserving and potentially growing muscle mass.
At Ember, given the historical (and current) disparities that still exist with women's access to quality care, we are hyper-focused on reducing barriers. Why wait until a woman has a full-blown metabolic disease before we treat her? The physiological and mental benefits of even a 10-pound weight loss can be profound. What she wants matters. She may just need a little support to get there, and we are fully ready to give it.
Other Peptides: Progressive, Evidence-Aware and Selected for Women
Peptides are having a moment, and we are here for it, but Ember is careful in how we offer it. Many peptides are still considered research‑based, and we treat them that way: with clinical caution, thoughtful selection, and a focus on mechanisms that make sense for women in midlife.
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For women who want access to regenerative and metabolic tools beyond GLP‑1, we offer a curated set of peptides with the strongest safety profiles and the clearest physiological rationale. Each one serves a different purpose: tissue repair, recovery, collagen support, cellular signaling, or growth‑hormone stimulation, and each is used with the same philosophy that guides everything at Ember: selected for the unique challenge's of the mid-life women, low-dose, slow-build, and grounded in what supports her best for the long-term.
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Below are the peptides we offer and how they’re used in a women‑centered clinical context.
BPC-157 Body Protective Compound 157 is the most studied and widely used peptide. It is a peptide designed to mimic the natural gastric peptide that is responsible for rebuilding the lining of the intestines. It supports tissue repair throughout the body by influencing angeiogenisis, fibroblast activity, and local inflammatory signaling.
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Clinical Use: BPC-157 is especially good for those with chronic inflammatory gut conditions, systemic inflammation, joint and injury recovery. It is considered a powerful anti-inflammatory peptided.
BPC-157/TB-500 Stack TB-500 is derived from thyomsin-beta, and exerts similar healing and anti-inflammatory benefits as BPC-157, but through different mechanisms including actin regulation, cell migration, and tissue remodeling. Together they support both micro and macro-level recovery processess, often referred to as the "Wolverine Stack."
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Clinical Use: Used for systemic inflammation, joint and overall musculoskeletal repair and recovery, tissue repair processes, and chronic gut conditions. Same consider this stack to be a synergetic combination.
GHK-Cu This is a naturally occurring copper binding-peptide, made up of just three amino acids bound to a copper peptide. This peptide has been studied extensively for its role in collagen synthesis, tissue remodeling, and antioxidant activity. This peptide makes up the core of "GLOW" peptide blends.
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Clinical Use: Applied topically for use on skin, it has been shown to improve skin firmness and reduce visible signs of aging. Also indicated for use on scalp to promote hair growth.
Sermorelin Sermorelin is a growth hormone releasing hormone (GHRH) analog that stimulates the pitutiary to produce endogenous (your own) growth hormone in a physiological and gentle pulsatile pattern. This supports downstream IGF-1 activity without overriding natural feedback loops.
Clinical Use: Sermorelin is used to promote body composition, recovery, sleep quality and overall vitality. This would be a good option for a woman who is looking to "get after it" and wants to support lean-muscle mass.
HORMONES /. THE PRESENT
New and Emerging Research
Hormone science is constantly evolving, and so are we. This is where we share new studies, clinical updates, and research that may help shape our understanding of women's health, hormones, aging, and longevity. While no single study changes practice overnight, staying informed allows us to make smarter, more personalized decisions over time.
The studies shared here are intended for educational purposes and should not be interpreted as individual medical advice. Research findings should always be considered within the context of a woman's unique health history, goals, and clinical picture.
Here are a collection of recent studies and position statements gathered here and made clear, so you can see the evidence for yourself. Before starting any MHT program, women should have a shared-decision making discussion with a qualified provider to determine their own benefit to risk landscape.
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MHT has a favorable safety profile for perimenopausal and post-menopausal women within 10 years of menopause. The 2022 hormone therapy position statement of The North American Menopause Society.
For women who reached menopause more than 10 years ago, the risk to benefit appears less favorable, but MHT may still be beneficial for you requiring thoughtful shared-decision making with your trained provider. For a more in-depth conversation on that, see our "Mothers and Daughters" page.
This general finding of safety is supported by FDA's November 2025 Press Release stating, “The removal of the black box warning, based on the best science and data, is an incredible step forward to empower millions of women to live longer, healthier lives.”
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Since the WHI 2002 report, a cumulative 18-year follow-up observational study showed that among post-menopausal women aged 50-79, treatment with conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA), or CEE alone, was not associated with an increased risk of all-cause cardiovascular, or cancer mortality. (Note: this study is helpful because it studied the exact types of hormones used in the initial WHI 2002 report.)
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Published March 2021 in the European Journal of Breast Health a retrospective study reviewed data for over 2,000 pre and post menopausal women who were treated with testosterone and followed for incidence of breast cancer. They found that when compared to age-matched data, women treated with testosterone had a 35.5% lower incidence of breast cancer than what was expected. This is the second long-term study showing testosterone confers a level of breast protection.
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If you have a history of breast cancer and are researching treatment options including MHT, you will find this article helpful. Dr. Bosserman and Dizon argue a nuanced approach is needed, and that formulation and preparation matters.
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Additionally, a 2025 meta-analysis looked at the use of localized low-dose vaginal estradiol in over 50,000 women with a prior history of BC and found no significant increase in breast cancer recurrence or mortality.
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Estrogen therapy may reduce the risk of cardiovascular disease by 50%, the risk of Alzheimer disease by 35% and reduce the risk of bone fractures by 50-60%.
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Ember is committed to staying current with emerging science and providing clear, accessible resources for any patient who wants to learn more. We invest in ongoing education, are members of the North American Menopause Society, and our providers sit for the Certified Menopause Practitioner exam, the gold standard in peri‑ and menopausal care.