Restoring cellular function and vitality for women.

With Elizabeth Wilson, MD, OB-GYN, Women’s Health Associates and Boone Health

As women approach midlife, the hormonal shifts of perimenopause and menopause can bring profound changes—hot flashes, disrupted sleep, mood swings, fatigue, and a sense that something just feels “off.” For many, hormone replacement therapy (HRT) can be a safe and effective way to restore cellular function and improve quality of life.

At Boone Health, Dr. Elizabeth Wilson, OB-GYN with Women’s Health Associates, is helping women better understand their options and feel empowered to take charge of their health. She specializes in HRT and has an interest in functional medicine, with an emphasis on holistic care.

Hormone replacement therapy involves restoring hormones that the body no longer produces in adequate amounts—most commonly estrogen, progesterone, and testosterone. 

“As women age, their hormone levels drop sharply, typically around age 51,” Dr. Wilson explains. “That loss affects everything from energy and sleep to metabolism and mental clarity.”

The goal of HRT is to replenish those essential hormones and ease symptoms associated with menopause and the aging process. “We do this in the same way we replace the thyroid hormone when someone has an underactive thyroid,” Dr. Wilson said. “It’s about helping the body regain proper function.”

A term that often comes up in discussions about HRT is bioidentical hormones. These are lab-made hormones that have the same chemical structure as the hormones naturally produced in the human body.

“When we say bioidentical, we mean it’s identical to what your ovary makes,” Dr. Wilson said. “It doesn’t come straight from a plant—plants don’t make human hormones—but the structure matches what your body recognizes and uses.”

Hormones can be delivered in several forms, including oral pills and troches; skin patches, creams and gels; injections and vaginal preparations. The right choice depends on the patient’s symptoms, health history, and preferences.

Dr. Wilson explains that no two patients are alike—and neither are their hormone needs. “This takes time, collaboration, and education,” she said. “There’s no one-size-fits-all approach. Increasing testosterone may help some women, but it’s unlikely to be the answer for everyone.”

She begins with a detailed hormone and symptom questionnaire, followed by a thorough discussion of each patient’s health goals. “Every woman has a different story and a different reason for wanting to explore HRT,” Dr. Wilson said.

Comprehensive lab work helps assess hormonal, metabolic, and nutritional health, allowing Dr. Wilson to see how all the pieces fit together. “It’s important that patients understand what’s happening in their bodies,” she adds. “Education is empowering.”

The changes women experience during perimenopause and menopause don’t occur in isolation. As Dr. Wilson explains, metabolic health also declines over time.

“Blood sugar and inflammation tend to rise, and we burn less energy for fuel,” she said. “Hormone loss can accelerate those changes.”

HRT can help improve energy, sleep, mood, and even bone health—but it works best as part of a comprehensive approach. “I believe hormones are a wonderful anti-aging and anti-frailty tool, but they’re not magic,” Dr. Wilson said. “Nutrition, exercise, and good sleep are equally important.”

For many years, hormone replacement therapy was viewed with caution due to findings from the 2002 Women’s Health Initiative (WHI) study, which suggested that HRT increased risks for breast cancer and heart disease.

However, subsequent research has shown that the story is more nuanced. Later analysis found that the increased breast cancer risk was seen only in women taking Provera, a non-bioidentical hormone. 

“Understandably, many women and doctors fear estrogen likely because some breast cancer drugs block estrogen. If you just take several steps back and consider that estrogen can lower blood sugar and improve sleep, both of which helps reduce overall cancer risk, the picture becomes much more nuanced,” Dr. Wilson explains. “The heart risks occurred mainly in older women who hadn’t used hormones for years and were given oral estrogen, which increases clotting risk. When used appropriately, bioidentical hormones—especially through the skin—can be both safe and beneficial.”

One of the most talked-about HRT delivery methods today is testosterone pellets—small implants that release hormones gradually over time.

“Pellets can raise testosterone levels much higher than normal, and some women feel fantastic with them,” Dr. Wilson said. “But others experience side effects or feel they don’t get the same results their friends do. The key is ongoing conversation and tailoring the approach to each woman’s needs.”

Patients often describe their HRT results as “life-changing” or say they “feel like themselves again.” Dr. Wilson said those comments drive her to learn more. “I want to understand exactly what changes for them and why.  I learn from each patient, and that gives me more knowledge to help the next patient.”

Dr. Wilson is interested in growing research connecting metabolism, insulin resistance and cancer. “We’re learning that insulin receptors may be just as important as estrogen receptors when it comes to cancer growth,” she said. “It’s an exciting time in women’s health – we’re finally connecting the dots.”

For Dr. Wilson, the heart of her work is helping women understand their bodies and make informed choices.

“Hormone therapy doesn’t stop aging,” she said, “but it can help women move through this stage of life with more strength, energy, and confidence. My goal is for every patient to walk away understanding what’s happening inside her body and knowing she has options.” 

When to Talk to Your Doctor About HRT

If you’re experiencing any of the following, it may be time to discuss hormone therapy with your healthcare provider:

• Frequent hot flashes or night sweats
• Mood changes, irritability, or brain fog
• Difficulty sleeping
• Vaginal dryness or discomfort
• Loss of sexual desire
• Unexplained fatigue or low energy
• Noticeable changes in weight or metabolism

Options for Hormone and Metabolic Therapy

Modern women’s health combines hormone balance and metabolic optimization for total wellness. Treatment plans are individualized and may include:

• Estrogen Replacement: Available as skin patches, creams, gels, oral tablets, or vaginal inserts. Helps manage hot flashes, improve sleep, and protect bone health.
• Progesterone Therapy: Often used with estrogen to balance hormones and protect the uterine lining. Taken as oral capsules.
• Testosterone Therapy: For women with low libido, fatigue, or loss of muscle mass. Delivered as creams, troches, or subcutaneous pellets.
• DHEA and Thyroid Support: Supplemental hormones that can support metabolism, mood, and energy in certain cases.
• GLP-1 Medications (Metabolic Hormone Therapy): GLP-1 receptor agonists, such as tirzepatide or semaglutide, help improve insulin sensitivity, reduce inflammation, and support weight management. 
• Lifestyle Integration:Nutrition, strength training, and stress management are key components of any hormone or GLP-1 therapy plan.

By Madison Loethen

Dr. Elizabeth Wilson is an obstetrician-gynecologist with Women’s Health Associates and Boone Health. She specializes in hormone therapy, metabolic health, and women’s wellness. Her colleagues Lynn Puckett, MD and Kimberly Morse, MD also work with hormone replacement therapy.

To learn more or to make an appointment, call 573-443-8796.