I wish I could tell you that HRT was the magical wand that fixed all these symptoms I listed above (I’m keeping the low tolerance drama by the way). HRT has helped with sleep, cholesterol, and some of the arthralgias, but it is not enough for me to live my “premenopausal life.” The cholesterol responded to ensuring that I was getting at least 25g of added fiber in my diet per day – and most days I get 35g (my supplement helped here), a diet loaded with natural antioxidants (Galveston Diet for the win) limiting my added sugar intake to less than 25g/day. My insulin resistance is a work in progress. I discovered this in the past few months, and I shudder to think what it would be if I did not follow the nutritional and exercise principals that I did. I have been wearing a continuous glucose monitor to help me understand how my lifestyle choices are impacting my blood sugar levels and it has been eye opening. Limiting alcohol, and ensuring good sleep hygiene seem to be moving the needle in the right direction. My joint pain has been helped with consistent exercise to include resistance training, stretching and balance training and my turmeric supplement. My Vitamin d level is now stable with 4,000 IU/day with Vitamin K of supplementation. My supplement is very helpful here (which also has Omega-3 fatty acids). My sleep quality is very dependent on the room temperature, how late I eat, my daily meditation and journaling and consistent exercise. Alcohol and I might be breaking up our long term relationship. There is simply zero upside for me. It affects everything in a negative way and I want to live a long and healthy life. Finally, over the past few years, shocked by my own menopause experience, I have devoted my life to the care and study of the menopausal woman. I teach constantly online, and in my clinic and have published the #1 NYT Be