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10/21/2026

Can hormone therapy make migraines worse?

Some new research presented at The Menopause Society’s annual meeting in San Diego raises an interesting question about hormone therapy and migraines.

Researchers looked at five studies involving nearly 24,000 postmenopausal women. They found that women using hormone therapy tended to have more frequent migraines, and those migraines lasted longer. However, the researchers didn’t find a significant difference in how severe the migraines were or how much pain medication women used.

So what does this mean if you’re considering hormone therapy?

First, this research doesn’t prove that hormone therapy causes migraines. We already know that changes in estrogen levels can affect headaches, particularly during perimenopause, when hormone levels can fluctuate quite a bit.

Hormone therapy is still one of the most effective treatments we have for hot flashes and night sweats. Having migraines doesn’t automatically mean you can’t use it.

What matters is looking at your symptoms, your medical history, and which treatment makes the most sense for you. The type of hormone therapy and how it’s delivered may also make a difference.

If you’re dealing with migraines around menopause, I would suggest keeping track of when they occur, how long they last, and whether you’ve noticed any changes since starting treatment. That’s useful information to bring to your healthcare provider.

The goal is to treat your menopause symptoms without overlooking other health concerns.

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Source: The Menopause Society, October 20, 2026. “Hormone Therapy Use Associated with Greater Migraine Burden in Postmenopausal Women.”

For educational purposes only. Treatment decisions should be individualized with your healthcare provider.

10/19/2026

Testosterone therapy and red blood cells: the lab number worth knowing

Testosterone therapy can raise your red blood cell count. It's one of the most common effects of treatment, not a rare one. The number clinicians track is hematocrit, the percentage of your blood made up of red cells. For men it normally runs about 41–53%.

It matters because thicker blood doesn't move as easily. That's why the Endocrine Society recommends checking hematocrit before starting, again at 3–6 months, then once a year. If it climbs above 54%, the guideline calls for holding treatment, looking for contributors like sleep apnea or low oxygen levels, and restarting at a lower dose once it settles.

The type of testosterone matters too. Injections create a peak-and-trough pattern, with a high level soon after each dose, and those peaks are linked to the biggest rise in red cells. Gels and creams deliver more steadily, with potentially less spikes. For men who already have a higher baseline hematocrit, that steadier delivery is worth talking through with a provider.

Two practical tips: get labs drawn well hydrated, since dehydration can falsely raise the number, and mention heavy snoring or daytime fatigue at your visit, because sleep apnea is a common hidden driver.

Sources: Endocrine Society Clinical Practice Guideline on Testosterone Therapy in Men (Bhasin et al., JCEM 2018) and a 2010 JCEM meta-analysis of 51 trials.

This is general education, not individualized medical advice. Talk with your healthcare provider before making treatment decisions.

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We accept insurance. Weight management, hormone therapy for men and women, and type 2 diabetes care in Waterbury, CT. In-person or telehealth. Book online.

10/18/2026

Good news for women dealing with menopause symptoms.

For years, low-dose vaginal estrogen products carried FDA boxed warnings that caused concern for many women considering treatment.

In November 2025, the FDA announced changes to hormone therapy warnings, and updated product labeling began receiving approval in February 2026.

Why does this matter?

Low-dose vaginal estrogen works mainly where it's applied, with very little estrogen reaching the bloodstream. Research has shown it can be an effective option for many women experiencing menopause-related symptoms.

These treatments may help with:
- Vaginal dryness and irritation
- Discomfort during in*******se
- Certain urinary symptoms, including recurrent urinary tract infections

One thing I want women to understand is that vaginal estrogen is different from estrogen treatments used throughout the body for symptoms like hot flashes and night sweats.

That doesn't mean it's appropriate for everyone. Your medical history matters, and the risks and benefits should always be considered before starting treatment.

Women deserve accurate information about menopause and the treatment options available to them. Sometimes, an older warning can create unnecessary concern even when newer evidence supports a different understanding.

The goal is to make informed decisions based on current medical evidence, not fear.

InHouse Medical LLC | Waterbury, CT
www.inhousemedicine.com

Educational information only. Treatment decisions should be discussed with your healthcare provider.

We accept insurance. Weight management, hormone therapy for men and women, and type 2 diabetes care in Waterbury, CT. In-person or telehealth. Book online.

10/15/2026

Can low testosterone cause depression, fatigue, and a loss of motivation in men?

If you’re feeling tired, less motivated, or just not quite yourself, it’s easy to assume it’s part of getting older. But sometimes there’s more to the picture.

Research from the UK Biobank involving more than 133,000 men ages 40 to 70 found an association between testosterone levels and the risk of developing depression.

Men with testosterone levels unusually low for their age had a reported 48% higher risk of depression. Interestingly, men with unusually high levels also showed an increased risk.

Does this mean low testosterone causes depression?

Not necessarily.

Testosterone plays a role in several aspects of men’s health, including sexual function, muscle mass, and energy. Low levels can be associated with fatigue and changes in mood, but depression is more complicated than a single hormone level.

Sleep apnea, chronic stress, medications, thyroid disorders, and other medical or mental health conditions can contribute to similar symptoms.

So how do you know if your testosterone is actually low?

A diagnosis of testosterone deficiency generally requires compatible symptoms along with consistently low testosterone levels confirmed by repeat morning blood testing.

A commonly used diagnostic cutoff is a total testosterone level below 300 ng/dL, although the full clinical picture matters.

And here’s something worth understanding: testosterone replacement therapy isn’t automatically the answer to fatigue or depression, even when a testosterone level is low.

When evaluating symptoms like these, I believe it’s important to look at the whole picture rather than assume everything is related to aging or hormones.

Sometimes testosterone is part of the problem. Sometimes it isn’t. The goal is to identify what’s actually contributing to how you’re feeling.

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Waterbury, Connecticut

Research: UK Biobank, longitudinal study of testosterone levels and depression risk in men.

Educational information only. This is not individualized medical advice. Consult your healthcare provider before making treatment decisions.

10/11/2026

Can testosterone therapy help reduce the risk of developing type 2 diabetes?

It’s an interesting question, and some research suggests there may be a benefit. But there’s more to the story.

The T4DM study followed men between the ages of 50 and 74 who were overweight or obese and at increased risk of developing type 2 diabetes. Everyone participated in a lifestyle program focused on improving their health. Some also received testosterone treatment.

After two years, fewer men in the testosterone group had developed type 2 diabetes compared with those receiving the lifestyle program alone.

So does this mean men should start testosterone to prevent diabetes? No.

Testosterone isn’t a replacement for proper nutrition, exercise, weight management, or addressing other health risks. And having a low testosterone level doesn’t automatically mean someone needs treatment.

When evaluating testosterone, I think it’s important to look at the whole picture. Are you experiencing symptoms? Are your testosterone levels consistently low? What about your weight, sleep, blood sugar, and overall cardiovascular health?

Typically, that means checking testosterone on two separate mornings and reviewing symptoms before considering treatment. We also need to discuss potential risks and appropriate monitoring.

I find this research interesting because it reinforces something worth understanding: hormones and metabolic health are connected. But treatment decisions still need to be individualized.

The goal isn’t simply to improve a laboratory number. It’s to improve your health while making sure the benefits of treatment outweigh the risks.

Steven Jeske, APRN
InHouse Medical LLC

Source: T4DM clinical trial and follow-up research presented at ENDO 2026.

This content is for educational purposes only and is not intended as medical advice. Always consult your healthcare provider before making treatment decisions.

10/10/2026

Is estrogen alone better than estrogen combined with progesterone?

That’s a question worth asking, especially with new research coming out about hormone therapy.

A recent study involving nearly 110,000 women reported a small difference in autoimmune diagnoses between women taking estrogen alone and those taking estrogen with a progestogen.

But here’s what I want women to understand. Just because a study finds a difference doesn’t necessarily mean one treatment caused it or that one option is better for everyone.

When I discuss hormone therapy with patients, one of the first things I consider is whether they still have their uterus.

Why? Because estrogen taken by itself can increase the risk of endometrial cancer in women who have a uterus. That’s why we generally add a progestogen to protect the uterine lining.

If you’ve had a hysterectomy, the conversation may be different.

We also need to consider your symptoms, medical history, risk factors, and what you’re hoping to improve with treatment.

Hormone therapy isn’t something I believe should be approached with a one-size-fits-all mentality.

My advice? Don’t change your hormones because of a headline. Understand why you’re taking them, what the benefits are, and what the risks may be.

That’s how we make better medical decisions.

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10/05/2026

Something worth paying attention to if you're a woman over 40

Something I've been seeing more of in practice lately — women in their 40s and 50s coming in with symptoms that keep getting brushed off. Fatigue, mood changes, just not feeling like themselves. Menopause gets blamed for everything, and that's often where the conversation ends.

What doesn't get talked about enough is testosterone. Most people think of it as a male hormone, but women make it too, and levels drop significantly through perimenopause and menopause. Prescriptions for women have gone up considerably over the last five years as more clinicians are paying attention to this.

The problem is there's still no FDA-approved testosterone product made specifically for women in the US. Clinicians who prescribe it are adapting doses that were designed for men. That creates inconsistency and more room for error. Experts from the Cleveland Clinic and UCLA just presented at an FDA workshop pushing for that to change. Australia has already approved a product formulated specifically for women.

The evidence right now supports testosterone for certain hormonal symptoms in menopause. Long-term data is still limited. But if you've been told your symptoms are just menopause and nothing has been offered — that's worth a second look.
Source: Splete H. Experts Urge FDA to Approve Testosterone Products for Women. Medscape. September 22, 2026.

10/02/2026

New research asks whether semaglutide may change how much migraine medication people need.

A large Danish study followed nearly 190,000 adults who started semaglutide for weight loss. Their triptan use gradually declined after treatment began. By 12 months, it was about 7% lower than researchers would have expected based on each person's earlier prescribing trends. The drop was larger in women and in people who had previously used preventive migraine medications.

So is semaglutide a migraine treatment? Not yet. This observational study used pharmacy records, which can't prove semaglutide reduced anyone's migraines. The researchers didn't have details on migraine severity or BMI changes, and the data came from Denmark, so it may not apply everywhere.

The authors concluded that semaglutide may reduce the need for acute migraine medication in people who already have migraines. They also said randomized trials are needed before we know whether there's a true treatment effect.

It does raise an interesting question: could GLP-1 medications influence migraine in some patients beyond their effects on weight and metabolic health? For me, it's another example of why we should look at the whole patient when managing weight and metabolic health. These medications can affect multiple systems, and we're still learning how.

Study: Roland N, et al. Journal of Headache and Pain, 2026;27:199.

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10/02/2026

Menopause is about more than hot flashes. When estrogen drops, a lot of women notice more belly fat, less muscle, and blood sugar that gets harder to keep in check.

A new study presented at EASD 2026 looked at hormone therapy, exercise, and the two together. It's small: 84 women ages 45 to 65, over 12 weeks, and these are interim results. The women were new to hormone therapy and had a BMI of 30 or under, so it may not apply to everyone.

Exercise helped on its own, with better strength and aerobic fitness. But doing both together showed the biggest improvement in insulin sensitivity.

It's early, so I wouldn't call it proof. Still, it's a good reminder that treatment tends to work best when it's paired with movement and strength work.

09/26/2026

New research published this week in The BMJ highlights an important point about menopause hormone therapy: how estrogen is delivered may matter.

Researchers analyzed nationwide Danish health data from women ages 50 to 69. Oral menopausal hormone therapy was associated with an increased risk of venous blood clots, regardless of dose or treatment duration. In contrast, transdermal therapy, which delivers estrogen through the skin, was not associated with an overall increase in thrombotic events.

This does not mean that one form of hormone therapy is appropriate for everyone. Symptoms, medical history, cardiovascular and clotting risk, medication choice, dose, and route of administration all need to be considered individually.

It is another reason hormone therapy should not be viewed as a one-size-fits-all treatment.

The study was observational, so it identifies associations rather than proving cause and effect.

Source: Berggreen J, et al. Contemporary menopausal hormone therapy and thrombotic disease: nationwide nested case-control study. BMJ. Published September 23, 2026;394:e100688. doi:10.1136/bmj-2026-100688.

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