Why Your HRT Isn’t Making You Feel Amazing (Yet)

A practical, compassionate guide for every woman wondering… “Is it me? Or is it my hormones?”

HRT (hormone replacement therapy) is powerful… but it’s not magic. And it can’t override a body that isn’t ready to receive it. I have spoken to so many women lately who are on HRT and yet they are still feeling anxious, bloated, exhausted and just not like themselves. They kinda feel a bit disappointed and maybe a bit betrayed by HRT.

You might ask: “Why isn’t my HRT working? What’s wrong with me?”

Nothing.

Nothing is wrong with you.

You’re not over dramatic, or “too sensitive.”

Your body simply needs even more support than a patch, cream, pellet, or pill can offer.

This post is the attempt to help you understand why, and what you can do to finally feel good again.

The Expectation vs. Reality of HRT

Most women are told (or sold) a version of this:

“HRT will fix everything; your mood, sleep, skin, libido, weight, energy…”

But here’s the truth:

HRT is powerful, but it does not override a body that isn’t ready to receive it.

Think of HRT as beautiful furniture delivered to a house…

But the house is full of clutter, the lights are flickering, the plumbing is off, and the floor are uneven.

The furniture isn’t the problem.

The house just needs a little work first.

Your hormones behave the same way.

1. Your Liver: The Gatekeeper of Hormone Balance

Your liver is like the cleaning crew of your hormone system.

It takes old estrogen, toxins, inflammation, alcohol, BPA, fragrances, and stress chemicals… and clears them out.

But when the liver is overwhelmed, hormones don’t get cleared properly.

They hang around, recirculate, and cause symptoms like:

• Bloating

• PMS

• Breast tenderness

• Headaches

• Mood swings

• Stubborn weight

• Anxiety

Then you add HRT on top of all that… and your body goes, “Ummm… no thank you.”

This is the #1 reason women don’t feel better on estrogen, progesterone, or testosterone.

2. Stress & Cortisol: The Hormone That Hijacks Everything

If estrogen is the beautiful, collected queen, graceful, elegant, steady...

then cortisol is the queen who storms into the palace in full armor, kicks open the doors, and shouts:

“Move. I’m in charge now.”

And here’s the thing…

She’s not trying to be dramatic.

She’s trying to keep you alive.

Cortisol is your emergency-response queen.

She takes over the entire kingdom when she senses danger... real or perceived.

The problem?

Your body can’t tell the difference between:

• a real threat,

• a busy schedule

• a sleepless night,

• a stressful relationship,

• too much caffeine,

• skipping meals,

• overtraining,

• clutter and chaos,

• or simply never resting.

So cortisol steps in… every day.

And when she takes over, every other queen gets shoved off the throne - estrogen, progesterone, thyroid, insulin, even your nervous system.

That’s why when cortisol is high or unstable, you feel like:

• you can’t lose weight

• your moods swing like a pendulum

• your anxiety spikes

• your sleep falls apart

• you feel puffy, wired, or exhausted

• your HRT feels unpredictable

• your cycle feels chaotic

Cortisol isn’t the villain. She’s the overprotective queen who never learned boundaries. When you calm her down, with nourishment, rest, safety, breath, emotional regulation, and nervous system support... your whole hormone kingdom finds order again.

3. Your Gut: The Hormone Communication Center

Your gut and hormones talk all day long.

But if your gut is inflamed or imbalanced, the conversation becomes:

“You know what… forget it, I’m done.”

Leaky gut, bloating, constipation, IBS, candida, parasites — all of these:

• Cause estrogen dominance

• Increase anxiety

• Disrupt detoxification

• Make HRT feel unpredictable

• Create inflammation that your hormones can’t overcome

This is why so many women say: “Sometimes my HRT works… sometimes it makes me worse.”

That’s not your hormones - that’s your gut.

4. Nutrient Deficiencies: Missing Ingredients = Missing Results

HRT cannot correct deficiencies.

And I see the SAME patterns over and over, especially in perimenopause:

• Vitamin D low

• Ferritin too low or too high

• B12 and B6 low

• Magnesium depleted

• Omega-3 low

• Selenium and zinc borderline

These deficiencies mimic hormone symptoms:

• Fatigue

• Low libido

• Anxiety

• Depression

• Brain fog

• Weight gain

• Hair loss

If the ingredients aren’t there, the recipe will never work — even if the hormones are right.

5. Blood Sugar: The Silent Saboteur of HRT

Insulin is your queen bee hormone.

When blood sugar is unstable:

• Cortisol spikes

• Estrogen becomes chaotic

• Progesterone drops

• Testosterone becomes unpredictable

• Inflammation rises

• Weight loss becomes impossible

Stable blood sugar makes HRT feel smoother, more effective, and more predictable.

Unstable blood sugar makes HRT feel like a rollercoaster... Facts!!

6. Movement, Muscle & Metabolism

Your hormone receptors live in your muscle tissue.

If you’re not building or maintaining muscle, your HRT literally has nowhere to “land.” It can’t anchor. It can’t do its job well.

Strength training makes HRT work better.

Sedentary living makes HRT feel weak or unstable.

And here’s the part most women get wrong…

When we feel puffy, tired, or “off,” we think we need to punish our bodies with more cardio, more HIIT, more sweat, more burning calories.

But in perimenopause, that often does more harm than good.

Too much intensity spikes cortisol.

And AGAIN... when cortisol is high, it pulls rank over every single hormone... even the ones you’re taking through HRT.

Your body doesn’t need more punishment.

• It needs more support.

• Gentle walking for regulation.

• Strength training for metabolism.

• Short sprints for bone building.

• Rest for recovery.

• Protein for muscle repair and growth.

• Consistency for balance.

• Stretching for mobility and agility.

This is the kind of movement that partners with your hormones... not against them.

7. Sleep: The Foundation People Ignore

If you’re not sleeping…

Your hormones are not balancing.

End of story.

Sleep is when:

• Estrogen resets

• Progesterone calms the brain

• Cortisol lowers

• Detoxification happens

• Tissue repairs

• Fat-burning hormones activate

Poor sleep = poor HRT response.

It’s never just “one thing.”

8. Sometimes the HRT Itself Needs Adjusting

But here’s the part most women don’t realise:

Even if you fix everything above, HRT can still be wrong for you.

Examples:

• Using synthetic progestin instead of bioidentical progesterone

• Too much estrogen

• Too little estrogen

• Using estrogen orally instead of transdermally

• No testosterone support

• Mirena confusion

• Patch that isn’t absorbing well

• Poor timing

HRT must be individualized, not copy-paste.

So What Should You Do Next?

Here’s the part that brings everything together:

If HRT isn’t working, it’s almost never the hormones… it’s the foundations.

Your liver.

Your gut.

Your stress.

Your sleep.

Your nutrients.

Your blood sugar.

Your inflammation.

Your absorption.

Your lifestyle.

When those improve, your HRT suddenly works the way it was supposed to.

Women often tell me: “Karin, it feels like my HRT finally ‘switched on.’

This is the first time "I feel like myself again" in a long time.

That’s what we want.

If you’re reading this and thinking, “This makes so much sense… but I don’t know where to start,” I can help.

We run full functional bloodwork panels so you can finally see what’s really going on inside your body — no guessing, no generic advice, just clarity.

And if you’re ready for deeper support, The Fabulous Formula Perimenopause Edition takes you step-by-step through everything your hormones need to find balance again.

Comment or reply "BALANCE" and I’ll send you all the details.

With love and grace always

Karin

🤍