When to Start Hormone Therapy: Protecting Your Heart, Bones, and Brain in Perimenopause with Dana Culp, DNP

When should you start hormone therapy in perimenopause or menopause? Can estrogen actually protect your heart, bones, and brain? And how do you know if you’re “too old” to begin?

In this episode of Real Food Stories, I sit down with certified menopause expert and founder of Thrive Midlife Medicine, Dana Culp, DNP, to cut through menopause misinformation and outdated hormone therapy fears.

We unpack:

The best timing for starting hormone therapy (and why the “window of opportunity” matters)
How estrogen supports cardiovascular health, bone density, and cognitive function
The real risks vs. outdated fears around HRT
FDA-approved hormone therapy vs. compounded hormones
What “bioidentical” actually means
When testosterone may be appropriate for women
Perimenopause symptoms many women don’t expect: anxiety, brain fog, insomnia, joint pain
GLP-1 weight loss drugs in midlife — benefits, risks, and muscle loss concerns
Why protein intake and strength training are non-negotiable after 40

Dana shares how being dismissed by multiple clinicians led her to specialize in menopause care — and why so many providers still rely on guidance that hasn’t evolved since the early 2000s.

We also discuss how telehealth is changing access to menopause hormone therapy for women who have struggled to find informed providers locally.

If you’re navigating:

Perimenopause anxiety
Midlife weight gain
Questions about starting HRT after 45
Concerns about heart disease risk after menopause
Bone loss prevention
Brain fog and cognitive changes
Or whether GLP-1 medications are right for you

This episode offers evidence-based clarity without all-or-nothing thinking.

Menopause doesn’t have to feel like a maze. It can be a turning point — when you understand your biology and make informed, personalized choices.

If this conversation helped you, follow Real Food Stories, leave a review, and share it with a woman who deserves real answers about menopause care.

Dana and Thrive Midlife Med click HERE

Take the Perimenopause Quiz HERE