Why HRT Isn’t Always the Silver Bullet Women Are Hoping For
Over the past few years, conversations around menopause have finally become more open and empowering — thanks in part to high-profile documentaries and media coverage. Women are now recognising their symptoms, feeling validated, and seeking solutions.
One of the most talked-about treatments is HRT (Hormone Replacement Therapy) — and rightly so. It can be incredibly effective for reducing hot flushes, improving sleep, boosting mood, and protecting long-term health. But for many women, HRT alone isn’t enough.
At Omniya, we frequently see clients who have started HRT but still feel “off.” They may still be tired, anxious, foggy, or struggling with weight changes — despite taking the correct dose and type of hormones. And that’s because perimenopause and menopause affect the whole body, not just the ovaries.
Let’s explore why HRT isn’t always the quick fix many hope for — and what a more personalised, integrative approach can offer instead.
The Hormonal Shift is Bigger Than Just Oestrogen and Progesterone
During perimenopause and menopause, we experience a decline in reproductive hormones like oestrogen, progesterone, and testosterone — but these hormones don’t function in isolation.
They interact with:
Cortisol, your main stress hormone
Insulin, which regulates blood sugar and fat storage
Thyroid hormones, which govern energy and metabolism
Melatonin, which affects sleep-wake cycles
DHEA, a precursor hormone that supports vitality
If these systems are not in balance, simply replacing oestrogen may not resolve your symptoms — and may even lead to frustration when things don’t improve as expected.
Why You Might Still Struggle — Even On HRT
Common complaints we hear from women already on HRT include:
Ongoing fatigue
Poor sleep
Weight gain around the middle
Anxiety or low mood
Brain fog
Digestive issues
These symptoms often point to underlying imbalances in areas such as:
Gut health: affecting nutrient absorption and hormone clearance
Blood sugar stability: which impacts mood, energy, and weight
Chronic inflammation: worsened by diet, stress, or hidden infections
Nervous system dysregulation: from years of multitasking and stress
At Omniya, we take a functional medicine approach to assess and address these root causes, combining advanced testing, nutritional strategies, and lifestyle interventions alongside HRT — where appropriate.
It’s Not Just About Replacing Hormones — It’s About Supporting the Whole System
HRT is a powerful tool, but to feel your best, your body also needs:
A nutrient-dense diet with sufficient protein and fibre
Blood sugar balance through smart food choices and meal timing
Exercise tailored to your biology — including strength training over excessive cardio
Gut and liver support to metabolise hormones effectively
Stress management to regulate cortisol and reduce inflammation
Rest and recovery — not just more to-do lists
Many women have been doing the same thing for decades — eating the same way, pushing through stress, skipping rest — but perimenopause is a signal that the body’s needs are changing. And your care plan should adapt too.
A Functional Approach to Menopause at Omniya London
If you’re navigating perimenopause or menopause and feel like HRT hasn’t quite delivered the results you hoped for — you are not alone. Our integrative, individualised approach at Omniya is designed to uncover what’s really going on in your body and help you feel energised, balanced, and empowered again.
We offer:
Functional testing to assess hormones, gut health, nutrients, and more
Personalised nutrition and lifestyle strategies
Bioidentical and body-identical HRT prescribing where appropriate
A deeper look at stress, sleep, and long-term prevention
Book a Consultation
Consultations available in person every Wednesday at Omniya Clinic, Knightsbridge and online.
Book via www.omniya.co.uk or call the clinic on 020 7584 4777
Follow Richa on Instagram: @richapuri_hormonesandfertility
Menopause isn’t the end — it’s the beginning of a new chapter. Let’s help you thrive in it.