Signs you may need hormone replacement therapy
Oestrogen receptors live in almost every tissue — brain, bone, joints, gut, skin, vagina, bladder, blood vessels. So when oestrogen drops, the signal can show up almost anywhere. The clearest diagnostic isn't a blood test — it's a patternof symptoms across multiple domains in a woman 40+.
Highest-specificity symptoms
These are most likely to be oestrogen-driven (versus another cause):
- Hot flushes and night sweats
- Vaginal dryness and painful sex
- Recurrent UTIs after age 45
- Joint pain that started in your 40s with no injury
- Frozen shoulder
Lower-specificity symptoms (need more context)
These overlap with thyroid issues, anaemia, depression and burnout. Worth investigating other causes too:
- Fatigue, low mood, brain fog
- Hair thinning, dry skin
- Weight gain, especially around the middle
Why blood tests don't work
Oestrogen swings wildly day-to-day in perimenopause. A normal result on Tuesday says nothing about your hormone state on Friday. NICE and NAMS both recommend diagnosis by symptom pattern alone for women over 45.
Track symptoms across all 6 domains.
Lila helps you spot the patterns clinicians actually look for — and arrive at appointments with proper data.