Feeling “Off” in your midlife? It could be your hormones!
Every week, I see many women (and men) come through my clinic looking for answers about hormone therapy in Austin and Scottsdale. Many of these patients feel as if they’re the only ones experiencing a loss of self, but the simple reality is, you’re not alone! Many women in their 40s and 50s come into my office saying:
“I’m gaining weight in my midsection even though I’m eating the same or less.”
“My sleep is terrible, and I’m exhausted.”
“I just don’t have the same spark.”
“I’m exhausted all of the time.”
“I don’t feel like myself anymore.”
“My breasts are getting larger and saggier, and I have cellulite in places I’ve never had before.”
These symptoms don’t just have to be chalked up to ‘aging’. They’re signs of hormonal imbalance during perimenopause or menopause, and they can absolutely be treated!
At Austin Cosmetic Surgery and The Cosmetic Center at DC Ranch, my entire team specializes in bio-identical hormone replacement therapy (BHRT), combined with comprehensive whole-body wellness services, aesthetic treatments, and hair restoration. Our goal is simple: we are here to help you look and feel like yourself again.
We genuinely believe in our tagline, “Beauty and Wellness Perfected”.
What is Hormone Therapy?
When we begin examining a patient's lab work, our process involves restoring hormonal balance by supplementing estrogen, progesterone, and testosterone as their natural production in the body declines. In addition to this, we find ways to implement small changes in your diet and daily activity, and prescribe medications if indicated. However, our primary focus is on the supplements and peptides you take to support the hormone therapy we are reintroducing into your body. We provide each of our wellness patients with knowledge and power to know what they need and avoid being exploited by the bro-science of the social media self-proclaimed “expert” bio-hackers that are not real, expert clinicians with 28 years of experience treating patients, and most of the time are transparently just trying to peddle affiliate products to turn a profit.
Benefits of BHRT include:
- Better sleep and energy
- Improved mood and focus
- Stronger libido and intimacy
- Easier weight management
- Stronger bone and heart health
- Radiant skin and hair
- Glucose and lipid control
Dr. Michelle's Hormone Therapy Tip: BHRT is not a one-size-fits-all approach. Your treatment is customized based on detailed lab results and your personal goals. She is a practicing, credentialed, and experienced biohacker with over two decades of experience in slowing or even reversing the aging process.
Why Hormone Imbalance Happens in Menopause
When women go into menopause, it isn’t something that happens overnight. It’s a gradual transition, often starting years before your last period, where your body begins to shift the way it produces and regulates hormones. This stage is called perimenopause, and it can last anywhere from four to sixteen years. During this time, your ovaries and adrenals begin to produce less estrogen, progesterone, and testosterone, the critical “sex hormones of youth” and most important hormones for overall women’s health. Menopause, by definition, is simply defined as not having had a period for a calendar year. Virtually, the same thing is happening to males, but at a much more subtle and slow rate, resulting in Andropause.
Estrogen, for example, plays a role in far more than just female reproduction. It supports bone strength, heart health, brain function, glucose and lipid control, and even the plumpness of your skin. I often refer to it as your ‘Barbie’ hormone, the thing that keeps you looking young, feminine, and youthful! As estrogen levels decline, women usually begin to notice hot flashes, night sweats, vaginal dryness, and weight gain. Still, they may also see more subtle changes like forgetfulness, trouble focusing, increased anxiety/depression, and a loss of skin elasticity. The most concerning things truly are the first signs of not being able to control lipids with your bad cholesterol, LDL, starting to increase, and your glucose control sputtering as your HgA1C goes up, as insulin resistance sets in.
Progesterone, which helps regulate the menstrual cycle and promotes restful sleep, also starts to decrease. Without enough progesterone, many women experience irregular cycles, difficulty falling or staying asleep, and increased feelings of anxiety or irritability. That’s why what feels like ‘just stress’ is often a deeper hormonal shift happening behind the scenes.
And while testosterone is often thought of as a ‘male hormone’, women need it too, just in smaller amounts! Testosterone supports muscle tone, metabolism, libido, and overall energy. When testosterone levels dip, it can feel like your vitality has been drained. You may find it harder to maintain muscle and control your weight despite watching calories and exercise, and notice a decrease in sexual desire, natural lubrication, and stamina.
One of the key hormones at play is estradiol, the most active form of estrogen in a woman’s body. Estradiol is not only responsible for reproductive health, but it also plays a vital role in protecting the cardiovascular system, regulating glucose and lipid levels, maintaining bone strength and density, influencing mood, and supporting healthy skin and hair. When estradiol levels fall during peri-menopause, women often experience hot flashes, night sweats, mood shifts, and vaginal dryness, but what’s less commonly talked about is the impact on long-term health.
Declining estradiol is one of the reasons why cholesterol issues often appear for the first time in peri-menopause. Before Menopause, women rarely struggle with lipid control, but when estrogen drops, the body’s ability to regulate cholesterol and triglycerides shifts dramatically. This is why many women who never had cholesterol issues or heart health concerns suddenly see changes on their lab reports after age 45.
More and more is understood about the impact of insulin resistance, and it is evident that it manifests as intra-abdominal weight gain or increases in visceral fat, the fat surrounding our vital organs. But did you know, the higher blood glucose is what predisposes us to lay down plaques in our brains, contributing to the cognitive disorders/dementia. Dementia is now thought to be a type III diabetes.
In addition to hormone replacement, we also take a comprehensive approach using targeted peptides to support metabolism, growth, and repair. Specific medical peptides can help address the insulin resistance that often develops during menopause, improving blood sugar control and making weight management easier. Others work to gently stimulate the body’s natural growth hormone production, which supports lean muscle development, improves sleep, enhances fat metabolism, and provides overall anti-aging benefits. When combined with bio-identical hormones, these therapies help restore balance at a cellular level, addressing not only symptoms but also the deeper drivers of aging.
The combination of all three declining: estrogen, progesterone, and testosterone, creates the roller coaster that so many women describe during their 40s and 50s. The imbalance doesn’t just affect the reproductive system; it influences nearly every part of the body. That’s why symptoms of menopause can feel so widespread, ranging from physical to emotional to cognitive.
In other words, menopause is not ‘just hot flashes’, and it is not something you just have to deal with until it goes away. It is a comprehensive hormonal transition that affects metabolism, mood, sleep, skin, hair, and overall long-term health. Recognizing this is key: when your hormones shift, your entire body feels it. That is precisely why hormone replacement therapy can be such a powerful tool to preserve and improve overall health in women (and men).
Hormone Therapy at Austin Cosmetic Surgery and The Cosmetic Center at DC Ranch
When women, and often their male counterparts, come to see me (whether in Austin, Lakeway, Bee Cave, Dripping Springs, Spicewood, and Marble Falls, or at our Scottsdale location in DC Ranch), they often arrive with the same feeling: “Something just isn’t right.” They’ve seen their primary care doctor or even their OB/GYN, but the solutions offered are usually limited to antidepressants, sleep aids, or a vague suggestion to “it’s just part of aging”.
That’s not how we do things here. At Austin Cosmetic Surgery and The Cosmetic Center at DC Ranch, hormone therapy is not a quick prescription or a one-size-fits-all patch. Together, we create a thoughtful, medical, and personalized plan tailored to your whole body, energy, mood, relationships, lifestyle, and long-term health.
Step 1: The Consultation + Lab Work
Every hormone journey begins with a set of comprehensive labs that we can draw in-house or send to the lab, dictated by your insurance carrier for collection. Then we sit down and have a conversation about what the lab work indicates, and we have a genuine discussion about lifestyle and goals. I want to know what you’re experiencing, whether that’s exhaustion, stubborn weight gain, low libido, brain fog, or anxiety. These symptoms may feel disconnected from your hormones, but in reality, they’re often tied to the exact root cause- hormonal shifts and imbalances related to perimenopause and menopause. My job is to listen to your goals and then walk with you every step of the way until we achieve that endpoint.
Step 2: Your Personalized Treatment Plan
Once we have your blood test results and have had a consultation, we start to develop a customized plan to introduce hormone therapy, supplements, and lifestyle changes.
This step might include:
-Bio-identical hormone replacement therapy (BHRT) delivered through pellets, injections, oral medications, transdermal patches to deliver hormones like estradiol, troches, or creams, depending on your needs and preferences. I will guide you on the efficacy of the various delivery systems.
-Lifestyle strategies such as nutrition guidance, exercise recommendations, and stress management to truly bio-hack the aging process.
-Integrative care where we connect your hormone balance with aesthetics, surgical options, or hair restoration so your confidence is supported inside and out, because when you feel good on the inside, you’re going to want your exterior appearance to match your revitalized internal self.
I like to tell my patients: hormone therapy is not about turning back the clock, it’s about helping you feel strong, energized, and vibrant in this stage of life. Menopause done the right way can be liberating and the start of a beautiful new chapter!
Step 4: Ongoing Monitoring and Adjustments
Our approach to hormone therapy isn’t a ‘set it and forget it’ take on medicine. As your body shifts, we adjust your plan. Frequently, I inherit men and women already on multiple medications. My goal is to restore the health of youth and help you reduce or eliminate the need for medications. You’ll have follow-up appointments and lab checks to ensure your levels are optimal and your symptoms are improving. This is where many women (and all our guys) feel the difference in coming to us. You’re not just a lab result or a prescription number; you’re part of our family, and we’re walking this wellness journey together!
The Austin Cosmetic Surgery and The Cosmetic Center at DC Ranch Difference
What sets us apart is the way we integrate hormone therapy with whole-woman (or man) wellness. Many clinics focus narrowly on hormones, but the “Dr. Michelle Cabret” approach is to look at the entire picture and, step by step, create lasting change.
-If your skin feels dry, saggy, or dull, we can pair hormone and peptide therapy with medical aesthetics to help restore collagen and achieve a radiant glow.
-If you’re noticing hair thinning, we offer advanced treatments, such as NeoGraft, FoLix, PRP, and Nutrafol, alongside your hormone therapy plan.
-If your body composition is shifting, we can combine hormone balance with weight-loss medication, peptides, and surgical solutions.
The goal is not only to help you feel like yourself again, but to look in the mirror and recognize the woman (or man) staring back at you, strong, radiant, and whole.
Whole-Body Wellness Beyond Hormones
We often see that hormone therapy is the missing puzzle piece for women in menopause; it is only one part of a bigger picture. Think of your hormones as the foundation of a house; a strong foundation is essential, but the walls, roof, and finishing touches are what make it a home you can truly enjoy. At Austin Cosmetic Surgery and The Cosmetic Center at DC Ranch, we approach menopause as more than just a hormonal shift. It’s a stage of life that requires care for your body, mind, and spirit.
Nutrition That Supports Hormone Balance
What you eat plays a powerful role in how your hormones function. During menopause, your metabolism slows, your body responds differently to sugar and carbs, and you may notice fat collecting around your midsection and breasts for the first time. We guide our patients toward protein-rich, anti-inflammatory diets that stabilize blood sugar levels, protect bone density, and help combat bloating. The right foods can complement bioidentical hormone replacement therapy (BHRT), enhancing your results and making them stronger and longer lasting.
Strength and Movement as Medicine
Menopause is often when women start to experience muscle loss, joint stiffness, and lower energy levels. This isn’t just ‘aging’; it’s directly tied to declining estrogen and testosterone levels. That’s why we encourage strength training and functional movement, which protect bone health, keep your metabolism active, and preserve lean muscle mass. A simple, consistent exercise plan can be one of the best anti-aging tools you’ll ever invest in.
Managing Stress and Cortisol
Cortisol, your stress hormone, is one of the biggest saboteurs of midlife wellness. High cortisol contributes to weight gain, poor sleep, and accelerated aging. We help women establish simple yet effective routines for stress reduction, whether that involves meditation, supplements, peptides, yoga, deep breathing, or scheduling guilt-free downtime. When cortisol comes down, weight, mood, and sleep often improve dramatically.
Skin Health and Aesthetics
Estrogen and testosterone are closely tied to collagen synthesis, dermal thickening, and blood supply, which is why so many women notice their skin becoming thinner, drier, or less elastic during menopause. While BHRT and peptides are beneficial, combining optimized biochemistry with medical aesthetics yields the best results. Treatments such as laser resurfacing, radiofrequency tightening, dermal fillers, and medical-grade skincare can restore vibrancy and firmness, giving your outward appearance the same energy your body feels inside.
Hair Growth and Confidence
One of the lesser-discussed symptoms of menopause is hair thinning. It can feel devastating to look in the mirror to see your ponytail shrinking or your part widening. We combine hormone balance with proven hair restoration treatments, including PRP (platelet-rich plasma) +/- microneedling of the scalp, FoLix (the first FDA-approved device shown to increase follicle density), NeoGraft FUE hair transplantation, and Nutrafol oral and topical supplements. By addressing both the hormonal and follicular aspects of hair health, we help women maintain their confidence during this stage of life, when they may experience a decrease in hair volume.
Emotional and Social Well-being
Ultimately, whole-body wellness encompasses more than just physical aspects. Menopause can impact mood, relationships, and even a woman’s sense of identity. We believe in creating a space where patients feel heard, supported, and empowered. Many women tell us that the most healing part of their visit wasn’t the prescription or the treatment, but simply knowing they’re not alone and there are solutions.
Frequently Asked Questions About Hormone Therapy
Is hormone therapy safe?
Yes. The notion of ‘safety’ has been turned on its head, showing that it is critical to maintain both cardiac and cognitive health. Modern BHRT utilizes bio-identical hormones, which are carefully monitored through laboratory testing to ensure optimal levels.
How long does it take to feel results?
Most women experience improvements within 10-14 days, with continued benefits lasting over several months.
Do you treat women only in Austin?
No. Our hormone patients come from Austin, Lakeway, Bee Cave, Leander, Spicewood, Dripping Springs, Marble Falls, San Antonio, and beyond, as well as Scottsdale, AZ, and throughout the greater Phoenix Metroplex. Many individuals travel from out of state and/or receive treatment through virtual visits, with medications, peptides, and supplements shipped nationwide to access the expert advice that I’ve amassed as an elite-trained MD physician utilizing cutting-edge bio-hacking technology and experience. I encourage my patients to stop taking advice from self-proclaimed “experts” on social media who have never treated a real human in their lives.
Menopause Is a New Beginning, Not the End
If no one has told you this yet, let me be the first: menopause is not the end of your best years; it’s the beginning of a brand-new chapter.
I know this not just as a physician, but as a woman. At 56 years old, I am living this journey right alongside you. I can attest that my labs say I am healthier than most 25-year-olds, and I look and feel better at 56 than I did at 46! I understand firsthand what it feels like when your body changes in ways you didn’t expect, when your sleep feels off, or when your confidence takes a hit from symptoms that seem to appear out of nowhere. I also know the incredible relief and renewal that comes when you finally take charge of your hormones and your wellness.
That’s why I can say with complete conviction, you are not broke, you are not fading, and you are not alone. This season of life is not about loss; it’s about growth, transformation, and quality of life.
Menopause permits you to put yourself first, finally. You’ve spent decades pouring into everyone else, your family, your career, your relationships. Now it’s your time. This is not the time to shrink back. This is the time to stand taller, shine brighter, and live unapologetically for yourself.
When we balance your hormones, restore your energy, boost your libido, and help you feel at home in your body again, it’s not about chasing youth. It’s about embracing your wisdom, your strength, and your vibrancy at this stage of life. And I promise you, you can feel amazing in your 40s, 50s, 60s, and beyond!
So no, menopause is not the end. It’s not a curtain closing. No more miserable days of periods, cramps, weight gain, or PMS. It’s a door opening, and on the other side is a version of you that is wiser, stronger, and more radiant than ever before. And from one menopausal woman to another, know this: I am here, and I am cheering you on every single step of the way!
If you’re ready to take your health and wellness to the next level, call to book a consultation today!
