98: Dr. Amy Killen: Why Your Doctor’s Failing You on Menopause (And How to Take Control)
Why Your Doctor's Failing You on Menopause (And How to Take Control)
Why are women constantly dismissed when bringing up perimenopause symptoms? Dr. Amy Killen breaks down the massive education gap in hormone health, HRT myths, and how to advocate for yourself.
Why are women constantly misdiagnosed and dismissed when they bring up perimenopausal symptoms to their doctors? The answer might shock you, and it's costing women their quality of life and long-term health.
This week, Tara sat down with Dr. Amy Killen, board-certified emergency physician turned hormone optimization and regenerative medicine specialist, to talk about the massive education gap in women's hormone health, why the medical establishment got scared of HRT in 2002, and what the latest research actually shows about hormone replacement therapy.
They dive deep into the difference between bioidentical and synthetic hormones, the supplements that actually matter for aging women, and why every woman deserves a conversation about hormone optimization, not just a dismissive "that's part of getting older."
The Education Gap in Women's Health Is Staggering
Here's something that should make you angry: most doctors receive little to no education about perimenopause and menopause in medical school.
Dr. Killen breaks it down: in four years of medical school, women's hormone health might get a couple of hours of lecture time, if that. And most of that education is outdated, focused on the wrong things, or based on flawed studies from decades ago.
So when you walk into your doctor's office complaining of irregular periods, weight gain, brain fog, insomnia, anxiety, or any of the dozens of symptoms associated with perimenopause, your doctor likely doesn't have the training to recognize what's happening. They might run some tests, tell you everything looks "normal," and send you on your way with a prescription for antidepressants or sleeping pills.
Meanwhile, you're left feeling gaslit, frustrated, and like you're losing your mind. Spoiler: you're not. Your hormones are changing, and your symptoms are real. But if your doctor doesn't know how to recognize or treat hormonal changes, you're stuck suffering unnecessarily.
This education gap is a systemic failure, and it's why so many women in their 30s, 40s, and 50s feel abandoned by the healthcare system.
Why Women Are Constantly Dismissed by Doctors
Let's talk about the dismissal factor, because this is where things get really frustrating.
Women show up to their doctors with legitimate symptoms, debilitating hot flashes, crushing fatigue, mood swings, sleep disruption, painful sex, weight that won't budge, and they're told it's stress, it's in their head, it's just part of getting older, or they should exercise more and eat less.
Dr. Killen sees this all the time. Women who've been to multiple doctors, spent thousands of dollars on tests, tried every lifestyle intervention under the sun, and still feel like garbage. And when they finally get their hormones tested and optimized, suddenly everything improves.
Why does this happen? A few reasons. First, the education gap we already talked about. Second, implicit bias, women's pain and symptoms are taken less seriously than men's. Third, the medical model is designed to treat acute problems, not optimize for long-term health and quality of life.
And fourth? Many doctors are still operating with outdated information about hormone replacement therapy, which brings us to the next point.
The 2002 Women's Health Initiative Study That Changed Everything
In 2002, a massive study called the Women's Health Initiative (WHI) was published, and it scared the living hell out of everyone, doctors and women alike.
The study seemed to show that hormone replacement therapy (HRT) increased the risk of breast cancer, heart disease, and stroke. The media went wild. Doctors stopped prescribing HRT. Women who were on it quit immediately. And an entire generation of women was left to suffer through menopause without any hormonal support.
But here's the thing: the study was flawed. Like, really flawed.
Dr. Killen explains that the WHI used synthetic hormones (not bioidentical), the average age of participants was 63 (way past the ideal window for starting HRT), and many of the women already had existing health issues. The study wasn't designed to evaluate HRT for perimenopausal or early menopausal women, the population that would actually benefit most.
Since then, subsequent research has shown that for most women, especially those who start HRT within 10 years of menopause, the benefits far outweigh the risks. But the damage was done. Doctors remain terrified of prescribing HRT, and women remain terrified of taking it.
The result? Millions of women suffering unnecessarily because of a single poorly designed study from over 20 years ago.
Are Doctors Getting Better Menopause Education Now?
Short answer: slowly, but not fast enough.
Medical schools are starting to add more content about menopause and perimenopause, but it's still not enough. And most practicing doctors, the ones you're actually seeing in clinic, were trained before these changes, so they're working with outdated or non-existent knowledge.
Dr. Killen says the burden is currently on women to educate themselves and advocate for their own care. Which, let's be honest, is exhausting and unfair. You shouldn't have to become an expert in hormone health just to get basic medical care.
But until the system catches up, that's where we are. So arm yourself with information, find doctors who specialize in hormone health, and don't accept "that's just part of getting older" as an answer.
Why "That's Just Part of Getting Older" Is a Harmful Narrative
Let's kill this phrase right now: "That's just part of getting older."
No. Just no.
Yes, hormonal changes are a natural part of aging. But suffering through debilitating symptoms is not inevitable. Losing your quality of life is not inevitable. Accepting brain fog, insomnia, hot flashes, loss of libido, and muscle loss as your new normal is not inevitable.
Dr. Killen is passionate about this: women deserve to feel good throughout their entire lives, not just until menopause hits. Hormone optimization isn't about staying 25 forever, it's about supporting your body so you can feel strong, energized, and capable as you age.
And here's the kicker: hormone replacement therapy isn't just about symptom management. It's also preventative medicine.
How Hormones Are Preventative for Chronic Diseases
This is the part most people don't realize: estrogen, progesterone, and testosterone aren't just about periods and sex drive. They play crucial roles in protecting your brain, bones, heart, and metabolic health.
When your hormones decline during perimenopause and menopause, your risk for chronic diseases increases dramatically. Osteoporosis, cardiovascular disease, cognitive decline, sarcopenia (muscle loss), metabolic syndrome, all of these become more likely when your hormones drop.
HRT can help mitigate these risks. Estrogen protects your bones and cardiovascular system. Progesterone supports sleep and mood. Testosterone helps maintain muscle mass, energy, and libido.
This isn't just about feeling better now, it's about protecting your health for the next 30, 40, 50 years. And that deserves a conversation with a knowledgeable doctor, not a dismissive wave-off.
How to Know If Symptoms Are Perimenopause vs. Other Issues
Here's where things get tricky: perimenopausal symptoms can look like a lot of other things. Depression, anxiety, thyroid issues, adrenal dysfunction, autoimmune conditions, the symptoms overlap significantly.
Dr. Killen recommends looking at the full picture. Are you in your late 30s or 40s? Are your periods changing, getting shorter, longer, heavier, lighter, more irregular? Are you experiencing multiple symptoms at once, sleep issues, mood changes, weight gain, brain fog, changes in libido?
If you check those boxes, perimenopause is likely. But you should also rule out other issues with proper testing.
What Tests to Ask For and Where to Get Them
So what tests should you actually get?
Dr. Killen recommends a comprehensive hormone panel that includes estradiol, progesterone, testosterone (free and total), DHEA, cortisol, thyroid panel (TSH, Free T3, Free T4, reverse T3, thyroid antibodies), vitamin D, and sometimes SHBG (sex hormone binding globulin).
The problem? Many conventional doctors won't order these tests, or they'll only order partial panels that don't give you the full picture.
Your options:
Find a functional medicine doctor, naturopath, or hormone specialist who will order comprehensive testing
Use at-home testing companies like DUTCH test (for hormones) or specialty labs
Advocate hard with your current doctor, bringing research to support why these tests matter
And here's an important note: hormone levels fluctuate throughout your cycle (if you're still cycling), so timing matters. Work with someone who understands how to interpret results in context.
Addressing Fears About HRT and Breast Cancer
Let's tackle the big fear: breast cancer.
Dr. Killen is clear about this, the data shows that bioidentical estrogen plus progesterone does not significantly increase breast cancer risk for most women. The increased risk found in the WHI study was associated with synthetic progestins (not bioidentical progesterone) combined with conjugated equine estrogen (not bioidentical estradiol).
Bioidentical hormones, which are chemically identical to what your body naturally produces, have a much better safety profile. And when you factor in the protective benefits for heart, bone, and brain health, the risk-benefit ratio strongly favors HRT for most women.
Of course, individual risk factors matter. If you have a personal or strong family history of breast cancer, you need to have a detailed conversation with a knowledgeable doctor. But for most women, the fear of HRT is vastly overblown.
When Is the Right Time to Start HRT?
Timing matters with HRT. The "window of opportunity" is generally within 10 years of menopause (or before age 60).
Dr. Killen explains that starting HRT during this window maximizes benefits and minimizes risks. Your cardiovascular system, brain, and bones are still healthy enough to benefit from hormonal support. Start too late, and you lose some of those protective effects.
But here's the thing: you don't have to wait until you're in full menopause to start. Many women benefit from starting hormone support in perimenopause, when symptoms first appear and hormones start fluctuating wildly.
The key is working with a doctor who understands how to dose appropriately for your stage of life and adjust as your needs change.
Do You Have to Take Hormones Forever?
This is a common question, and the answer is: it depends on your goals.
Some women take HRT just long enough to get through the worst of perimenopausal symptoms, then taper off. Others stay on it long-term because they value the protective benefits for brain, bone, and heart health, and they feel so much better on it.
There's no one-size-fits-all answer. This is a personal decision based on your symptoms, risk factors, values, and quality of life goals.
Supplements: What Women Actually Need as They Age
Let's talk supplements, because not everything requires a prescription.
Dr. Killen's short list of what actually matters for aging women:
Creatine: Supports muscle mass, brain health, and bone density. Aim for 5g daily. This is especially important for women, and most aren't taking it.
Protein powder: If you're struggling to hit your protein goals (0.7-1g per pound of body weight), a quality powder can help bridge the gap.
Vitamin D: Most people are deficient. Get tested and supplement accordingly, usually 2000-5000 IU daily.
Omega-3s: Support cardiovascular and brain health. Aim for 1-2g of EPA/DHA daily.
Magnesium: Supports sleep, mood, muscle recovery, and bone health. Magnesium glycinate or threonate are good options.
Collagen: May support skin, joint, and bone health, though the evidence is mixed.
Beyond that? Most supplements are optional or situational based on individual needs. Don't fall for expensive stacks promising miracles. Focus on the basics first.
Why Women Should Take Creatine
Creatine deserves its own section because it's so underutilized by women.
Dr. Killen is passionate about this: creatine isn't just for bodybuilders. It supports muscle mass and strength (crucial as you age), brain health and cognitive function, and bone density, all things women desperately need as estrogen declines.
The research is clear: creatine is safe, effective, and one of the most well-studied supplements out there. Yet most women don't take it because they think it's only for men or they're afraid of "bulking up" (spoiler: you won't).
Five grams daily. That's it. Mix it in your coffee, water, or protein shake. One of the simplest, most effective things you can do for your long-term health.
How to Figure Out If a Supplement Is Actually Working
Here's Dr. Killen's advice for evaluating supplements: give it at least 4-8 weeks, then assess. Are you noticing improvements in the specific issue you're trying to address? Energy, sleep, mood, recovery, whatever?
If yes, keep taking it. If no, stop wasting your money.
Track objective markers when possible, bloodwork, body composition, sleep quality via wearable, strength in the gym. Subjective feelings matter too, but data helps cut through placebo effects and marketing hype.
Key Takeaways
Here's what you need to remember from this episode:
Most doctors receive inadequate education about women's hormone health
Women are routinely dismissed when bringing up perimenopausal symptoms
The 2002 WHI study was flawed and created unnecessary fear around HRT
"That's just part of getting older" is not an acceptable answer
Hormone replacement therapy is preventative medicine for brain, bone, and heart health
Bioidentical hormones have a much better safety profile than synthetic versions
The ideal window for starting HRT is within 10 years of menopause
Every woman deserves a conversation about hormone optimization with a knowledgeable doctor
Key supplements for aging women: creatine, protein, vitamin D, omega-3s, magnesium
Creatine is massively underutilized by women and supports muscle, brain, and bone health
Ready to Take Control of Your Health?
If you're tired of being dismissed and ready to advocate for the care you deserve, start by educating yourself. Listen to experts like Dr. Killen, find a hormone-knowledgeable doctor, and don't settle for "that's just part of aging."
For comprehensive 1:1 support navigating perimenopause, hormone health, and strength training, check out Broads coaching.
What's your biggest frustration with navigating hormone health and the medical system? Share your experience on Instagram and tag @broads.podcast.
For more no-BS content about women's health and hormone optimization, follow @taralaferrara and check out the full Broads podcast library for 90+ episodes.
