Why does the topic of hormones suddenly seem to be everywhere? 

As a physician, one thing I love about medicine is how it is constantly evolving. Patients are increasingly advocating for themselves and speaking openly about menopause, cognition, sleep, sexuality, mood, musculoskeletal symptoms, and quality of life. Clinicians are now being challenged to address menopause more comprehensively rather than simply encouraging women to “wait it out.” 

I still see women whose menopausal symptoms and experiences have been minimized or dismissed. Yet in the United States, the average age of menopause is 51–52, while average female life expectancy approaches 80 years. Perimenopause often begins in the mid- to late 40s. This means many women spend more than one-third of their lives in peri- and post-menopause. 

The primary hormones affected during this transition include estrogen, progesterone, and testosterone. Fluctuations and decline in these hormones can impact many aspects of health and well-being. Despite this, mainstream medicine historically devoted limited attention to hormonal health after the reproductive years. 

My own journey as a local primary care physician has been shaped by listening closely to patients and helping guide colleagues at Telluride Regional Medical Center toward evolving perspectives in women’s health. For many years after 2002, finding balanced, evidence-informed guidance on HRT — especially for perimenopausal women — was surprisingly difficult. 

To better understand this field, I explored educational resources from organizations such as Institute for Functional Medicine, WorldLink Medical, and American Academy of Anti-Aging Medicine, alongside more traditional medical literature. My curiosity grew as I observed many patients who either chose to remain on HRT or sought care elsewhere reporting improvements in energy, musculoskeletal comfort, sexual health, sleep, and overall quality of life. 

In recent years, organizations such as The Menopause Society and American College of Obstetricians and Gynecologists have also shifted toward more proactive discussions around menopause symptoms and treatment beyond “the lowest dose possible, the shortest amount of time”.  

I am proud that our providers at Telluride Regional Medical Center are embracing these conversations. I believe menopause and perimenopause care belong within primary care — family medicine and internal medicine practices — and that women should not necessarily need to seek out a separate “hormone specialist” to begin these discussions. 

Emily McGough, FNP-BC is currently becoming a Menopause Society Certified Practitioner, and Laura Cattell, MS PA-C is pursuing advanced hormone education through WorldLink Medical. Additional providers within our practice are also expanding their education in this area, and patients can be referred for more in-depth consultations when appropriate. 

Perimenopause and menopause therapy are never “one size fits all.” Perimenopause often involves unpredictable hormone fluctuations, while menopause treatment tends to be more standardized — though every woman metabolizes and responds to hormones differently. Individualized care matters. 

If you have questions about menopause or are interested in learning more, we are here to help. I often remind women that this is a journey, and it may take time — and sometimes multiple visits — to determine the right approach based on age, symptoms, health history, risk factors, and personal goals. 

Importantly, this care should not be financially out of reach. Many hormone therapies are covered by insurance or are available at relatively modest cost, and extensive laboratory testing is not always necessary. 

One of the best places to start is simply discussing menopause during your annual preventive visit. The goal is to establish a trusted relationship with a provider who can help guide you through this stage of life with evidence-based, individualized care. 

Your health matters. 

Dr Sharon Grundy