For years, hormones were treated as a taboo topic or something women only discussed when they reached menopause. That’s changing. When hormones like estrogen, testosterone, progesterone, and thyroid shift, so can how we feel, function, and even look. During a recent NewBeauty webinar sponsored by Belmar Pharma Solutions, world-renowned physician, women’s hormonal health expert, medical educator, and best-selling author Angela DeRosa, DO, MBA, CPE (known as Dr. Hot Flash) shared what women should know about today’s hormone health.
1) Hormone changes can start earlier than you think
Hormonal shifts can begin long before the hot flashes start. “Hormones start to decline ten to fifteen years before menopause,” said Dr. DeRosa. “Usually, it’s about the mid-30s when that deficiency starts. It starts with testosterone deficiency…then in the 40s we start to develop estrogen deficiencies.”
She notes that many women in their 30s and 40s are already seeing the effects: fatigue, irritability, low libido, and even changes in recovery after workouts. “We picture menopause as something that happens in your 50s, but biologically, women start declining a decade or more before that,” she explained.
Recognizing these changes early is key. “If you can impact women at that point, you can support them, and help prevent many of the chronic diseases or health issues that can occur from having those imbalances,” she said.
2) Balanced hormones can support skin, hair and recovery
Hormone health affects more than just energy levels. It can also influence how skin and hair react. “If women become estrogen-deficient, their collagen starts to decline and their hair gets brittle,” said Dr. DeRosa. “If you can introduce hormones in those settings, you can not only make them feel better and prevent chronic illness but also give them a better opportunity to maintain external beauty. The procedures and treatments you do in your office will be more successful.”
It’s one reason why many aesthetic professionals are starting to view hormone health and beauty as connected conversations. “You’re not just chasing glow,” she said. “You’re supporting the foundation of how your skin and body renew themselves.”
3) It’s not just about estrogen
“Testosterone is actually our most abundant hormone, and it does exactly the same things for us as it does for men,” said Dr. DeRosa. “When testosterone becomes deficient, we get depressed, anxious or apathetic, and most importantly, we just don’t feel like having sex anymore.”
She added that low testosterone is often mistaken for something else. “Instead of identifying it as a testosterone deficiency, women get put on antidepressants, which, by the way, make the deficiency even worse,” she said.
Progesterone also plays an important role. She explained that it helps calm the nervous system, supports better sleep, and counterbalances estrogen.
4) A sluggish thyroid can masquerade as ‘just aging’
By the time most women reach their 40s, thyroid changes add another layer to the picture. “Eighty to ninety percent of my patients over the age of forty have some degree of thyroid slowdown, and most physicians are not addressing this problem,” said Dr. DeRosa. “When it slows down, every organ system slows down. You get hair thinning, constipation, fatigue, you’re cold all the time, and you gain weight.”
She stresses that thyroid testing shouldn’t stop at one number. “You need a full panel, T3, T4, antibodies, reverse T3, to see the whole picture. When doctors only check one marker, they often miss the issue entirely.”
5) The goal isn’t to turn back time, it’s to feel like yourself again
“We’re not going to prevent aging, but we can certainly slow it down,” said Dr. DeRosa. “When your body is functioning optimally, you sleep better, you have more vitality, and you feel more like yourself again.”
Her approach centers on individualization. “There’s no one-size-fits-all. It’s about optimizing what your body needs and keeping you functioning at your best.”
Her book, The Women’s Hormonal Health Survival Guide: How to Prevent Your Doctor from Slowly Killing You, walks readers through every major hormone and symptom pattern in plain language. It includes checklists to help identify potential imbalances, sample questions to ask your provider, and a section titled “When to Run Out the Door,” highlighting red flags in medical advice. “It’s really a guide to self-advocacy,” she says. “Women deserve to understand their bodies and have doctors who listen.”
