The hormones, plainly
The vocabulary, before the prescribing conversation
One focused page per hormone, in plain language. Pick the one you came here for.
In 30 seconds
- Estrogen and progesterone do most of the day-to-day work. Testosterone matters too.
- FSH and LH are lab numbers, not symptoms. They rarely change the plan.
- This page is vocabulary, not a prescription. Pick a hormone below, then head to treatments.
The cast
Pick the hormone you came here for
Five names, in the order they tend to matter.
The load-bearing one
Estrogen
The one most people mean when they say 'hormones'. Estradiol is the version your ovaries make most of in your reproductive years.
Read estrogenThe calming one (and most-mis-Googled)
Progesterone
The hormone that calms, sedates, and balances estrogen. The one most likely to be mis-Googled into contraception content.
Read progesteroneYes, you make it. Yes, it matters.
Testosterone
Yes, you make it. Yes, it matters. No, the search results aren't about you.
Read testosteroneThe 'test result' hormones
FSH and LH
The hormones the lab measures when someone tries to 'confirm' menopause with a blood test. Often less useful than people think.
Read fsh and lhThe one everyone blames
Cortisol
The stress hormone that gets blamed for everything in midlife. Here's what it actually does, what genuinely changes in perimenopause, and what's worth testing.
Read cortisol
OptionalHow they work together, in one map
How they fit together
One conversation, four hormones, talking to each other
The brain (hypothalamus and pituitary) sends FSH and LH down to the ovaries. The ovaries answer back with estrogen and progesterone, on a monthly rhythm. Testosterone runs alongside, made in the ovaries and adrenals, on its own quieter dial. In perimenopause that loop starts to misfire. This is why one symptom is rarely traceable to one hormone.
Brain
Hypothalamus & pituitary
Send FSH and LH: the 'go ovulate' signal.
FSH · LHOvaries
Estrogen & progesterone
Answer back monthly. Estrogen builds, progesterone steadies, until the cycles get erratic.
Estradiol · ProgesteroneWhy it matters
When estrogen swings, the brain pushes FSH harder. Progesterone falls in cycles where you don't ovulate. Testosterone drifts. One symptom rarely traces to one hormone, and one number on one day rarely tells the story.
OptionalIs this you? Framed for your stage
If you came here from a search
Progesterone is not the same thing as the progestin in your pill
Search results for "progesterone" mostly show contraception, where the active ingredient is a progestin. Perimenopause and MHT use micronized progesterone, body-identical, lower dose, usually at night. Same family, different drug.
Read the progesterone pageThe synthetic family, and the newer drugs
Progestins, Premarin, ethinyl estradiol, tibolone, NK3 antagonists, BHRT
Most old HRT fear traces back to one specific old combination. Most "bioidentical" marketing sells what the regulated version already does. And NK3 antagonists like fezolinetant are a genuinely new option for people who can't take estrogen.
Read the synthetics pageIf you've had a hormone-sensitive cancer
The conversation is different, but it isn't closed
The answer used to be a flat no. It's more careful than that now, and it's decided with your oncology team and a menopause-aware doctor, not a search engine.
The detailFour things worth knowing
- Local vaginal estrogen is a separate question from systemic MHT. The doses are tiny, the systemic absorption is low, and current guidance from major menopause societies treats it as discussable for many people after breast cancer — including those on aromatase inhibitors — when GSM is hurting daily life.
- Non-hormonal options for hot flashes have moved on. SSRIs and SNRIs (with caveats around tamoxifen interactions), gabapentin, oxybutynin, and the newer NK3 receptor antagonists (fezolinetant, with elinzanetant on the way) give people who can't take systemic estrogen real levers for vasomotor symptoms.
- Treatment-induced menopause is its own pathway. Chemotherapy, ovarian suppression, oophorectomy, and aromatase inhibitors land harder and faster than the gradual perimenopause story most resources are built around.
- "No MHT" is a starting position, not the whole answer. Even when systemic MHT is off the table, sleep, mood, joint pain, GSM, libido, bone, and brain symptoms still need a plan.
What this page isn't
A primer, not a prescription
Vocabulary, so the appointment makes sense. Doses and choices live on treatments.