Over the past few years, conversations around menopause have finally become more open and empowering - thanks in part to high-profile documentaries and media coverage. Women are now recognising their symptoms, feeling validated, and seeking solutions.
One of the most talked-about treatments is HRT (Hormone Replacement Therapy) - and rightly so. It can be incredibly effective for reducing hot flushes, improving sleep, boosting mood, and protecting long-term health. But for many women, HRT alone isn’t enough.
At Omniya, we frequently see clients who have started HRT but still feel “off.” They may still be tired, anxious, foggy, or struggling with weight changes - despite taking the correct dose and type of hormones. And that’s because perimenopause and menopause affect the whole body, not just the ovaries.
Let’s explore why HRT isn’t always the quick fix many hope for - and what a more personalised, integrative approach can offer instead.
The Hormonal Shift is Bigger Than Just Oestrogen and Progesterone
During perimenopause and menopause, we experience a decline in reproductive hormones like oestrogen, progesterone, and testosterone - but these hormones don’t function in isolation.
They interact with:
- Cortisol, your main stress hormone
- Insulin, which regulates blood sugar and fat storage
- Thyroid hormones, which govern energy and metabolism
- Melatonin, which affects sleep-wake cycles
- DHEA, a precursor hormone that supports vitality
If these systems are not in balance, simply replacing oestrogen may not resolve your symptoms - and may even lead to frustration when things don’t improve as expected.
Why You Might Still Struggle - Even On HRT
Common complaints we hear from women already on HRT include:
- Ongoing fatigue
- Poor sleep
- Weight gain around the middle
- Anxiety or low mood
- Brain fog
- Digestive issues
These symptoms often point to underlying imbalances in areas such as:
- Gut health: affecting nutrient absorption and hormone clearance
- Blood sugar stability: which impacts mood, energy, and weight
- Chronic inflammation: worsened by diet, stress, or hidden infections
- Nervous system dysregulation: from years of multitasking and stress
At Omniya, we take a functional medicine approach to assess and address these root causes, combining advanced testing, nutritional strategies, and lifestyle interventions alongside HRT - where appropriate.
It’s Not Just About Replacing Hormones - It’s About Supporting the Whole System
HRT is a powerful tool, but to feel your best, your body also needs:
- A nutrient-dense diet with sufficient protein and fibre
- Blood sugar balance through smart food choices and meal timing
- Exercise tailored to your biology - including strength training over excessive cardio
- Gut and liver support to metabolise hormones effectively
- Stress management to regulate cortisol and reduce inflammation
- Rest and recovery - not just more to-do lists
Many women have been doing the same thing for decades - eating the same way, pushing through stress, skipping rest - but perimenopause is a signal that the body’s needs are changing. And the way you care for, look after, feed and nourish yourself needs to adapt too.
A Functional Approach to Menopause at Omniya London
If you’re navigating perimenopause or menopause and feel like HRT hasn’t quite delivered the results you hoped for - you are not alone. Our integrative, individualised approach at Omniya is designed to uncover what’s really going on in your body and help you feel energised, balanced, and empowered again.
We offer:
- Functional testing to assess hormones, gut health, nutrients, and more
- Personalised nutrition and lifestyle strategies
- Bioidentical and body-identical HRT prescribing where appropriate
- A deeper look at stress, sleep, and long-term prevention
Book a Consultation
Richa Puri is a prescribing pharmacist and functional medicine practitioner with over 15 years of clinical experience. She specialises in women’s health, hormones, fertility and integrative HRT prescribing and support. To book a consultation with Richa, please book here.
