Dr. Denise Bogard on Why Women’s Hormone Health May Deserve Attention Before Menopause
Women may come to regard weight gain, fatigue, abdominal weight, disrupted sleep, vaginal dryness, lower libido or hair loss as expected parts of getting older. Denise Bogard, M.D., founder of Well Aging Med, an integrative and functional medicine practice, believes these changes may warrant a closer conversation about hormones, nutrition, thyroid function, stress and other aspects of health.
That conversation may be especially relevant as people spend more years in later life. Global life expectancy increased from 66.8 years in 2000 to 73.1 years in 2019, while healthy life expectancy rose from 58.1 to 63.5 years during the same period. For Dr. Bogard, those additional years invite a broader discussion about how women can support their health throughout midlife.
Dr. Bogard’s perspective is that earlier awareness may give women more opportunity to understand changes as they arise and discuss appropriate options with qualified clinicians. “Hormones are part of a much larger conversation about how a woman is functioning,” she says. “When we listen to the symptoms and look at the whole person, we can ask better questions about what may be contributing to them.”
That broader view also influences the way Dr. Bogard discusses testosterone. The hormone may be frequently associated with sexual health, while research has explored its potential relevance to areas such as energy, cognition, muscle, bone, vascular health and body composition. Testosterone can be viewed as an important hormone in women’s physiology, and its role may extend well beyond sexual function.
For Dr. Bogard, the larger lesson is the importance of understanding hormones within an individual’s medical context. “I want women to understand that there is more to hormone health than a single number on a laboratory report,” she says. “Estrogen, testosterone, progesterone, thyroid function, cortisol, the GI tract, nutrition, sleep and stress can all be relevant pieces of the conversation.”
This perspective reflects Dr. Bogard’s medical training across conventional and functional medicine. At Well Aging Med, she considers factors such as hormone balance, gut health, inflammation, stress, nutrient status and immune function when evaluating a patient’s concerns. Her goal is to connect those pieces with the person’s symptoms, history and broader health priorities.
Her own experience as a patient also influenced this philosophy. After navigating cancer treatment, Dr. Bogard says she became particularly aware of the value of asking broader questions and participating actively in medical decisions. “I describe my earlier experience of care as sometimes having a ‘tunnel vision’ quality, where individual medical concerns could receive intense attention while other aspects of a person’s health received less consideration,” Dr. Bogard explains.
That experience helped reinforce an idea she now brings into her clinical work: the body can be viewed as an interconnected system. Hormonal changes may coincide with shifts in thyroid function, stress physiology, digestion, sleep, metabolism and physical strength. Dr. Bogard also points to hormone receptors within the gastrointestinal tract as an example of why she believes these systems merit consideration together.
The complexity can become particularly important when discussing hormone therapy. Women can encounter conflicting information about potential benefits, risks, formulations and timing. “I’ve seen current clinical guidance emphasizing individualized decision-making based on symptoms, medical history, age, health risks and personal circumstances,” Dr. Bogard states. “For women with a history of breast cancer, hormone-related treatment requires particular medical consideration.”
Dr. Bogard’s experience has made patient education a significant part of her philosophy. She encourages women to ask questions when symptoms persist, learn about available options and seek additional medical perspectives when appropriate. Changing oncologists during her own cancer experience became one example of that process.
“You have to be your own advocate,” Dr. Bogard says. “You have to be willing to ask questions, learn and find the person who can help you understand your particular situation.” That message extends beyond hormone therapy. Healthy aging can involve paying attention to physical function, sleep, strength, nutrition, emotional well-being and other elements of daily life long before a major transition occurs.
For women entering their mid-to-late 30s and early 40s, Dr. Bogard believes that hormonal changes and awareness become an important part of personal health planning. “It is also important to understand that if you had the injection for contraception or oral contraception, your hormones can drop to very low levels,” she says. She notes that symptoms can have multiple possible explanations, and evaluation should remain individualized, yet recognizing a change and bringing it into a medical conversation may open useful avenues for understanding.
“Healthy aging starts with paying attention to yourself,” Dr. Bogard emphasizes. “You know your body better than anyone. When something changes, that is an opportunity to ask why and to explore what support may be appropriate.” Her broader philosophy places healthy aging within a longer horizon: understanding the body earlier, asking informed questions and participating actively in decisions may help women enter later stages of life with a stronger understanding of their health and the choices available to them.
This article is for informational purposes only and does not substitute for professional medical advice. If you are seeking medical advice, diagnosis or treatment, please consult a medical professional or healthcare provider.
