Free Perimenopause Guide by Dr. Amy Killen, MD

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Feeling the fog, the dips in energy, or restless nights? You are not broken. You are transitioning. This guide is your science backed roadmap to build confidence, clarity, and vitality through perimenopause.

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dr.amybkillen

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Jul 24

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Women are understudied, under treated, under estimated (at every turn!) yet we still live almost five years longer. 🔥

Yes, we spend 20% more time in poor health.

But why is nobody talking about the advantages we have?

Why is nobody talking about how insanely badass we are? THAT'S the conversation I want to have. 🎉

Who's with me? ⁉️ 💃

🎥 from @vitalistbay , Berkeley, 2026.

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dr.amybkillen

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Jul 24

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Join me at Luminescence in Los Angeles Oct 17 2026:

-A gathering for women who are done figuring out their health alone.
-A full day of real talk about women's health.
-The daylong doctor's appointment you've never had.
-One day. Two thousand women. The best experts in women's health.
-You should not need a medical degree to understand your own body.

I'll be speaking on hormones and the female longevity advantage.

Get your tickets today at luminescence.health/los-angeles (use KILLENMD20)

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dr.amybkillen

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Jul 23

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What questions do you have about progesterone?

Or progestins?

Let me know below! 👇

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dr.amybkillen

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Jul 22

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Is a lower dose of estrogen safer?? 🤔

It turns out... We have no idea!

We have NO clinical trials looking at different doses of estrogen and outcomes like Breast Cancer, Heart Attacks or Stroke. ❎

The observational studies we have that included different doses of estrogen do not suggest a relationship between dose and risk outside of oral estrogen and stroke and endometrial cancer.

My recent Substack is FREE and goes through all of the evidence. 🎉

Comment "Substack" below. 👇

P.S. I'm only talking about estrogen doses within the approved FDA range.

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dr.amybkillen

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Jul 21

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Want to find the lowest price on your specific estrogen product? 🤔

Want to learn about alternatives if yours is on backorder?

Want to see the estimated serum estradiol level for your dose? 🥰

Whether you're a midlife woman or a clinician, the free Estradiol Swap tool is for you. 🔥

Comment "SWAP" and I'll send you the link. ✅

Let me know in the comments what you think! ⁉️

@karenmkarlsen

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dr.amybkillen

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Jul 20

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The office thermostat is set to 64. There's a sign taped over it: DO NOT ADJUST. 😲

Everyone's been cold for twenty-three years. Nobody remembers who set it. The man who taped up the sign doesn't work here anymore.

That sign is "lowest effective dose."

Nobody ever ran the trial. Not one study has compared a higher estrogen dose to a lower one and counted the strokes, the cancers, the deaths. ❎

I'm not arguing more is better. I'm arguing less is not necessarily safer.

If your doctor recommends the lowest effective dose, ask her why.

Comment "Substack" and I'll send you the deep dive.

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dr.amybkillen

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Jul 19

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Most of us got almost nothing on hormones in training. ❎

I built the HOT Provider Course to fix that: 23 videos plus a 300 page guidebook on hormone optimization therapy, from labs to prescribing to follow-up.

We cover menopausal hormone therapy (MHT) for women and testosterone replacement therapy (TRT) for men.

Includes 15 hours of CME/CE. 🎉

Comment "QUICK START" and I'll send you my free Provider Quick Start Checklist. ✅

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dr.amybkillen

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Jul 18

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"Menopause brain" 🧠

Maybe it should be called "Full Body Mitochondria Malfunction" instead.

Mitochondria create energy from food and oxygen. Estrogen helps keep mitochondria running safe and efficient, especially in times of areas. ✅

The loss of mitochondrial energy production at menopause not only causes brain changes it causes system-wide effects, some of which can affect libido and sexual function. 😩

What were your most notable symptoms during the menopause transition?⁉️

P.S. the brain imaging studies are by @dr_mosconi
and team. The citation is on the image.

Footage from @abundancesummit

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dr.amybkillen

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Jul 17

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We've been estimating maximum heart rate in women incorrectly. 😩

The old "220-age" tends to over-estimate the max HR in women, especially as we get older.

A better formula for most women is the Gulati formula (Gulati, Circulation, 2010) which is...

206 - (0.88 x age). ✅

My estimated Gulati Max HR is 162 (I'm 50).

But, this is just a starting point. VO2 Max testing or all-out on your own workouts will give you a more accurate number.

What's your estimated Gulati max HR? How does that relate to your actual maximum HR (if known)? ⁉️

P.S. I haven't tested my VO2 max in years but get up to 172-175 during workouts so my max HR is somewhere above that. I probably outta test sometime!

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dr.amybkillen

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Jul 16

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You’ve never seen wellness like this. 150+ experts. 100+ brands. 🎉

Dozens of treatments.

All coming together for the most significant health & wellness event of the year. 🔥

This is where I will be this November 5–8. Join me.

#EudēmoniaSummit @humanauthealth

Photo by @lancomeofficial

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dr.amybkillen

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Jul 14

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Pellets - once they're in, they're in! ✅

But, why? Why not just take them out like you put them on?

This is why. Pellets are put in using a trocar, which means the pellets live several centimeters away from the incision. 🤔

If you have side effects, you usually have to just wait them out.

Pellets dissolve over time, 3-6 months.

Have you ever had side effects with pellets? ⁉️

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dr.amybkillen

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Jul 13

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Are hormone pellets Good? Bad? Ugly? 🤨

Pellets, which have been used since 1940, are compressed hormone formulations (estradiol or testosterone) delivered under the skin during an in-clinic procedure by a medical provider.

Pros: "Set it and forget it" for 3-6+ months. Very stable, steady estradiol serum levels. Steady but slowly declining testosterone serum levels. ✅

Cons: Risks of the procedure are very small (but possible). The real risk is that the procedure is irreversible so if you have a side effect, you're stuck with it for months. ☠️

I've placed thousands of pellets over the years. They're not my first choice or my favorite way to give hormones but I do think they can be safe and effective when dosed correctly.

What's your opinion on pellets? ❓

Comment "SUBSTACK" for a deep dive!

P.S. Don't ask why this girl's hand is so messed up. And, the Testosterone graph should say "Great at month two, running low by month 3-4.

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dr.amybkillen

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Jul 12

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Is it good reason not to prescribe hormone therapy?

The only absolute contraindications to MHT are active/recent hormone sensitive cancer, severe liver disease and undiagnosed dysfunctional uterine bleeding. ❎

Things like hormone sensitive diseases, active thromboembolic disease, and past hormone sensitive cancers deserve discussion with a knowledgeable doctor about risks and benefits. 🤔

What reason did your doctor give for not prescribing? ⁉️

If you're a clinician and want to learn more, comment "QUICK START" below and I'll share my Provider Quick Start Guide. 👇

Shirt by @humanauthealth

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dr.amybkillen

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Jul 8

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Statin users have more menopausal symptoms than non-users. 😩

And statin side effects overlap significantly with menopause symptoms.

Unfortunately, the big lipid studies did not pay attention to menopause or hormone status in most cases so we have limited data on this. ❎.

I'm not anti-statins but I am against knee-jerk prescribing instead of working on hormone health and lifestyle first in otherwise healthy women.

What's your experience with statins been? ⁉️

Comment SUBSTACK for more. 👇

@dr_mosconi

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dr.amybkillen

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Jul 7

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Is Late-Start transdermal estradiol with progesterone safe?

Show me the evidence!

No, we don't have many randomized controlled trials. But we do have strong mechanistic data that shows us that TD estradiol:

🔺Does NOT increase lipids
🔺 Does NOT cause vasospasm
🔺 Does NOT increase CRP
🔺 Does NOT increase MMP
🔺 Does NOT increase blood clots (VTE).

I created a free Take it To Your Doctor (TITYD) guide all about Late-Start Hormones.

Comment "LATE START" to get yours. 👇

What have you been told about late start hormones? ⁉️

P.S. ELITE study was an RCT trial but the others were observational.

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Jul 6

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dr.amybkillen

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Jul 5

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Show me the evidence! 🎉

Late-start hormone therapy is only a problem when you're using the older forms of hormones.

With transdermal estradiol and micronized progesterone we don't see increased risk of... Anything compared to early-starters.

Yes, there are fewer benefits to starting late. Yes, you may have annoying side effects. Yes it's not a magic 💊.

Comment "Late Start" and I'll send you a free guide. ✅

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dr.amybkillen

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Jul 2

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Does Hormone Therapy reduce heart disease risk? 🤔

Early-start oral estradiol with the right progestogen reduced CV disease risk in three clinical trials. 🎉

Transdermal (TD) estradiol is associated with lower CV disease risk in many observational studies but doesn't yet have a big, randomized controlled trial showing benefit.

Oral estrogen is better for lipids like LDL, ApoB, HDL and Lp(a). TD is better for triglycerides. ✅

So, yeah. It's complicated.

What have you been told about HRT and heart disease? ⁉️

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dr.amybkillen

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Jul 2

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It's not too late! ❎

It's NEVER too late for low dose vaginal estrogen.

And, it's likely not too late for systemic estrogen (ex estradiol patch and oral progesterone).

My recent Substack article breaks down the side effects, benefits and how to think about Late-Start hormones. ✅

Thank you to Teri for sharing her story. 🙏

Have you started hormones more than 10 years from menopause onset? What did you notice? ⁉️

Comment "LATE START" and I'll send you my free guide. 👇

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dr.amybkillen

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Jul 1

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Can you relate? ❓

#estrogen #menopause #perimenopause #womenshealth #HRT #estrogenmatters

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What you will get inside

A Perimenopause Cheat Sheet

What’s happening and why you’re not crazy

Hormone Optimization 101

The truth about estrogen, progesterone, and testosterone

Find a Rocking Doctor

What to look for when finding a doctor to help you with your journey

Get the Guide

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A Perimenopause Cheat Sheet

Hormone Optimization 101

Find a Rocking Doctor

Bonus!

My favorite supplements and lifestyle hacks for peak cognitive and physical performance

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