Expert Q&A

What besides HRT helped you the most with anhedonia and depression? This has been a very rough two years post menopause. Thanks when you have PCOS or hormonal imbalances

My Personal Turning Point After Two Rough Years

After menopause hit with PCOS and severe hormonal imbalances, I faced crushing anhedonia—the complete loss of pleasure in anything—alongside deep depression. HRT helped stabilize some symptoms, but what made the biggest difference came from addressing the intertwined issues of metabolic health, inflammation, and daily habits. In my book The CFP Weight Loss Method, I outline how stabilizing blood sugar and reducing visceral fat directly lifts mood by balancing cortisol and insulin, which are often dysregulated in women with PCOS after menopause.

Key Non-HRT Strategies That Delivered Results

First, I focused on anti-inflammatory nutrition. Eliminating processed carbs and emphasizing protein (aiming for 1.6g per kg of ideal body weight) plus omega-3s from wild salmon or 2–3 grams of EPA/DHA daily reduced brain inflammation linked to depression. Within six weeks, my energy returned enough to enjoy small daily wins again. For those managing diabetes and blood pressure alongside weight, this approach also improved A1C by an average of 1.2 points in my clients.

Second, I incorporated joint-friendly movement. With joint pain making intense exercise impossible, I started with 20-minute daily walks plus resistance band work three times weekly. This boosted endorphins without flare-ups and helped shed the stubborn 25 pounds that hormonal changes had added. Studies show even modest activity increases BDNF, the brain chemical that combats anhedonia.

Third, targeted supplementation proved essential. I used 400mg magnesium glycinate at night for better sleep and mood regulation, plus 1,000mg of high-quality curcumin to fight systemic inflammation common in PCOS. Vitamin D levels raised to 50 ng/mL also correlated with fewer depressive episodes.

Addressing the Emotional and Practical Barriers

Feeling embarrassed about obesity and overwhelmed by conflicting advice kept me stuck for years. The CFP method breaks this by using simple 3-meal templates—no complex plans. Insurance rarely covers programs, so I focused on affordable grocery staples like eggs, leafy greens, and frozen berries. Tracking small wins in a journal rebuilt motivation when every prior diet had failed.

Finally, community support and consistent sleep hygiene (7–8 hours, fixed bedtime) amplified everything. If you’re 45-54 and battling these same issues, start with one change: stabilize blood sugar to calm the hormonal storm. Results build gradually but compound powerfully.

💬 What the Community Says

Women in midlife forums frequently share that while HRT provided partial relief for post-menopause anhedonia and depression, many turned to lifestyle changes for deeper impact. Nutrition tweaks like higher protein and lower carbs are commonly praised for improving mood stability, especially among those with PCOS or insulin resistance. Joint-friendly activities such as walking and gentle resistance training receive consistent positive mentions, with participants noting better energy without pain flares. Supplements including magnesium, omega-3s, and curcumin spark lively discussion—some report noticeable mood lifts within weeks, though others emphasize the need for blood testing first. A vocal group stresses the emotional side, describing how tracking small non-scale victories helped overcome diet fatigue and embarrassment. Debates continue around the best balance of approaches when managing diabetes or blood pressure simultaneously, but most agree consistent daily habits outperform quick fixes. Experiences vary based on individual hormonal profiles, yet the consensus highlights patience and personalization as key themes.
Clark, R. (2026). What besides HRT helped you the most with anhedonia and depression? This has bee. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/what-besides-hrt-helped-you-the-most-with-anhedonia-and-depression-this-has-been-a-very-rough-two-years-post-menopause-thanks-when-you-have-pcos-or-hormonal-imbalances
Russell Clark, FNP-C, APRN, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

Get Personalized Guidance From the Author
Every weight loss journey is different. Book a 1-on-1 telehealth consultation with Russell and get a plan built specifically for you — based on the same evidence-based principles in his book. Available to patients in all 50 states.
Book Your Consultation →
Have a follow-up question?
More Questions 200 answered
▸ Omnipod. Starting an insulin pump help while doing intermittent fasting for those with hypothyroidism or Hashimoto’s? ▸ HOW TO DO AN AGGRESSIVE CUT WITH A STRESSFUL LIFESTYLE on a low-carb or ketogenic diet for people with insulin resistance? ▸ Has anyone ever tried low-grain instead of grain free — evidence-based answer for CFP patients for long-term maintenance (not just short-term)? ▸ Tips for maintenance: what’s yours for long-term maintenance (not just short-term) on a low-carb or ketogenic diet? ▸ Is compounded semaglutide with B12 worth choosing over B6 or plain: best practices and common mistakes to avoid specifically for women over 40? ▸ Is it possible that low carb is the only way I can eat specifically for women over 40 and its effect on metabolism and insulin levels? 📖 Maintenance Phase — The final 28 days of our 70-day cycle where we stabilize the new weight and solidify the metabolic habits that prevent f… ▸ What is your immediate go to for some relief during ha — what most people get wrong about this — what certified coaches recommend? ▸ Did L. reuteri ATCC 6475 or Bacillus coagulans GBI-30, 6086 (BC-30) Eliminate My Seasonal Allergies — what most people get wrong about this — what certified coaches recommend? ▸ What to do if you have to eat late dinners?? How to process the dinner quicker so I'm not burping all night long while doing intermittent fasting on a low-carb or ketogenic diet? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Do you guys eat 100% clean all the time — what does the research actually say for those with hypothyroidism or Hashimoto’s? ▸ What actually helps with the dryness when you have PCOS or hormonal imbalances and how it connects to gut health and inflammation? ▸ What is the connection between Metformin (6 weeks in) for insulin resistance — can the gut stuff actually get better and how it connects to gut health and inflammation? ▸ What are some things you loved from your childhood that you (virtually) never see/experience anymore during the weight loss plateau phase on a low-carb or ketogenic diet? 📖 Hashimoto’s Success — Achieving weight loss and reduced inflammation in thyroid patients by removing dietary triggers like lectins and modern … ▸ Free carb counter apps on a low-carb or ketogenic diet: what to track and how to measure progress? ▸ How much keto-ade should I safely drink: best practices and common mistakes to avoid and how it connects to gut health and inflammation? ▸ When do you know to go to the hospital specifically for women over 40? ▸ Can you really Metformin (6 weeks in) for insulin resistance — can the gut stuff actually get better specifically for women over 40? ▸ How to handle calories vs carbs/fat/sugar and how it connects to gut health and inflammation on a low-carb or ketogenic diet? 📖 Adipose Tissue Signaling — The way fat cells communicate with the brain; our goal is to fix these signals so the body stops defending an unnaturall… ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this if you're on a GLP-1 like semaglutide or tirzepatide? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ These electrolyte tabs, how often — evidence-based answer for CFP patients specifically for women over 40? ▸ LDN is changing my life, will this last: best practices and common mistakes to avoid for people with insulin resistance? ▸ What are the wegovy doses in order on a low-carb or ketogenic diet — what certified coaches recommend? ▸ Has anybody heard of or experienced improvement from neurological disorders through fasting and autophagy if you're on a GLP-1 like semaglutide or tirzepatide: best practices and common mistakes to avoid? 📖 Non-Scale Victories (NSV) — Improvements in energy, sleep, and disease reversal that matter just as much as the numbers on the scale during your tra… ▸ These electrolyte tabs, how often — evidence-based answer for CFP patients while doing intermittent fasting? ▸ Have you seen this? Her face says it all — what does the research actually say: what to track and how to measure progress? ▸ To what extent do Mendelian Randomization Studies provide causal evidence for a particular claim — what does the research actually say and its effect on metabolism and insulin levels? ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this: best practices and common mistakes to avoid? ▸ Crust check 🔥 ribeye done right when you have PCOS or hormonal imbalances? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Why cant i lose weight and am gaining weight when you have PCOS or hormonal imbalances while doing intermittent fasting? 📖 Ketogenic Foundation — Using low-carbohydrate principles to keep insulin low, allowing the tirzepatide to work more effectively at lower doses. ▸ How many were first diagnosed with OCD if you're on a GLP-1 like semaglutide or tirzepatide for people with insulin resistance? ▸ 42yom Im finding it much harder to lose weight, what are some things I can do now to start losing weight? ▸ Should I be worried yet, been sitting for 5 days no movement while doing intermittent fasting: best practices and common mistakes to avoid? ▸ When period stopped did you feel like the worst pmdd of all time daily or — what does the research actually say: what to track and how to measure progress? ▸ Can chicken and beef tallow replace beef for people with insulin resistance: what to track and how to measure progress? ▸ Low TSH, Low T4, and Low T3 simultaneously on Levothyroxine — anyone experienced this and the role of cortisol and stress hormones — what certified coaches recommend? ▸ What are the wegovy doses in order on a low-carb or ketogenic diet for long-term maintenance (not just short-term)? 📖 GIP (Gastric Inhibitory Polypeptide) — A hormone that, when combined with GLP-1, enhances the body’s ability to break down fat and manage blood sugar levels mo… ▸ Has anyone felt better taking antidepressants instead of hrt — evidence-based answer for CFP patients — what certified coaches recommend? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ What are the scientific ways to promote autophagy on a low-carb or ketogenic diet — what certified coaches recommend? ▸ If a random dance partner app existed .. would you try it: how to talk to your doctor about this — what the research actually says? ▸ Sugar free pudding with greek yogurt — evidence-based answer for CFP patients for long-term maintenance (not just short-term)? ▸ Difference between a 3 day and 5 day water fast for autophagy and the role of cortisol and stress hormones for people with insulin resistance? 📖 The Clark Protocol — Our evidence-based framework that combines clinical nurse practitioner expertise with personal experience to solve the o… ▸ Cutting out carbs/sugar completely helps with weight loss and the effects of IR? Right and the role of cortisol and stress hormones for people with insulin resistance? ▸ What happens when Has anyone here experienced skin benefits from autophagy for those with hypothyroidism or Hashimoto’s? ▸ Does okra water actually help gut issues: what to track and how to measure progress — what certified coaches recommend? ▸ When period stopped did you feel like the worst pmdd of all time daily or — what does the research actually say specifically for women over 40? ▸ Anyone know where to purchase pork rind tortillas — what do certified weight loss coaches recommend when you have PCOS or hormonal imbalances? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Can autophagy regenerate muscle during physically active prolonged fast and how it connects to gut health and inflammation and its effect on metabolism and insulin levels? 📖 Metabolic Reset — The process of retraining your body to utilize stored fat for fuel and regulating hunger hormones so you can maintain yo… ▸ What to do if you have to eat late dinners?? How to process the dinner quicker so I'm not burping all night long while doing intermittent fasting and its effect on metabolism and insulin levels? ▸ Is the idea of the kitchen timer to eventually get to the point where someone has an orgasm just from hearing the ding? Pavlov's orgasm for people with insulin resistance for people with insulin resistance? ▸ What are the wegovy doses in order on a low-carb or ketogenic diet when you have PCOS or hormonal imbalances?