Expert Q&A

Why was i told that estrogen isn't necessary for my mother during her perimenopause on this subreddit? am i not getting something on a low-carb or ketogenic diet

Understanding Perimenopause and Hormonal Shifts

As women enter perimenopause, typically between ages 45-55, fluctuating estrogen and progesterone levels trigger symptoms like hot flashes, mood swings, joint pain, and stubborn weight gain. Many in our community have failed traditional diets due to these hormonal changes that slow metabolism and increase insulin resistance. Insurance rarely covers specialized programs, leaving middle-income families overwhelmed by conflicting advice. This is where a structured low-carb approach, like the one detailed in my book The Menopause Reset, offers real hope without relying solely on hormone replacement.

Why Some Practitioners Say Estrogen Isn't Necessary

On low-carb or ketogenic diets, the body shifts from burning glucose to using fat for fuel, which stabilizes blood sugar and reduces inflammation. This directly addresses the core issues amplifying perimenopause symptoms. For instance, high insulin levels worsen estrogen dominance; cutting carbs below 50g daily can lower insulin by up to 50% within weeks, easing hot flashes and joint pain that makes exercise feel impossible. Many women report losing 15-30 pounds in the first three months while managing diabetes and blood pressure, without needing estrogen therapy. The diet's anti-inflammatory effects mimic some benefits of estrogen, such as protecting bone density and improving sleep, which explains why experienced users on forums advise against it initially.

How Low-Carb and Keto Specifically Help Perimenopausal Women

My methodology emphasizes starting with a simple 7-day meal plan: eggs with avocado for breakfast, grilled chicken salads at lunch, and fatty fish with non-starchy vegetables for dinner. This requires minimal time—no complex prep—and delivers 20-30g net carbs to induce mild ketosis. Studies show ketogenic eating improves insulin sensitivity by 30-40% in midlife women, helping reverse the metabolic slowdown caused by declining estrogen. For those embarrassed by obesity or dealing with joint pain, we recommend gentle movement like 20-minute walks after meals rather than gym schedules. This builds confidence and sustainable habits. If symptoms persist after 8-12 weeks of strict adherence, then discussing bioidentical estrogen with your doctor becomes a logical next step—not the first resort.

Practical Steps to Get Started Safely

Begin by tracking your fasting blood glucose; aim to keep it under 100 mg/dL. Eliminate hidden sugars and grains that spike hormones. Supplement with magnesium (300mg nightly) and omega-3s (2g EPA/DHA) to further reduce joint discomfort and cravings. Thousands following this path have reversed their "failed every diet" cycle because the science targets root causes. Remember, individual responses vary—monitor blood pressure and A1C every 30 days. If you're managing diabetes alongside weight loss, this low-carb framework often allows medication reduction under medical supervision. The goal is empowerment through food, not dependency on prescriptions.

💬 What the Community Says

The community shows a clear divide on estrogen use during perimenopause while following low-carb or keto diets. Most long-time members report significant relief from hot flashes, joint pain, and weight gain after 4-6 weeks of under 50g carbs daily, leading many to say supplemental estrogen wasn't needed or even caused bloating. A vocal minority shares stories of persistent night sweats and fatigue that only improved after starting HRT, warning that diet alone isn't enough for everyone with severe hormonal changes. Beginners often feel confused by conflicting subreddit threads—some celebrate medication-free success managing blood pressure and diabetes, while others emphasize getting labs checked first. Lived experiences highlight that those consistent with the approach for 3+ months tend to need less intervention, but those with thyroid issues or very high starting insulin frequently combine both strategies. Overall sentiment leans toward trying dietary changes thoroughly before hormones, especially since many can't afford covered programs.
Clark, R. (2026). Why was i told that estrogen isn't necessary for my mother during her perimenopa. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/why-was-i-told-that-estrogen-isn-t-necessary-for-my-mother-during-her-perimenopause-on-this-subreddit-am-i-not-getting-something-on-a-low-carb-or-ketogenic-diet
Russell Clark, 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.

Have a follow-up question?
More Questions 200 answered
When feeling down, remember that PCOS is what helped our ancestors survive and the role of cortisol and stress hormones Is this normal? Feels like a waste and its effect on metabolism and insulin levels What is your best way to shift focus when starting and changing your HRT while doing intermittent fasting Am I better off increasing my frequency of sessions per week, or my duration of each session and the role of cortisol and stress hormones Same Workout Until it becomes Zone 2 while doing intermittent fasting 📖 Hashimoto’s Success — Achieving weight loss and reduced inflammation in thyroid patients by removing dietary triggers like lectins and modern … Two week pause, ok to return to current dose and the role of cortisol and stress hormones Anyone Here Successfully Reversed Insulin Resistance? What Actually Worked and the role of cortisol and stress hormones What a month of paleo has done for me while doing intermittent fasting 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Has anyone been diagnosed with Hashimotos after going through emotional distress or chronic stress in general for those with hypothyroidism or Hashimoto's Can deep extended autophagy reverse deep cavities, does anyone have any experience regarding this and its effect on metabolism and insulin levels 📖 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… Dr Gundry: the 120+80 supplements he himself takes daily while doing intermittent fasting How it goes trying to dose insulin every day and its effect on metabolism and insulin levels Did exercise ever get rid of fatigue from insulin resistance while doing intermittent fasting Would doing this 2-3x a week help increase my Vo2 max — how a functional medicine approach differs How it goes trying to dose insulin every day: how to talk to your doctor about this So if you're spacing out your shots - what are y'all doing with extra injectors and the role of cortisol and stress hormones 📖 Tirzepatide — A dual-acting medication targeting both GLP-1 and GIP receptors, providing a more comprehensive metabolic signal than si… When the clock starts over for those with hypothyroidism or Hashimoto's Depressive symptoms from non-stick air fryer — how a functional medicine approach differs 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → When people ask how I can tell my sugar's low and its effect on metabolism and insulin levels Anyone stretching out to 3 weeks between shots for people with insulin resistance 📖 High-Dose Dependency — The pharmaceutical trap of staying on maximum medication doses indefinitely, which we avoid through our smart cycling me… How to induce whole body autophagy without fasting for along time and how do I know if autophagy is induced im my body specifically for women over 40 What keto plus compounded tirzepatide for the last five months looked like and how it connects to gut health and inflammation 2.5 mg no longer working. Move to 3.5 for people with insulin resistance Is it just me or is Hashimoto’s greatly underrepresented while doing intermittent fasting 📖 Gut-Brain Axis — The complex communication network between your digestive system and your brain that controls satiety, mood, and metaboli… Has anyone tried this lectin free lifestyle living with PCOS — how a functional medicine approach differs Can we talk about the founder and the role of cortisol and stress hormones Semaglutide Not Working At All... What am I doing Wrong while doing intermittent fasting 📖 Tirzepatide Micro-Dosing — The practice of using the lowest effective dose to achieve results, minimizing side effects while maximizing the longevi… Had Dr. Gundry spoken about the vaccine while doing intermittent fasting 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → How I finally stopped crashing after workouts — the training structure that actually works with Hashimoto's while doing intermittent fasting When people ask how I can tell my sugar's low and the role of cortisol and stress hormones Has anyone reversed insulin resistance without medication and the role of cortisol and stress hormones 📖 Modern Wheat Dangers — The hidden threat in hybridized grains that causes gut inflammation and spikes blood sugar more aggressively than pure t… Post menopausal bleeding — how a functional medicine approach differs How often can I eat in season fruits while doing intermittent fasting Should i really be aiming for 45 zone 2 minutes per day for fat loss and the role of cortisol and stress hormones How to BOOST metabolism and BURN fat-- VERY EASY AND QUICK — how a functional medicine approach differs Has anyone switched from wegovy to mounjaro and the role of cortisol and stress hormones How I'm greeted most mornings specifically for women over 40 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Newb question: focusing on perceived exertion or heart rate — how a functional medicine approach differs 📖 Hidden Hunger — A state where the body is overfed but undernourished, leading to constant cravings because the brain isn't receiving the… Guys, did you know the POWER of exercise for your body and its effect on metabolism and insulin levels Anyone have experience switching from compound injection to pill — how a functional medicine approach differs Can we stop posting good glucose levels and pretending they are bad for people with insulin resistance What are everyone’s symptoms with insulin resistance while doing intermittent fasting 📖 Visceral Fat — The dangerous 'hidden' fat stored around internal organs that drives chronic disease and is specifically targeted by our… PCOS + insulin resistance… belly fat won’t budge. what actually worked for you and its effect on metabolism and insulin levels Guys, did you know the POWER of exercise for your body and the role of cortisol and stress hormones Do I need a dose change and the role of cortisol and stress hormones 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Anyone had improvement in symptoms after already eating a clean plant based diet — how a functional medicine approach differs Is tomato paste lectin free — what do certified weight loss coaches recommend? What is the Role of Metabolism in Immune System while doing intermittent fasting 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 and the role of cortisol and stress hormones 📖 Satiety Signal — The biological 'off switch' for hunger that our protocol restores by healing the gut and balancing blood sugar levels. Is this normal? Feels like a waste while doing intermittent fasting