Branch with green leaves

Bonza Health Blog

Gain the tools and understanding you need to help manage the challenges of perimenopause and beyond.

Women experiencing perimenopause or menopause can reclaim their health and vitality. At Bonza Health, we help women see hormone changes as a natural midlife transition and provide the doctor-backed information women need to navigate hormonal health conditions with confidence. 

Check out our latest blog posts from our leading physician’s best tips and tools for easing hormonal symptoms, special announcements on our courses and services, and much more! Be a part of our ever-growing community of like-minded women who are thriving in health -- even with perimenopause or menopause conditions.

Search Blogs

Search by Category

Wellness, Hormone Sarah Bonza MD Wellness, Hormone Sarah Bonza MD

Why FSH Is Not a Reliable Indicator of Perimenopause—And What Is

Many women entering perimenopause are told by their clinicians that a single follicle-stimulating hormone (FSH) blood test will determine whether they are in the menopausal transition and whether they are candidates for menopause hormone therapy (MHT). This practice is widespread, but it is not supported by current evidence or by leading menopause guidelines. Understanding why requires a clear look at what FSH is, how it behaves during perimenopause, and what measures actually correlate with both menopausal status and the likelihood of benefit from treatment.

Read More
Wellness Sarah Bonza MD Wellness Sarah Bonza MD

Your Heart’s Hidden Language: How Heart Rate Variability Reveals What Perimenopause Is Doing to Your Body

If you’ve noticed your sleep getting worse, your anxiety creeping up, or your body taking longer to bounce back from a workout, you’re not imagining things. Something real is shifting inside your body during perimenopause — and there’s a simple, trackable number that can help you see it happening: Heart Rate Variability, or HRV. HRV isn’t just for fitness enthusiasts with fancy watches. It’s a powerful window into how well your nervous system is coping with everything life (and hormones) are throwing at it. And the best part? You can track it from your wrist and take real steps to improve it.

Read More
Wellness, Hormone Sarah Bonza MD Wellness, Hormone Sarah Bonza MD

The Silent Thief: Why We Must Advocate for Earlier DEXA Screening in Women

Osteoporosis is often called “the silent thief” because it steals bone density without warning — no pain, no symptoms, and no red flags — until a fracture occurs. Despite affecting over 200 million people worldwide and causing more than 8.9 million fractures annually, our screening guidelines remain reactive rather than proactive, particularly for women under 65 who carry significant risk factors. As clinicians, we must ask ourselves: are we waiting too long to look?

Read More
Hormone, Wellness, Hot flashes, Brain fog Sarah Bonza MD Hormone, Wellness, Hot flashes, Brain fog Sarah Bonza MD

Your Body in Transition: A System-by-System Guide to Perimenopause

Yesterday, a patient in her early forties sat across from me describing something she had never experienced before: her heart would suddenly race for no apparent reason, jolting her awake at 2 a.m. She could not fall back asleep. She felt foggy at work. She wondered if something was seriously wrong. Nothing was wrong with her heart. What she was experiencing were some of the earliest signals of perimenopause. The purpose of this blog is to walk you through the major body systems affected by perimenopause and to show you what to expect at each phase. My hope is that by understanding these changes, you will feel empowered rather than frightened, and that you will recognize the signals your body is sending you as it moves through this natural, but sometimes disorienting, transition.

Read More
Hormone, Wellness Sarah Bonza MD Hormone, Wellness Sarah Bonza MD

Why Women Shouldn’t Have to Wait: The Case for Menopause Hormone Therapy During Perimenopause

If you’re a woman in your late thirties or forties experiencing mood swings, brain fog, weight gain, insomnia, crushing fatigue, or a vanishing libido, you’ve probably been told one of two things: “It’s just stress,” or “You’re too young for menopause.” As a clinician who works with women navigating the perimenopause transition every day, I want to be clear: that advice is outdated, and it is leaving millions of women suffering unnecessarily. The research is catching up to what many of us are seeing in practice—and what women have been telling us about their own bodies for years.

Read More
Hormone, Wellness Sarah Bonza MD Hormone, Wellness Sarah Bonza MD

The Hidden Value of Lab Testing in Perimenopause: A Clinical Perspective on Prescribing Hormone Therapy

If you've been told your labs are "normal" while experiencing brain fog, night sweats, crippling anxiety, or sleep disturbances, you're not imagining things. You are not crazy. And you're certainly not alone. At Bonza Health, we hear this story constantly: women in their late 30s, 40s, and early 50s who know something has changed in their bodies seek help from their healthcare providers, only to be told that because their FSH isn't elevated or their estradiol looks "fine," they don't need hormone therapy. They're sent home with suggestions to reduce stress, exercise more, or consider an antidepressant.

Read More
Hormone, Wellness Sarah Bonza MD Hormone, Wellness Sarah Bonza MD

Getting Menopausal Hormone Therapy Right: Why the Details Matter

If you're waking up multiple times a night drenched in sweat, unable to fall back asleep, and feeling exhausted all day, you're not alone. For many women going through menopause, severe sleep disruption is more debilitating than hot flashes. Yet the conversation around menopausal hormone therapy often oversimplifies the solution. The truth is, not all hormone therapy is created equal. The type of hormones you use, how they're delivered, and when you start them can mean the difference between relief and continued suffering, or even between safety and risk.

Read More
Hormone, Wellness Sarah Bonza MD Hormone, Wellness Sarah Bonza MD

Beyond Survival: Preserving Intimacy and Quality of Life After Hormone Receptor-Positive Breast Cancer

Breast cancer survival rates continue to improve, with over 4 million survivors in the United States alone. However, the journey beyond diagnosis presents significant challenges to quality of life, particularly for women with hormone receptor-positive (HR+) cancers who require long-term endocrine therapy. Sexual dysfunction affects up to 93% of women on aromatase inhibitor therapy, profoundly impacting intimate relationships and marital satisfaction. This article examines the biological mechanisms underlying these challenges, the impact on relationships and marriages, and evidence-based treatment strategies specifically tailored for HR+ breast cancer survivors seeking to reclaim their sexual health and intimate connections.

Read More
Wellness, Hormone Sarah Bonza MD Wellness, Hormone Sarah Bonza MD

Beyond the Hot Flash: Why Bonza Health Blends Allopathic Safety with Functional Root-Cause Care

As a physician, I've dedicated my career to bridging two worlds of medical knowledge—I'm trained by both the Institute for Functional Medicine (IFM) and the Menopause Society. This dual perspective lets me offer a blended, cost-effective approach that prioritizes both your safety and your long-term vitality. My goal is simple: help you feel and function better by addressing the root causes of your symptoms while using clinically proven treatments.

Read More
Hormone, Wellness Sarah Bonza MD Hormone, Wellness Sarah Bonza MD

It's Not Just Aging: The Hidden Connection Between Estrogen and Your Rising Cholesterol

The relationship between estradiol (the primary form of estrogen in the female body) and cholesterol metabolism is well-established in the medical literature, yet it remains one of the most overlooked factors in women's cardiovascular health. Research published in peer-reviewed journals consistently demonstrates that declining estrogen levels fundamentally alter how the body processes cholesterol. Understanding this connection can empower you to have more informed conversations with your healthcare provider and advocate for your cardiovascular health.

Read More
Wellness, Hormone Sarah Bonza MD Wellness, Hormone Sarah Bonza MD

Peptides in Perimenopause: A Physician's Cautiously Curious Perspective

Peptides, while recommended in some situations, are not a replacement for foundational health. They are not a shortcut, not a magic solution, and certainly not appropriate for everyone. In my practice, I only consider peptides as a potential addition after we've optimized hormonal health, addressed nutritional deficiencies, regulated nervous system strain, and established consistent lifestyle habits including strength training, quality sleep, and stress reduction.

Read More
Hormone, Wellness, Hot flashes Sarah Bonza MD Hormone, Wellness, Hot flashes Sarah Bonza MD

Beyond the Black Box: What the FDA's Historic Decision Really Means for Women's Health

On November 10, 2025, the FDA announced the removal of black box warnings from menopausal hormone therapy products—a decision that FDA Commissioner Dr. Marty Makary called "one of the greatest mistakes in modern medicine" to finally correct[1]. As a physician who specializes in perimenopause and menopause care in Ohio, I've spent years watching qualified women be denied treatment because of outdated fears. This announcement should be cause for celebration. And it is, but with important caveats that every woman and clinician needs to understand.

Read More
Hormone, Wellness, Hot flashes Sarah Bonza MD Hormone, Wellness, Hot flashes Sarah Bonza MD

Perimenopause Unveiled: The Complete Guide to Recognizing Symptoms, Understanding Your Body, and Reclaiming Vitality

Perimenopause can be a significant transition in a woman’s life—one that is widely misunderstood and often neglected in conventional healthcare. If you’re experiencing shifts in mood, energy, cognition, or bodily comfort in your 30s, 40s, or early 50s, you are not alone. This comprehensive guide will empower you to understand perimenopause, recognize its earliest and most surprising signs, and know when to seek help. At Bonza Health, our holistic approach centers your unique experience—because perimenopause is not “one size fits all.”

Read More
Brain fog, Wellness, Fatigue Sarah Bonza MD Brain fog, Wellness, Fatigue Sarah Bonza MD

Creatine Isn’t Just for Gym Bros Anymore: The First Study on Creatine in Perimenopausal Women Shows Surprising Brain and Mood Benefits

A groundbreaking 2025 randomized controlled trial, recently published in the Journal of the American Nutrition Association, looked specifically at the effects of creatine on brain metabolism, mood, reaction time, and lipid health in midlife women. The results were remarkable: even low doses of creatine hydrochloride led to measurable improvements in brain energy, focus, and emotional balance—with no identified adverse effects.

Read More
Hormone, Wellness, Fatigue, Brain fog Sarah Bonza MD Hormone, Wellness, Fatigue, Brain fog Sarah Bonza MD

The Untold Power of Testosterone for Women: What Every Perimenopausal and Menopausal Woman Should Know

Testosterone isn’t just a “male hormone.” It’s an essential part of every woman’s hormonal orchestra—powerfully influencing libido, mood, cognition, and energy. As a Menopause Society Certified Physician, I often see women who have optimized their estrogen and progesterone therapy yet still feel their spark is missing. That missing piece? Often testosterone.

Read More
hormone, Wellness Sarah Bonza MD hormone, Wellness Sarah Bonza MD

The Perimenopause-Gut Connection: Why Your Digestive Health Matters During the Transition

As estrogen and progesterone fluctuate and ultimately decline during perimenopause, women often notice unexpected symptoms like bloating, irregular bowel habits, or even food intolerances. Behind these digestive issues is a crucial player: the gut microbiome, a complex ecosystem of trillions of microbes that deeply influences hormone regulation, immune function, and even mental health.

Read More
Hormone, Wellness Sarah Bonza MD Hormone, Wellness Sarah Bonza MD

Science-Backed Guide to the Four Stages of Perimenopause

Perimenopause is a complex and widely misunderstood transition period in a woman's life, yet it represents a critical window for preventive health and symptom management. Despite affecting millions globally, many women do not recognize their symptoms as perimenopausal, and physicians often lack adequate training to diagnose and support this stage. Women frequently experience perplexing symptoms—irregular periods, mood shifts, fatigue, sleep disruptions—long before the final menstrual period.

Read More
Hormone, Wellness Sarah Bonza MD Hormone, Wellness Sarah Bonza MD

10 Ways Your Hormones Can Impact Intimate Relationships in Midlife – and How to Navigate Them

If you’ve noticed changes in your partnership during the menopausal transition, you’re not alone. Hormonal fluctuations can ripple through every layer of connection: physical intimacy, emotional closeness, and day-to-day communication. Fortunately, it’s possible to navigate these changes with awareness, grace, and compassion.

Read More