You know that thing where your brain understands that something is technically over, but your body absolutely didn’t get the memo?
Like the breakup happened. The hard conversation happened. The scary season happened. The job stress finally calmed down. The family chaos settled a little. Whatever it was, the event itself isn’t actively happening in front of you anymore, but your body is still walking around like it might start again any second.
That is such a weird place to be, because from the outside, you can look completely fine. You’re working. You’re answering texts. You’re showing up. You’re making dinner, folding laundry, pretending you didn’t just reread the same paragraph six times because your brain wandered into a side quest. Very normal adult woman behavior, obviously.
But internally? Different story.
Your chest feels tight for no clear reason. Your stomach drops when your phone buzzes. You’re jumpier than usual. Your thoughts are louder than they need to be. You’re tired, but not sleepy. You’re overstimulated, but also somehow bored. And if you’re an ADHD girlie like me, your brain already came with 900 tabs open, so now it’s 900 tabs open plus one emotional support tornado in the background.
Cute. Love that for us.
If any of that resonated… keep reading…
Selank is a compounded prescription nasal spray through EllieMD, and it’s a synthetic neuropeptide being studied for stress-response regulation, emotional balance, and cognitive function. It may help support the systems that help you feel steady, regulated, and mentally clear when your body has been running a little too “brace for impact.”
And I want to be clear about what I’m not saying here. I’m not saying Selank treats anxiety, fixes heartbreak, replaces therapy, or magically makes life stop being life. If someone is in crisis, having severe symptoms, or feeling like they truly need mental health support, that is a provider conversation, full stop.
What I am saying is that there is a whole group of people who are not in full on crisis, but also don’t feel like themselves. They’re functional, but fried. They’re “fine,” but one unexpected noise away from becoming a feral raccoon in leggings. They don’t necessarily want to be sedated or checked out. They just want their internal alarm system to stop acting like every email, text, memory, or minor inconvenience is a threat.
Your stress response is supposed to activate when it needs to, then come back down when the threat is gone. But after a rough season, a big emotional hit, chronic stress, burnout, grief, or even just a long stretch of “I am handling everything because apparently that’s my assigned role in this lifetime,” sometimes that system feels like it gets stuck halfway on.
Not fully panicking. Not fully relaxed. Just hovering.
Selank is being studied for its potential role in supporting a calmer, more balanced stress response, emotional steadiness, and mental clarity without the goal being “knock me out so I can function less.”
And honestly, I think a lot of women, especially Xennial/Millennial women, are living in that middle ground. Not falling apart enough to call it a crisis, but not regulated enough to call it peace. We’re calling it “busy,” “stressed,” “overwhelmed,” “just a rough season,” or “I’m probably fine,” when sometimes what we mean is: my life moved on, but my body is still standing in the wreckage with a clipboard.
With EllieMD, Selank is reviewed by a licensed provider, and eligibility is determined by your individual health history and intake. It’s compounded, which means it is not FDA-approved, and the FDA does not evaluate compounded medications for safety, effectiveness, or quality before use. That is also why sourcing matters, because if I’m talking about a peptide nasal spray that interacts with brain and nervous system pathways, I am not interested in mystery-vendor roulette.
Here’s the question I’d start with: Do you feel like you need more focus, or do you feel like you need your body to feel safe again? Because Selank is more the 2nd one. Not “make me a new person.” Not “erase stress.” More like: can we support the system that helps me feel steady while life is doing life?
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
Scope of practice
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment. These statements have not been evaluated by the FDA. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
Transparency
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links in this email are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
Results + Testimonials
Any testimonials or results shared here reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
If you’ve been seeing people talk about peptides, peps, peppers, pepper gardens, or some weird version of the word peptide typed like it came from a ransom note, and you’ve been wondering what in the actual wellness internet is going on, you aren’t alone. It’s come to my attention that a lot of people are watching us talk about peptides like we have two heads because they have no clue what we’re even talking about or why they seem to be everywhere right now. And honestly? Fair.
Before I became more involved in the wellness side of things, I understood the basic science of peptides, but I didn’t fully understand how they were being used in longevity, skin health, energy support, recovery, metabolic health, or the newer wellness conversations happening online. I knew peptides existed in the body. I knew they mattered. But I wasn’t sitting around casually talking about peptide therapy over coffee like that was a normal Tuesday.
Why is everyone talking in code about peptides?
Before we even get into what peptides are, we need to talk about why you might see people calling them peps, peppers, pepper garden, 🌶️🌊, or some bizarre character version like Pɛp+ḷꝺΣ. It can look ridiculous from the outside, and to be clear, sometimes it IS ridiculous. But there’s a reason for it.
Social media platforms are not great at telling the difference between someone in the healthcare or wellness space providing legitimate educational content and someone selling gray market research peptides like they’re selling illegal drugs on the corner. So the people who are trying to talk about this responsibly often end up getting creative with language because platform filters can flag the topic before even getting to the context.
That doesn’t mean every coded post is trustworthy, and it definitely doesn’t mean every person using normal wording is unsafe. It just means the online peptide conversation has gotten weird because the internet made it weird. Shocking, I know.
So what are peptides?
Peptides are already in your body. They’re not some random wellness invention someone cooked up because they ran out of collagen powder to sell. Peptides are short chains of amino acids, and amino acids are the building blocks your body uses to make proteins.
Think of it like language. Amino acids are the letters. Peptides are short words or phrases made from those letters. Proteins are the longer sentences, paragraphs, or full instruction manuals made from those same letters arranged in more complex ways. That’s the simplest way to understand the relationship without turning this into a biochemistry class, which I promise nobody asked for today.
Peptides can act like messengers in the body. Depending on the peptide, that message may relate to skin health, collagen support, recovery, metabolic signaling, appetite signaling, cognitive function, tissue support, immune signaling, or cellular repair. That’s why the phrase “I take peptides” is honestly not very specific. It’s kind of like saying, “I take medication.” Okay… which one? For what? Through what route? Under whose guidance? For what goal?
What Are Peptides Used For? It Depends on the Peptide
This is one of the biggest things people miss when they first start hearing about peptides. Peptides aren’t all the same. They don’t all do the same job, and they aren’t all used for the same reason.
Some peptides are talked about for energy and cellular function. Some are being explored for skin, collagen, and tissue support. Some come up in conversations around muscle recovery, joint comfort, or workout recovery. Some are discussed in cognitive wellness. Others are connected to metabolic health and appetite signaling. Even within the same general category, two different peptides may work through completely different mechanisms in the body.
That’s why I don’t love when people ask, “What peptide should I take?” as if there is one universal answer. The better question is, “What am I trying to support, and what does my health history actually look like?” Because the peptide conversation for a woman who’s exhausted but sleeping fine may look very different from the peptide conversation for a woman dealing with skin changes, hair thinning, workout recovery issues, brain fog, or metabolic changes.
Why Women Over 40 Are Interested in Peptide Therapy for Energy, Skin, and Recovery
A lot of women aren’t peptide curious because they want another trendy wellness thing. They’re curious because something changed, and the old tools aren’t working the way they used to.
Maybe your skincare routine used to be enough, and now your skin still looks tired no matter how consistent you are. Maybe the Botox still smooths the lines, but it doesn’t fix the dullness, the skin laxity, the crepey texture, the volume loss, or the fact that your face still looks tired underneath it all. Maybe you’re working out, eating well, sleeping okay, and still dragging by 2pm. Maybe your recovery from workouts feels slower than it used to. Maybe your hair feels thinner, your body composition is changing, your brain feels foggy, or maybe your skin just doesn’t bounce back the way it used to. It’s annoying as hell because you’re still doing the skincare, the SPF, the appointments, all of it.
Then you go to your doctor, get the usual labs, and hear, “Everything looks fine.” Which is frustrating because “fine” does not explain why you feel exhausted, your skin looks different, your workouts take longer to recover from, and your body responds differently, even though your routine hasn’t changed.
That is where a lot of women start researching peptides. Not because they’re trying to become one of the bodybuilding biohacker bros. Not because they want to chase every shiny wellness trend. They’re trying to understand what’s happening under the surface and whether there are smarter options than just doing more of the same.
Are peptides FDA approved?
This is where we need to be specific, because “peptides are not FDA approved” is too broad.
Some FDA approved medications are peptide based or peptide related, like GLP-1s. But many of the peptides being discussed online in the wellness, longevity, recovery, skin, and performance spaces are not FDA approved medications. Compounded medications are also not FDA approved, which means the FDA does not evaluate them for safety, effectiveness, or quality before use.
That can sound scary, but it doesn’t automatically mean something is bad or unsafe. It means the details matter a lot. It means you need to care about who is evaluating you, where the medication is coming from, whether the pharmacy is licensed and regulated, whether testing is being used to verify quality, whether the instructions are clear, and whether there is actual support if you have questions or concerns.
This isn’t the category where I want anyone playing mystery vial roulette because a website had sophisticated branding and a price that looked too good to be true.
I know “not FDA approved” can sound scary, so let’s put that phrase in context. Dietary supplements, including many vitamins, minerals, and wellness products people buy every day, are also not FDA approved for safety and effectiveness before they hit the market. That doesn’t automatically make them bad, but it does mean the quality, sourcing, claims, testing, and company behind them matter.
The same general idea applies here, but with an important distinction: many peptides being discussed in wellness are not supplements. They are often compounded medications, which means they belong in a more medically guided lane. Compounded medications are not FDA approved, and that is exactly why provider review, a licensed pharmacy, clear instructions, and testing standards matter so much.
How to Choose a Peptide Source: Provider Review, Licensed Pharmacies, and Quality Testing
You can find almost anything online. That doesn’t mean you should put it in your body.
One of the biggest issues with peptides right now is that a lot of people don’t understand the difference between medically guided options and research grade gray market products. Some websites look polished. Some use medical language. Some have branding that feels legitimate at first glance. But clean branding doesn’t automatically mean provider oversight, proper pharmacy standards, clear dosing instructions, sterility, potency, purity, or support.
My green flag list is boring on purpose. I want licensed provider review. I want a licensed and regulated compounding pharmacy. I want third party testing for potency and purity. I want clear instructions. I want actual support if I have questions or concerns. I want transparency around what is compounded and what isn’t FDA approved. I want the process to feel medically guided, not like someone tossed you into the internet wilderness with a vial and a prayer.
That is the difference between “this exists online” and “this is a source I’d actually be comfortable putting my name next to.”
Why I Use EllieMD for Provider-Reviewed Peptide and Wellness Options
I personally use EllieMD, and I’m also a brand partner with them. That means yes, I may earn from qualifying orders through my link. It also means I’m putting my name, my nursing background, and my personal standards next to the company I’m choosing to talk about publicly.
The reason I talk about EllieMD isn’t because peptides are trendy. It’s because I wanted a source that checked the boxes I care about as a nurse and as a woman using some of these tools myself. And I wanted to have a trusted source to be able to recommend when I’m asked questions about peptides. Licensed provider review matters. A regulated pharmacy process matters. Clear instructions matter. Support matters. Quality standards matter. And not making people feel like they have to decode this entire category alone matters too.
For the woman who is already investing in skincare, med spa treatments, wellness tools, supplements, fitness, and better health, this is not about finding the cheapest option. It’s about asking whether the next investment actually makes sense, whether it is medically guided, and whether it is addressing the thing you’re actually trying to support.
Do peptides replace your doctor, labs, skincare, nutrition, or strength training?
No. And anyone making it sound that simple is already making me nervous.
Peptides are not a replacement for medical care. They are not a replacement for appropriate labs, nutrition, strength training, sleep, hormone evaluation, skincare, or an actual provider who understands your health history. They are one category of tools that may be worth discussing depending on your goals, medications, history, labs, budget, and what you are actually willing to do consistently.
The right conversation depends on the person. One woman may be looking at peptides because she’s sleeping fine but still exhausted. Another may be more focused on skin changes, collagen support, hair thinning, slower workout recovery, brain fog, libido, sleep, or metabolic support.
And for some people, peptides may not be the right fit at all. That is exactly why provider review matters.
That is why provider review matters. That is why your health history matters. And that is why I will never be the person telling everyone on the internet to take the same thing because one person had a good experience.
How to Know Which Peptide Might Fit Your Wellness Goals
If you’re new to peptides, I wouldn’t start with, “What is the best peptide?” I’d start with, “What am I actually trying to support?”
Are you looking for help with energy? Skin texture? Collagen support? Hair changes? Workout recovery? Brain fog? Metabolic health? Sleep? Libido? Joint comfort? Inflammation? Are you already taking medications or supplements? Do you have recent labs? Do you have a medical history that needs to be reviewed? Are you willing to give yourself injections, or do you need a nasal spray, capsule, or troche option? What are you actually going to use consistently?
Those questions matter more than whatever peptide is getting the most attention online this week.
Peptide Therapy for Women: What to Understand Before You Start
Peptides are not new. They aren’t magic internet dust. They’re not all the same. And they are definitely not something I’d recommend buying from a random research use only website because the pricing looked shockingly good.
Peptides are short chains of amino acids that can act like messengers in the body. Different peptides have different jobs, and some are being used or studied in wellness areas like energy, skin health, collagen support, recovery, tissue support, metabolic health, and cognitive function.
But the source matters. The provider matters. Your health history matters. Your goals matter. And whether this actually makes sense for you matters more than whatever the internet is screaming about this week.
This post contains affiliate links and/or brand partnership content. I may earn a commission at no extra cost to you.
LET’S BE CLEAR ABOUT WHO I AM (AND WHO I’M NOT).
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing on this site replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
SCOPE OF PRACTICE.
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment — this is not something that should be DIY’d. These statements have not been evaluated by the FDA. Products discussed on this site are not intended to diagnose, treat, cure, or prevent any disease.
TRANSPARENCY.
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links on this site are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate I earn from qualifying purchases.
RESULTS + TESTIMONIALS.
Any testimonials or results shared on this site reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
HRT for Menopause Support: What Changed, What the HRT Scare Missed, and What Women Should Know Now
If you’ve ever brought up hot flashes, night sweats, sleep changes, brain fog, low libido, vaginal dryness, painful intimacy, or the general “why does my body feel like it changed the rules overnight?” situation and gotten the medical equivalent of a shrug, you’re absolutely not alone.
Menopause care has been largely neglected for something that literally affects half the population, and that’s absolutely wild. And when HRT does come up, a lot of women immediately remember the scary version of the conversation they heard years ago. Hormones are dangerous. HRT causes cancer. Just deal with menopause because that’s safer.
Except that should never have been the full conversation.
While menopause may be normal, being brushed off is not.
What Are Common Menopause Symptoms Besides Hot Flashes?
Hot flashes get all the attention, and honestly, fair. Randomly feeling like your internal thermostat has gone feral is hard to ignore. But menopause is not just hot flashes.
Menopause symptoms can include night sweats that wreck your sleep, mood changes that make you feel like you owe half your household an apology, brain fog, low libido, vaginal dryness, painful intimacy, urinary urgency, joint aches, fatigue, body composition changes, and sleep that suddenly acts like it no longer knows you personally.
And what makes this extra frustrating is that many women are told this is “just aging,” as if that’s an actual plan. It isn’t.
A symptom being common does not mean it’s automatically something you have to white-knuckle through. Menopause is a normal life transition, but symptoms that affect your sleep, mood, intimacy, cognition, energy, and quality of life deserve treatment.
Why Are Menopause Symptoms So Undertreated?
A Mayo Clinic study found that more than 3 out of 4 women ages 45 to 60 reported menopause symptoms, and more than 80% didn’t seek medical care for those symptoms. Only about 1 in 4 were receiving any treatment at the time of the survey. (Mayo Clinic)
That isn’t because women are fine.
That’s because too many women were never told there were real options, were dismissed when they asked, or were scared so badly by the hormone therapy conversation that they never felt safe bringing it up in the first place.
Menopause care should be individualized, not brushed off or treated like something women just have to deal with.
Why Did HRT Get Such a Scary Reputation?
A lot of the fear around hormone replacement therapy traces back to the Women’s Health Initiative (aka WHI). This was a large study from the early 2000s that looked at hormone therapy in postmenopausal women.
The part that made the biggest headlines followed more than 16,000 generally healthy postmenopausal women ages 50 to 79 who still had a uterus. The average age was about 63. This was not mostly newly menopausal women in their late 40s or early 50s who were asking for help with hot flashes, night sweats, sleep, mood, and quality of life.
That group was given a specific oral combination of estrogen + progestin. That arm of the study was stopped early because, in that group, using that specific hormone combination, researchers saw increased risks of coronary heart disease, stroke, pulmonary embolism, and invasive breast cancer. The original WHI report also noted that the risk-benefit profile didn’t support using that regimen for primary prevention of chronic disease. (PubMed)
And yes, those risks are serious.
Heart events, stroke, blood clots, and breast cancer aren’t tiny little side notes. We aren’t pretending they don’t matter. Absolutely not.
But what happened next is where the conversation got flattened into something that hurt a lot of women. The public message became “HRT is dangerous.” PeRIOD.
No timing conversation. No route conversation. No dose conversation. No “who was actually in the study?” No “what exact hormones were used?” No “does this apply to every woman in every stage of menopause?” No “are we talking about symptom relief or trying to prevent chronic disease?”
Just fear. And that fear shaped menopause care for decades.
What Did the Women’s Health Initiative Actually Show About HRT?
It gave providers real safety data. It changed how clinicians evaluate hormone therapy, especially when it comes to age, time since menopause, personal risk factors, and using hormones for symptom support versus chronic disease prevention.
A 63-year-old postmenopausal woman taking a specific oral estrogen plus progestin combination for chronic disease prevention isn’t the same clinical situation as a 49-year-old newly symptomatic woman who can’t sleep, is soaking through pajamas, has vaginal dryness, feels like her libido packed a bag and left town, and wants to know what her options are.
Timing matters. Route matters. Dose matters. Medical history matters. Whether someone has a uterus matters. Estrogen alone versus estrogen with progesterone matters. The reason someone is considering HRT matters.
HRT may be incredibly helpful for the right person, at the right time, with the right provider reviewing their health history. And yes, some people shouldn’t take it. That is exactly why this should be a real medical conversation, not a Facebook comment section.
Is HRT Still Recommended for Menopause Symptoms?
The Menopause Society’s 2022 position statement says hormone therapy remains the most effective treatment for vasomotor symptoms, which include hot flashes and night sweats, and genitourinary syndrome of menopause. It also states that for most healthy symptomatic women who are younger than 60 or within 10 years of menopause onset, the benefits outweigh the risks when there are no contraindications and treatment is individualized. (The Menopause Society)
The FDA has also been moving toward updated labeling language for menopausal hormone therapies to better clarify benefit and risk considerations. In 2025, the FDA requested labeling changes to remove broad risk statements about cardiovascular disease, breast cancer, and probable dementia from boxed warnings for many menopausal hormone therapy products, while still keeping the endometrial cancer boxed warning for systemic estrogen-alone products in women with a uterus. (U.S. Food and Drug Administration)
What Is EllieMD’s HRT Program for Menopause and Postmenopause Support?
EllieMD’s new HRT options include things like estradiol, progesterone, vaginal estradiol, DHEA, and pregnenolone, depending on what someone is looking into and what a licensed provider determines is appropriate.
The initial rollout is focused on menopause and postmenopause support, with perimenopause support coming in a later phase. If the current rollout doesn’t apply to you yet, that doesn’t mean the door is closed forever. EllieMD is rolling this out in phases, so provider review, safety, and appropriate prescribing stay front and center.
Hormones are not something to casually toss at everyone with a symptom and a credit card. Your history matters. Your uterus matters. Your age, symptoms, risk factors, and goals matter. That is the whole point of having a licensed provider review everything before prescribing if appropriate.
EllieMD’s HRT Program offers personalized, physician directed hormone care for menopause support.
What Does Estradiol Support During Menopause?
Estradiol is a form of estrogen, and estrogen was quietly involved in a lot more than most of us were taught. We usually think of estrogen as a period or fertility hormone, but it also plays a role in temperature regulation, vaginal and urinary tissue health, bone support, skin elasticity, mood, sleep, cognition, and metabolic function.
So when estrogen drops during menopause, symptoms can show up all over the body. Hot flashes and night sweats are the obvious ones, but estrogen changes can also be part of the bigger picture with sleep disruption, brain fog, mood changes, vaginal dryness, urinary symptoms, and body composition changes.
What Does Progesterone Support During Menopause?
Progesterone deserves its own spotlight because it isn’t just estrogen’s quiet coworker.
Progesterone often declines before estrogen fully drops, and a lot of women feel that shift in their sleep and nervous system. This is the kind of sleep disruption where you are exhausted, you want to sleep, you’ve tried the magnesium, the clean sheets, and the “no caffeine after noon” nonsense, and your body is still acting like sleep is an optional hobby.
Progesterone can interact with GABA pathways, which help calm the nervous system. That’s why progesterone is often discussed in relation to sleep quality and nighttime restlessness.
Progesterone also matters for uterine safety when systemic estrogen is used in someone who still has a uterus. If you have a uterus, systemic estrogen without adequate progesterone can stimulate the uterine lining.
What Does Vaginal Estradiol Support During Menopause?
Vaginal estradiol is different from systemic HRT because it is used locally for vaginal and urinary symptoms related to estrogen loss in those tissues.
Genitourinary syndrome of menopause, or GSM, is wildly under-discussed. It can include vaginal dryness, burning, irritation, painful intimacy, urinary urgency, urinary frequency, and discomfort that women often assume they just have to tolerate now.
Nope. We aren’t doing “painful intimacy is just what happens after 50” as the whole plan.
Local vaginal estrogen may help support vaginal tissue moisture, elasticity, and comfort where estrogen loss is evident. The Menopause Society notes that GSM can affect vaginal, vulvar, sexual, and urinary symptoms, and unlike hot flashes, these symptoms often don’t just fade away over time without treatment. (The Menopause Society)
That is why vaginal symptoms deserve a real conversation. Not whispering. Not embarrassment. Not “well, you’re not 25 anymore.”
Absolutely not.
What Does DHEA Support During Menopause?
DHEA is a hormone precursor, which means the body can use it as raw material to make other hormones, including estrogen and testosterone.
And because apparently this still needs to be said in 2026, testosterone is NOT just a “man hormone.” Women make and need testosterone, too. It plays a role in libido, lean muscle, motivation, energy, and metabolic function.
DHEA levels decline with age, so DHEA support may be part of the conversation for women dealing with low libido, lower motivation, energy changes, or changes in muscle tone.
What Does Pregnenolone Support During Menopause?
Pregnenolone is another hormone precursor. It sits upstream from several steroid hormones, which means it is part of the raw material conversation.
EllieMD includes pregnenolone capsules as one of its HRT-related options. This may be considered for women looking into hormone support for cognitive function, mental clarity, and neurological wellness.
Can HRT Help With HOT Flashes and Night Sweats?
Hormone therapy is considered the most effective treatment for vasomotor symptoms, which include hot flashes and night sweats. (The Menopause Society)
And hot flashes aren’t just “getting warm.” They are more like the brain’s temperature control system becoming overly reactive as estrogen changes. That is why a normal temperature shift can suddenly feel like your body is trying to host a small electrical fire.
Night sweats are basically hot flashes that waited until you were finally asleep and comfortable.
So if you are waking up drenched at 3am, peeling off your pajamas, flipping the pillow, and then trying to function the next day like you didn’t just spend the night fighting invisible lava, that deserves a conversation.
Can HRT Help With Brain Fog, Mood Changes, and Sleep?
HRT may support brain fog, mood changes, and sleep for some women, depending on what is driving the symptoms and whether hormone therapy is appropriate.
Estrogen receptors are found in areas of the brain involved in memory, mood, and focus. Estrogen also interacts with neurotransmitter systems that help regulate mood and temperature. Progesterone can also have calming effects through GABA pathways, which is one reason progesterone comes up so often in the sleep conversation.
This is why I get a little spicy when women are told, “You’re probably just stressed.”
Sure. You might be stressed. Most women in midlife are running a household, managing work, remembering everyone’s appointments, answering emails, feeding people, and trying not to lose their mind in the Target parking lot.
But if your mood suddenly feels hijacked, your sleep is wrecked, your patience is gone, and your brain feels like it has 47 tabs open with music playing from one of them, hormones deserve to be part of the discussion.
Can HRT Help With Low Libido, Vaginal Dryness, and Painful Intimacy?
For some women, hormone support may help with low libido, vaginal dryness, and painful intimacy, depending on the cause and the treatment option used.
Low libido can be complicated. Stress, sleep, relationship dynamics, medications, body image, pain, and hormones can all be involved. But hormones absolutely belong in the conversation.
Estrogen helps support vaginal tissue health, moisture, elasticity, and blood flow. DHEA may support androgen pathways, including testosterone, which can play a role in sexual desire. Vaginal estradiol may be considered when symptoms are more localized, like dryness, irritation, discomfort, or painful intimacy.
And if sex hurts, that is not something you should be expected to silently tolerate.
Painful intimacy is common in menopause, but common does not mean acceptable. It definitely does not mean “well, that’s your life now.”
Can HRT Help With Weight Gain, Muscle Changes, and Body Composition?
This is where we need to be honest and not turn HRT into something it is not. HRT is not a weight loss medication.
Menopause can absolutely change body composition. Estrogen changes can affect fat distribution, insulin sensitivity, muscle maintenance, inflammation, sleep, and energy regulation. So when a woman says, “I am doing the same things I have always done, but my body is not responding the same way,” I believe her.
Because menopause can change the rules.
That does not mean HRT is automatically the answer for weight changes or body composition. But it does mean women deserve a better explanation than “eat less and walk more,” especially when they are already doing the things and still feel like their body has moved the goalpost.
Who Is EllieMD HRT For Right Now?
EllieMD’s initial HRT rollout is focused on menopause and postmenopause support. Perimenopause support is coming in a later phase.
That means the current HRT options may not apply to everyone yet. It also means eligibility is not determined by vibes, TikTok comments, or whether your friend said something worked for her.
A licensed provider reviews your medical intake and determines whether prescribing is appropriate based on your individual history, symptoms, risk factors, and goals.
That matters, and I’m not going to gloss over it, because “compounded” doesn’t mean “the exact same thing with a different label.” It means a licensed provider can prescribe a customized medication when appropriate, and that medication is prepared by a licensed compounding pharmacy.
For EllieMD, the pharmacy side matters. These medications are dispensed through state-licensed, 503A-compliant compounding pharmacies, which means they are prepared for individual patients based on a valid prescription. EllieMD also states that its medical-grade formulations undergo testing for identity, purity, and potency, and that its pharmacy partners source ingredients from FDA-registered suppliers.
Translation: this isn’t the same thing as ordering research-grade or gray-market products from a site that looks official but doesn’t include real provider review, appropriate prescribing, or pharmacy-level accountability.
Because that’s the part that gets people. Not everything sketchy looks sketchy anymore.
Some of these websites look polished. They have nice branding, medical-looking language, and product pages that feel very “wellness clinic adjacent.” But if there is no actual provider oversight, no valid prescription, no licensed compounding pharmacy preparing medication for you as an individual patient, and no clear quality testing standards, that is a very different situation.
EllieMD’s options are compounded. While they aren’t FDA-approved, they still require provider review, appropriate prescribing, and individual medical decision-making.
But there is a very big difference between compounded medication through a licensed pharmacy with quality standards and provider oversight, and something that only looks legitimate because the website got a Canva upgrade.
Compounded options can be valuable in personalized care, but they require appropriate prescribing, quality standards, and provider oversight. This is why I am picky about where I point people.
FAQ: HRT, Menopause Symptoms, and Hormone Therapy
Is HRT only for hot flashes?
No. Hot flashes and night sweats are some of the most well-known menopause symptoms, but hormone therapy may also be discussed for sleep disruption, mood changes, vaginal dryness, painful intimacy, urinary symptoms, and other symptoms depending on the individual person.
Is HRT safe for everyone?
No. HRT is not appropriate for everyone. Age, time since menopause, personal medical history, family history, uterus status, symptoms, and risk factors all matter. This is why provider review is required.
What is the difference between systemic HRT and vaginal estrogen?
Systemic HRT is intended to affect the body more broadly. Vaginal estrogen is more localized and is often discussed for vaginal and urinary symptoms related to estrogen loss.
Do you need progesterone with estrogen?
If someone still has a uterus and is using systemic estrogen, progesterone is commonly part of the conversation because it helps protect the uterine lining. A provider determines what’s appropriate.
Is perimenopause support available through EllieMD?
EllieMD’s initial rollout is focused on menopause and postmenopause support. Perimenopause support is coming in a later phase.
Is EllieMD HRT FDA-approved?
No. EllieMD’s HRT options are compounded medications, so they aren’t FDA-approved, and the FDA doesn’t evaluate compounded medications for safety, effectiveness, or quality before use.
That said, “not FDA-approved” doesn’t automatically mean “random gray-market website with nice branding.” EllieMD’s HRT options are prescribed after provider review and prepared through licensed, 503A-compliant compounding pharmacies, with quality standards like testing for identity, purity, and potency.
So yes, it’s still compounded. No, it isn’t FDA-approved. But it’s also not the same thing as ordering research-grade products from a polished website with no real medical oversight or pharmacy-level accountability.
What makes me excited about EllieMD adding HRT isn’t just that there is a new option on the menu. It’s that more women may finally get to have a real conversation about symptoms they have been told to tolerate for way too long.
The goal isn’t to pretend menopause is a disease. The goal is to stop pretending symptoms that affect your sleep, mood, intimacy, cognition, energy, and quality of life are just some cute little midlife inconvenience you are supposed to white-knuckle through while still running the whole household and remembering the orthodontist appointment.
Absolutely not.
Common doesn’t mean “you just have to deal with it.” Normal aging doesn’t mean “sorry, no options.” And fear-based medical information shouldn’t be the reason women spend years suffering silently without ever getting the full conversation.
If the doctors you have local access to don’t want to have this conversation, EllieMD providers will.
This post contains affiliate links and/or brand partnership content. I may earn a commission at no extra cost to you.
LET’S BE CLEAR ABOUT WHO I AM (AND WHO I’M NOT).
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing on this site replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
SCOPE OF PRACTICE.
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment — this is not something that should be DIY’d. These statements have not been evaluated by the FDA. Products discussed on this site are not intended to diagnose, treat, cure, or prevent any disease.
TRANSPARENCY.
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links on this site are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
RESULTS + TESTIMONIALS.
Any testimonials or results shared on this site reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
I saw the new KLOW blend and was immediately like… hold up, wait a minute.
This has the GHK-Cu that I already LOOOOOVE, plus the BPC-157/TB-500 I had already been contemplating adding… ANNNND the KPV all in one?
Hell yes, sign me up.
If you’ve been around here for more than five minutes, you already know I’m not just casually curious about GHK-Cu. I’m on it. I love it. I have been very impressed by it. I’ve had more new baby hairs with GHK-Cu than I’ve seen with anything else I’ve tried in the last 10 years. My hair is growing faster, and I’ve also noticed improvement in the loose skin on my arms and neck.
So when I saw that EllieMD released a new compounded peptide blend with GHK-Cu in it, I wanted the details immediately. Then I realized it also includes BPC-157/TB-500, which I had already been looking at for recovery and tissue support, plus KPV, which I’ve been curious about for gut and inflammatory balance. It brings together several peptides I was already looking into separately, especially for the stuff so many of us start caring about when our bodies stop bouncing back like they used to…
Skin changes. Recovery. Gut support. Inflammation. Collagen. The “why do I feel like my body needs a system update?” era.
KLOW is one I would absolutely want to know about if you’ve been curious about peptides beyond GLP-1s, especially if you’re thinking more about long-term wellness, recovery, and supporting what your body is already trying to do.
CHECK OUT KLOW HERE
If you’ve clicked a link and can’t see KLOW, it’s because it’s one that requires Exclusive Access to view. Just sign in with your free EllieMD account
OR CREATE ONE HERE
XOXO, NIKI
PCOS. Perimenopause. Metabolic health. The real stuff. Not just “eat less, move more.”
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
Scope of practice
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment. These statements have not been evaluated by the FDA. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
Transparency
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links in this email are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
Results + Testimonials
Any testimonials or results shared here reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
Last summer, at 41 years old, I developed new-onset eczema.
On my EYELID. And under my eye. Of all the places on my body, it picked my face. Then, a few weeks later, a patch showed up on my neck like the party needed more guests.
I was furious. I was confused. I was LITERALLY doing everything right.
It would start to clear up… and then come right back. Over and over. For months.
Why would eczema suddenly show up in your 40s when you’ve never had it?
Turns out this is a real thing. And it’s way more common than anyone talks about.
Perimenopause does a number on your skin in ways most of us are never warned about. As estrogen starts to decline, your skin produces less oil, loses ceramides (the lipids that hold your skin barrier together), and the whole barrier function is compromised. Your skin microbiome shifts. Your immune response shifts. And the inflammation that your body used to handle quietly? Now it’s showing up on your face.
Research published in dermatology literature confirms that the drop in estrogen during perimenopause can trigger new-onset eczema or worsen existing eczema, even in women with no prior history. Skin gets thinner, drier, more reactive, and more easily inflamed.
So… cool. One more thing nobody tells you about your 40s.
But wait. Aren’t you on a GLP-1? Shouldn’t that be handling the inflammation?
GLP-1s reduce one type of inflammation, the metabolic kind. The kind driven by insulin resistance, visceral fat, and blood sugar dysfunction. And they do that really well.
But the inflammation driving perimenopausal skin changes is a different beast entirely. It’s hormonal. It’s local. It’s happening in my skin because my estrogen is dropping, my skin barrier is compromised, and my skin’s immune response is reacting to things it never used to.
GLP-1 is putting out the metabolic fire in my body. But the hormonal fire showing up in my skin needed something else.
Enter NAD+
Available in Injection or Nasal Spray through EllieMD
I started NAD+ injections last fall. I wasn’t taking them for my skin, honestly. I was taking them for energy, recovery, and general cellular function. You know, the perimenopausal brain fog. The skin improvement was surprising, but then when I thought about it, it made PERFECT SENSE.
But within a few weeks, I noticed my eczema was staying cleared up. Not in the “it’s better today, let’s see what happens tomorrow” way. In the actually gone way.
And then I did what nurses do, which is make absolutely terrible patients. I got busy. I skipped a week. Then another one.
Guess what came back.
I went straight to my kitchen, pulled my vial out of the fridge, and took my injection. It cleared up again after a couple of weeks. Then I missed another week (I KNOW, I KNOW). Started seeing the early signs creeping back. Back to the kitchen I went. I also bumped up to tier 2 dosing, which is a higher dose, and the skin kept improving. Not getting worse. Which matters to me because it tells me my skin is responding to more NAD+, not less.
But is there actual science behind this, or am I just seeing things?
I want to be honest with you here, because I am not trying to oversell anything.
Research on NAD+ and inflammatory skin conditions is still in its early stages. But what’s out there looks really promising.
NAD+ is a molecule every cell in your body uses to make energy and repair itself. When you’re young, you have a lot of it. As you age, levels drop. When NAD+ drops, your cells can’t handle stress as well, can’t repair damage as well, and can’t calm inflammation as well.
One 2023 study found that boosting NAD+ calmed down one of the main inflammation pathways (called Th17) that drives skin conditions like eczema and psoriasis. Basically, more NAD+ told the inflammation to settle down.
Another study on a form of NAD+ showed it reduced eczema symptoms, itching, and helped the skin barrier rebuild itself. It calmed the fire AND helped the wall.
And a big review from 2025 on a related form of vitamin B3 (nicotinamide) laid out why this whole family of molecules is already being used by dermatologists for eczema, rosacea, and other inflammatory skin issues.
So no. This is not me seeing things.
It’s me having a body that was inflamed, a skin barrier that was compromised, a hormonal transition nobody warned me was starting, and a cellular molecule (NAD+) that supports the exact repair and anti-inflammation work my skin needed.
It makes sense that it worked. It makes sense that when I stopped, it came back. And it makes sense that when I bumped up my dose, it kept improving.
The full stack from EllieMD. Metabolic, cellular, skin. All working together.
What I want you to hear:
If you’re in your late 30s or 40s and something new is showing up on your skin, whether that’s eczema, rosacea flares, random dryness, or sensitivity you never had before, this is worth paying attention to. Your skin is telling you your hormones are shifting. That’s just physiology.
And if you’re already in the longevity and anti-aging conversation and you’re curious about NAD+ for energy, recovery, collagen, mitochondrial health… all the things… this is one more reason to pay attention. The skin benefits are real, even if the research is still catching up.
NAD+ is not a miracle cure. The research is preliminary. Anyone who tells you otherwise is selling you something.
But for me? It’s part of the stack now. PERMENANTLY
If you’re curious about NAD+ or want to actually talk to a provider about whether it’s something worth exploring for you, I use EllieMD for my telehealth. The physicians are real, the messaging is unlimited, and you can ask all the questions you need to ask before you start anything. (They work with CloveRX for compounding, which is the pharmacy that actually makes the peptides. Same consistent quality every single time, which is what I wanted when I made the switch.) With EllieMD you now have the option of NAD+ Injections or an NAD+ Nasal Spray (which I will probably try out with my next order).
As always, talk to your own provider, do your own research, and don’t start anything without understanding what it does and what it doesn’t do. I am a nurse, but I am not YOUR nurse, and this is not medical advice. It’s my story, the research I’ve pulled, and an invitation to look into it if it resonates.
Love you, mean it.
XOXO, NIKI, RN
PCOS. Perimenopause. Metabolic health. The real stuff. Not just “eat less, move more.”
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
Scope of practice
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment. These statements have not been evaluated by the FDA. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
Transparency
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links in this email are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
Results + Testimonials
Any testimonials or results shared here reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
Can I tell you the thing that still makes me want to flip a table?
It’s the phrase “your labs are normal.”
Because for a lot of women… especially women with PCOS, perimenopause knocking, and years of “borderline” results that nobody ever actually addressed… “normal” doesn’t mean fine. It means nobody looked deep enough.
Here’s what most routine bloodwork checks when it comes to blood sugar: fasting glucose and A1C. That’s it.
And here’s what those tests miss: how hard your body is working to keep those numbers where they are.
Your fasting glucose could be sitting at a perfect 94 mg/dL. Your A1C could be a beautiful 5.4%. And your pancreas could be GRINDING out insulin behind the scenes just to hold those numbers in place. You wouldn’t know. Because nobody ordered the test that shows it.
That test is called fasting insulin. And when you pair it with your fasting glucose, you can calculate something called your HOMA-IR score… which basically tells you how insulin resistant your body is right now.
Not how your blood sugar looks on paper. How your body is actually functioning.
The CDC says over 115 million American adults have prediabetes. 8 in 10 don’t know it. That’s not because they’re ignoring their health. It’s because the standard tests aren’t catching it early enough.
And research published in Diabetes Care found that using A1C alone to screen for prediabetes missed about 75% of at-risk people.
If that doesn’t make you want to flip the table too… I don’t know what will.
Here’s what I want you to do:
Next time you have bloodwork, ask your doctor to add a fasting insulin level. It’s drawn from the same blood, at the same time. You may need to specifically request it because it’s not included in standard panels.
Once you have it, here’s the math: (fasting glucose x fasting insulin) / 405 = your HOMA-IR score. Under 1.0 = optimal. Over 2.5 = insulin resistance may be present. Over 3.0 = significant.
That one number could explain more about why you feel the way you feel than every “normal” result you’ve ever gotten combined.
I wrote a full deep dive on this on the blog… why standard panels miss it, what it means if you have PCOS, and the exact labs I’d tell my best friend to ask for. If you want the whole picture, it’s there for you.
Not sure where to start? Take my free quiz and I’ll send you a custom plan.
WHAT’S RIGHT FOR MY BODY?
P.S. Missed the previous editions of The Nurse’s RX? ↓ Catch up here ↓
READ PAST EDITIONS
↓ LET’S CONNECT ↓
Let’s be clear about who I am (and who I’m not)
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
Scope of practice
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment. These statements have not been evaluated by the FDA. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
Transparency
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links in this email are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
Results + Testimonials
Any testimonials or results shared here reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
I need to explain something about sleep that nobody told me for most of my life. And I’m willing to bet nobody told you either.
I’ve been a night owl since second grade. Every time my schedule forced me onto days, I reached for melatonin, thinking it would help me adjust. It got me to sleep. I still woke up every single time feeling like I hadn’t slept at all.
For years, I thought my body was just bad at this. Turns out the problem was never falling asleep. The problem was what was (or wasn’t) happening AFTER.
Here’s your nurse lesson for the day.
Your sleep has stages. Stage 3, also called deep sleep, is where your body does the actual overnight repair work. Your brain files away memories. Your immune system does its thing. Your hormones get regulated. Tissue gets repaired. ALL of it happens in deep sleep.
And here’s what your doctor probably never connected for you… deep sleep is the FIRST stage to get destroyed by stress, hormonal shifts, and age. Perimenopause? Your sleep architecture starts changing before you even realize what’s happening. You can sleep 8 hours and barely touch the deep stage. You were in the pool all night, but you never went below the surface.
Melatonin doesn’t fix this. Melatonin tells your body WHEN to sleep. That’s it. It puts up the “closed” sign on the store. But whether the cleaning crew actually shows up to do the repair work? Melatonin has nothing to do with that.
The sign said closed. The cleaning crew never came.
There’s also a handoff that’s supposed to happen every night between your stress system and your sleep system. They take turns. Stress runs the day, then clocks out so sleep can take over. When that handoff breaks down, you get that “tired but wired” feeling… exhausted, but your brain won’t stop running the list. That’s not a personality trait. That’s a broken shift change inside your body.
DSIP (Delta Sleep-Inducing Peptide) is being studied for BOTH of these things. The depth of your sleep AND the stress handoff. It’s been researched for over 40 years. It’s not a sedative. No morning fog. No dependency. It works with your body’s own systems instead of overriding them.
I’m about to be forced onto day shift for three months (I KNOW). Then, a few days later, EllieMD dropped DSIP. The TIMING. I dug into the research and… this sounds like exactly what I need right now. You know I’ve already ordered it! I’ll keep you updated on how it goes.
I wrote a full breakdown on the blog. What DSIP is, how it’s different from melatonin, what deep sleep actually does for your body, and who this might help most.t it with real physician oversight.
If you’ve been sleeping “enough” hours and STILL waking up exhausted… this post explains WHY. And that answer alone is worth the click.
Not sure where to start? Take my free quiz and I’ll send you a custom plan.
WHAT’S RIGHT FOR MY BODY?
P.S. Missed the previous editions of The Nurse’s RX? ↓ Catch up here ↓
READ PAST EDITIONS
↓ LET’S CONNECT ↓
Let’s be clear about who I am (and who I’m not)
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
Scope of practice
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment. These statements have not been evaluated by the FDA. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
Transparency
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links in this email are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
Results + Testimonials
Any testimonials or results shared here reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
Remember how I told you about my accidental experiment of skipping my injections last week? And how the joint swelling and inflammation came back with a vengeance?
Well, I am checking in today with an update that honestly blows my mind, even as a nurse.
Yesterday, I finally took my compounded GLP-1/GIP + glycine, along with my NAD+ and GHK-Cu injections. It has only been 24 hours, and that inflammation that was creeping back like no joke is already mostly resolved. I still have a tiny bit of swelling, but it is not nearly as bad as it was yesterday.
And the best part? The food noise is officially GONEZO!
As a nurse, I love knowing the “why” behind how our bodies work. If you have ever typed “does GLP-1 help with joint pain” or “how fast do weight loss meds reduce inflammation” into your search bar late at night, I have some answers for you. I went digging into reputable clinical studies, and the science behind this rapid relief is wild.
Here is what the research actually says about GLP-1 medications and systemic inflammation (and I brought the receipts so you can check them out yourself!):
It works fast:Studies show that a single dose of a GLP-1 medication can start reducing inflammatory cytokines (the specific proteins that cause swelling and pain) within literally hours. This perfectly explains why my joint pain and stiffness got better by the very next day.
It is not just because of the weight loss:Clinical trials have proven that GLP-1 medications consistently lower C-reactive protein. That is the main inflammation marker your doctor checks when you get routine bloodwork. The crazy part is that the research shows a massive chunk of this reduction happens completely independent of weight loss. The medicine itself is actively fighting the inflammation!
Whole body relief: These meds do not just target your stomach to make you full. They actually help block the pathways that cause chronic inflammation all over your body. The science shows they have direct anti-inflammatory effects on your joints, heart, liver, and immune system.
So if you have been wondering if GLP-1 weight loss medications do more than just help you drop pounds, the answer is a massive yes. They are powerful tools that help manage chronic conditions from the inside out.
Have you noticed a major difference in your own inflammation or joint pain since starting your wellness journey? Reply back and let’s chat about it!
XOXO, NIKI, RN
PCOS. Perimenopause. Metabolic health. The real stuff. Not just “eat less, move more.”
Not sure where to start? Take my free quiz and I’ll send you a custom plan.
WHAT’S RIGHT FOR MY BODY?
P.S. Missed the previous editions of The Nurse’s RX? ↓ Catch up here ↓
READ PAST EDITIONS
↓ LET’S CONNECT ↓
Let’s be clear about who I am (and who I’m not)
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
Scope of practice
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment. These statements have not been evaluated by the FDA. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
Transparency
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links in this email are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
Results + Testimonials
Any testimonials or results shared here reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
I get asked all the time if I’m planning on staying on a GLP-1 forever. For me personally? The answer is a hard yes. But before you panic, that doesn’t mean you’ll have to.
I actually had a little “accidental experiment” last week. I totally forgot to take my shot, and by the time I realized it, the week was halfway over, so I figured I’d just wait. Well, here I am due for my next dose and OH EM GEE. The joint swelling is so real. I can literally feel the inflammation in my body, and it is no joke y’all!
That alone is one reason why I plan to stay on at least a microdose for the long haul.
I’ll also keep it 100 with you: the food noise definitely creeped back in hardcore over the last two days. The good news? I’m still maintaining my 94lb weight loss within an acceptable fluctuation range, but the mental load of that food noise is something I’m happy to leave behind.
Why I’m choosing the “forever” route:
Hormonal Harmony: For the first time in my life (outside of being pregnant), I actually feel balanced.
Heart Health: Given my personal and family history, the cardioprotective features of these medications are a huge priority for me.
Managing PCOS: Even when my labs look “normal,” I know I’ll always have some level of insulin resistance and metabolic disorder. I’d much rather manage that with a GLP-1 than let it get out of hand.
Staying on this medication isn’t a sign that “it didn’t work” because I still need it. To me, it’s about accepting that I have chronic conditions that I am finally able to manage with one single medication instead of several. It’s honestly such a relief.
What this means for YOU
None of this means you’re “stuck” on them. If you and your doctor decide that coming off is the right move for your body, that is amazing! Just know that if you do stop and notice the weight creeping back up or that old food noise getting loud again, you can always use the meds for short periods to reset and restore.
It’s about having the tools in your kit, not about being “perfect.”
Are you worried about the “forever” aspect of weight loss meds, or are you just taking it one shot at a time? Reply and let’s chat!
XOXO, NIKI, RN
PCOS. Perimenopause. Metabolic health. The real stuff. Not just “eat less, move more.”
Not sure where to start? Take my free quiz and I’ll send you a custom plan.
WHAT’S RIGHT FOR MY BODY?
P.S. Missed the previous editions of The Nurse’s RX? ↓ Catch up here ↓
READ PAST EDITIONS
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Let’s be clear about who I am (and who I’m not)
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing here replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
Scope of practice
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment. These statements have not been evaluated by the FDA. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
Transparency
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links in this email are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate, I earn from qualifying purchases.
Results + Testimonials
Any testimonials or results shared here reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
TL;DR: At 41, I developed new-onset eczema on my eyelid, under my eye, and later on my neck. I was already using eczema-approved skincare. Topical hydrocortisone and Aquaphor weren’t holding it. It would clear and come right back. NAD+ injections are what actually cleared it and kept it cleared. When I missed doses, it came back. When I resumed, it cleared again. Here’s the story, the research, and why this is more common in your 40s than anyone told you.
What New-Onset Eczema on the Face Looks Like at 41
New-onset eczema can show up in your 40s even if you’ve never had it before, and it often appears on the face, including sensitive areas like the eyelids. That’s exactly what happened to me.
I had never had eczema in my life. Not as a kid. Not as a teenager. Not as an adult.
And then last summer, it showed up on my EYELIDS. And under my eyes. Of all the places on my body, it picked my face. A few weeks later, a patch showed up on my neck.
I was furious. I was confused. I was LITERALLY doing everything right.
It would start to clear up… and then come right back. Over and over. For months.
Why Does Eczema Suddenly Show Up in Your 40s?
Turns out this is a real thing. And it’s way more common than anyone talks about.
Perimenopause does a number on your skin in ways most of us are never warned about. As estrogen starts to decline, your skin produces less oil, loses ceramides (the lipids that hold your skin barrier together), and the whole barrier function is compromised. Your skin microbiome shifts. Your immune response shifts. And the inflammation that your body used to handle quietly? Now it’s showing up on your face.
Research published in dermatology literature confirms that the drop in estrogen during perimenopause can trigger new-onset eczema or worsen existing eczema, even in women with no prior history. Skin gets thinner, drier, more reactive, and more easily inflamed.
So… cool. One more thing nobody tells you about your 40s.
Do GLP-1s Reduce Skin Inflammation? Why Mine Didn’t Help My Eczema
This was literally my exact question. I’ve been on a GLP-1 for over two years. GLP-1s are known to reduce inflammation. So why was my face actively revolting?
GLP-1s reduce one type of inflammation, the metabolic kind. The kind driven by insulin resistance, visceral fat, and blood sugar dysfunction. And they do that really well, even at very low doses.
But the inflammation driving perimenopausal skin changes is a different beast entirely. It’s hormonal. It’s local. It’s happening in my skin because my estrogen is dropping, my skin barrier is compromised, and my immune response in my skin is reacting to things it never used to react to.
GLP-1 is putting out the metabolic fire in my body. But the hormonal fire showing up in my skin needed something else.
How NAD+ Injections Cleared My Perimenopausal Eczema
I started NAD+ injections (also available as a nasal spray)last fall. I wasn’t taking them for my skin, honestly. I was taking them for energy, recovery, and general cellular function. The skin improvement was not on my bingo card.
My NAD+ injection, prescribed through EllieMD and compounded by CloveRX. This is the one that changed my skin.
But within a few weeks, I noticed my eczema was staying cleared up. Not in the “it’s better today, let’s see what happens tomorrow” way. In the actually gone way.
I added GHK-Cu later, which also has some skin benefits, but I want to be really clear. The eczema had already cleared before I added GHK-Cu. The NAD+ was doing the heavy lifting.
My skin stack from EllieMD.
What Happened When I Stopped Taking NAD+
If you stop taking NAD+, the anti-inflammatory benefits don’t stick around indefinitely. I found that out the hard way.
I did what nurses do, which is make absolutely terrible patients. I got busy. I skipped a week. Then another one. Then another…
Guess what came back. The damn eczema!!!!
I went straight to my kitchen, pulled my vial out of the fridge, and took my injection. It cleared up again. Then I missed another week (I KNOW, I KNOW). Started seeing the early signs creeping back. Back to the kitchen I went.
Ever feel like your “get up and go” just got up and left? NAD+ is basically a cellular deep clean that helps with energy and metabolic health.
Is There Actual Research Behind NAD+ and Eczema?
Yes, there is peer-reviewed research looking at NAD+ for inflammatory skin conditions, though the body of evidence is still early. I want to be honest with you here, because I am not trying to oversell anything.
Research on NAD+ and inflammatory skin conditions is still in its early stages. But what’s out there looks really promising.
NAD+ is a molecule every cell in your body uses to make energy and repair itself. When you’re young, you have a lot of it. As you age, levels drop. When NAD+ drops, your cells can’t handle stress as well, can’t repair damage as well, and can’t calm inflammation as well.
What the Peer-Reviewed Studies Show
A 2023 study in Cell Reports Medicine found that boosting NAD+ calmed down one of the main inflammation pathways (called Th17) that drives skin conditions like eczema and psoriasis. Basically, more NAD+ told the inflammation to settle down.
A 2022 study in International Immunopharmacology on a direct NAD+ precursor showed it reduced eczema-like symptoms, itching, and water loss through the skin. It also helped the skin barrier rebuild itself by boosting the proteins that hold it together. It calmed the fire AND helped the wall.
A 2023 paper on NAD+ and skin damage showed NAD+ administration decreased skin damage by reducing oxidative stress, inflammation, DNA damage, and cell death.
And a 2025 review in Medicina on a related form of vitamin B3 (nicotinamide, the precursor to NAD+) laid out why this whole family of molecules is already being used by dermatologists for atopic dermatitis, rosacea, and other inflammatory skin issues. It restores cellular energy, repairs DNA damage, and suppresses pro-inflammatory signals.
So no. This is not me seeing things.
It’s me having a body that was inflamed, a skin barrier that was compromised, a hormonal transition nobody warned me was starting, and a cellular molecule (NAD+) that supports the exact repair and anti-inflammation work my skin needed.
It makes sense that it worked. It makes sense that when I stopped, it came back. And it makes sense that when I bumped up my dose, it kept improving.
Who Should Consider NAD+ Supplements for Skin and Inflammation?
NAD+ isn’t for everyone, but there are two groups of women who tend to benefit most from this therapy.
If You’re in Your Late 30s or 40s and Something New Is Happening to Your Skin
If eczema, rosacea flares, random dryness, or sensitivity you never had before is suddenly showing up, this is worth paying attention to. Your skin is telling you your hormones are shifting. That’s just physiology.
If You’re Already Curious About NAD+ for Longevity and Anti-Aging
If you’re already in the longevity conversation and you’re looking at NAD+ for energy, recovery, collagen, mitochondrial health… all the things… the skin benefits are one more reason to pay attention. Even though the research is still catching up, what’s out there supports what a lot of women are already noticing.
The full stack from EllieMD. Metabolic, cellular, skin. All working together.
What to Ask Your Provider About NAD+ Supplements
If you want to actually have an informed conversation with a provider instead of Googling at midnight (we’ve all been there), here are the questions I’d bring to the table.
Could my new skin issues be connected to perimenopause or hormonal changes?
What’s your take on NAD+ for inflammation and skin health?
Is subcutaneous NAD+ something you prescribe or would consider?
What about the Nasal Spray option?
Are there labs you’d want to check first, like hormone panels or inflammation markers?
If your current provider isn’t familiar with NAD+, peptides, or the perimenopause skin conversation, that doesn’t mean you’re out of options. I use EllieMD for my telehealth provider. The physicians are real, the messaging is unlimited, and you can ask every question you need to ask before you start anything. They work with CloveRX for compounding, which is the pharmacy that actually makes the peptides. Same consistent quality every single time. Made specifically for human use. Medical grade, not research grade. Tested for purity and potency. Triple purified for safety. And within the next month, they’ll be the first compounding pharmacy with all their peptide ingredients made in the USA rather than sourced internationally and compounded here. That’s what I wanted when I made the switch with my telehealth provider.
The Bottom Line on NAD+ for Eczema and Perimenopausal Skin
NAD+ is not a miracle cure. The research is preliminary. Anyone who tells you otherwise is selling you something.
But for me? It’s part of the stack now. Permanently.
If something new is showing up on your skin in your 40s and nothing you’re doing is making it stick, it’s worth looking into. Talk to your own provider. Do your own research. Don’t start anything without understanding what it does and what it doesn’t do. I am a nurse, but I am not YOUR nurse, and this is not medical advice. It’s my story, the research I’ve pulled, and an invitation to look into it if it resonates.
This post contains affiliate links and/or brand partnership content. I may earn a commission at no extra cost to you.
LET’S BE CLEAR ABOUT WHO I AM (AND WHO I’M NOT).
I’m a registered nurse and health coach who shares real, BS-free information about metabolic health, PCOS, perimenopause, and weight loss, because y’all deserve better than vague wellness fluff. But here’s what I need you to know: I am not YOUR nurse. Everything I share here is for educational purposes only. It is not medical advice, it’s not a diagnosis, and it doesn’t create a provider-patient relationship between us. Nothing on this site replaces the care of a licensed provider who actually knows your full health history. The opinions and content here are my own and do not reflect the views of my employer or the hospital where I work.
SCOPE OF PRACTICE.
As a nurse health coach, I can recommend over-the-counter products and supplements that may support your wellness goals. I don’t prescribe specific prescription medications. When it comes to GLP-1s and peptides, what I can do is talk about the science, what’s available, and what may be beneficial, so you can have an informed conversation with your licensed medical provider. The decision about what’s right for your body always belongs to you and your provider. Always consult your licensed provider before starting any prescription treatment — this is not something that should be DIY’d. These statements have not been evaluated by the FDA. Products discussed on this site are not intended to diagnose, treat, cure, or prevent any disease.
TRANSPARENCY.
I only recommend things I actually trust. Most are products I personally use, some are from partners whose clinical standards I believe in. I will always let you know when it’s something I haven’t tried personally. Some links on this site are affiliate links or part of brand partnerships, which means I may earn a commission at no extra cost to you. As an Amazon Associate I earn from qualifying purchases.
RESULTS + TESTIMONIALS.
Any testimonials or results shared on this site reflect individual experiences only. Results are not guaranteed and will vary based on individual circumstances.
