Ask Dr. Dombo: Common HRT Questions, Answered
BY DR. KUDZAI DOMBO
Hormone replacement therapy (HRT) can feel overwhelming when you are first exploring options. Many women have questions about how hormones work, when to take them, and what combinations are safe or effective.
As a board-certified OB-GYN and menopause specialist, Dr. Kudzai Dombo helps women better understand how hormones, stress, sleep, nourishment, movement, and emotional wellbeing all work together during midlife through her whole-woman framework, The Hukadzi Way™.
Here are a few of the most common hormone therapy questions women ask.
Can progesterone help even if I don’t have a uterus?
Many women are surprised to learn that progesterone may still offer benefits even if they no longer have a uterus or currently have an IUD.
Progesterone is often prescribed alongside estrogen to protect the uterine lining, but it may also help support sleep, relaxation, and anxiety regulation for some women during midlife.
Dr. Dombo often explains that progesterone can have a calming effect on the nervous system, which is why many women notice improvements in sleep quality or nighttime anxiety after starting treatment. Some providers even refer to it as “nature’s Xanax” because of its calming properties.
Every woman’s needs are different, but this is one reason progesterone may still be part of a treatment plan beyond uterine protection alone.
When should testosterone be taken?
Timing matters with testosterone therapy.
Testosterone can support energy, motivation, strength, libido, and overall vitality during menopause, but because it can feel energizing, Dr. Dombo generally recommends applying testosterone gel in the morning rather than at night.
Using testosterone too close to bedtime may contribute to sleep disruption or insomnia in some women.
Morning application better aligns with the body’s natural energy rhythms and may help reduce the likelihood of nighttime restlessness.
Where should estrogen patches be placed?
Many women do not realize that patch placement can affect absorption.
According to Dr. Dombo, estrogen patches are often best absorbed when placed on the buttocks or lower body rather than higher-friction areas.
Women also frequently ask whether they can use both an estrogen patch and vaginal estrogen cream together.
For many patients, the answer is yes.
Vaginal estrogen is typically used to help address localized symptoms such as dryness, irritation, discomfort with intimacy, or urinary symptoms related to menopause. Unlike systemic estrogen therapy, vaginal estrogen is minimally absorbed into the bloodstream and is often used alongside other hormone therapies under the guidance of a healthcare provider.
The Importance of Individualized Care
One of the most important things women should understand about hormone therapy is that treatment is not one-size-fits-all.
Hormone needs, symptoms, health history, and treatment goals vary from person to person. What works well for one woman may not be the right approach for another.
This whole-body perspective is central to The Hukadzi Way™, Dr. Dombo’s approach to helping women navigate midlife health with greater clarity, balance, and support.
The goal is not simply replacing hormones. It is helping women feel informed, supported, and better equipped to navigate this stage of life with confidence.
Related Pillars of The Hukadzi Way™
- Hormones
- Sleep
- Healthspan
Learn more about The Hukadzi Way™ and Dr. Dombo’s whole-woman approach to midlife wellness.
