By Ann Marie McQueen
The first video I saw was posted on May 14 on Instagram. Leanne Duncan, a hormone and fat loss coach with 67.5K Instagram follower, who runs a “peptide/hormone program”, posts a Reel with her equally gorgeous partner.
They walk toward the camera, hand-in-hand, smiling as if they both have a secret. The words on the screen read: “At 55, we didn’t need a couples retreat. We needed microdosing, GLP-1 peptides, NAD and muscle.”
They kiss. He cups her behind. She leaps onto him, wrapping her legs around his waist. She gets down. They hug. They kiss again.
The caption reads like an infomercial:
“Let me be real with you. I already knew what to do. I’ve been in shape. I know hormones. I’m an integrative practitioner. This is literally what I do. But menopause doesn’t care how much you know. I was doing everything ‘right’ and still felt off. Tired. Puffy. Not myself. And honestly, that disconnection showed up in our marriage, too.
Then I started microdosing GLP-1 peptides. That was the shift.”
(Btw: Her hubby also “felt off,” and the microdosing worked for him too. Now their marriage is apparently even more swell.)
She goes on to talk about weight, inflammation, insulin sensitivity and then, boom: “…and finally letting my hormone therapy work the way it was supposed to”.
My Spidey senses were already tingling, but here is where the needle scratched off the record for me. Um, pardon? Your hormone therapy needs something else (other than lifestyle changes) to “work the way it was supposed to”?
Dr Mary Claire Haver joins in
Then on May 29, Dr. Mary Claire Haver sent out a Substack titled: “What I Got Wrong About Menopause and Metabolism, and What I Recommend Now: GLP-1s and Hormone Therapy—A New Era in Menopause Metabolic Care.”
But first, a little context on the whole GLP-1 thing:
GLP-1s 101
GLP-1s, or glucagon-like peptide-1 receptor agonists, are medications that mimic a hormone your gut naturally releases after eating. This hormone helps regulate appetite and metabolism by signaling the brain you’re full, slowing how quickly food leaves your stomach, and improving how your body manages insulin and blood sugar.
Originally developed to treat type 2 diabetes, GLP-1s are now being widely used for weight loss – just check out any shrinking celebrity – and that’s where the controversy heats up. Some experts call them a breakthrough for people struggling with obesity and metabolic issues, while others worry about things like:
- Overprescribing
- Side effects
- High costs
- Rebound weight gain
There is also a concern about greater muscle than loss, so when weight returns, you’re left with more fat than before. This was a topic raised a few years ago when I was on a panel at the Future Wellness Summit. Dr. Ali Hashemi, who uses them to help reverse prediabetes Zone.Health center in Dubai called the situation of someone regaining weight in this way “a metabolic disaster.”
There are some big, lingering questions. Meanwhile, people are starting to use GLP-1s (and other peptides) to optimize the other parts of their life too, all things that feed into metabolic health, like sleep, energy and reducing inflammation.
Also worth noting: GLP‑1s are just one piece of a growing family of metabolic peptides. Companies are combining GLP-1 with GIP (Glucose-Dependent Insulinotropic Polypeptide) and glucagon for greater effect. Lately I’ve been hearing more about Retatrutide, a triple-agonist targeting all three.
Lastly, people are taking larger, FDA approved doses, and they are micro doing GLP-1s. This article mixes references to stacking hormone therapy with both.
Back to Dr Haver’s “New Era”
Dr Haver’s Substack was sprinkled with mea culpas about bias and how she “failed women,” followed by her big come-to-light moment, which also sounds like an infomercial. She writes: “If you’ve been experiencing weight gain during menopause, please understand it is not your fault. It’s not a lack of willpower. And it’s not too late. You deserve a strategy grounded in science, supported by compassion, and tailored to your unique biology. GLP-1 medications and hormone therapy, together, offer a powerful, evidence-based approach to help restore your health and confidence.”
To bolster her argument, Dr. Haver cites a 2024 study in Menopause (journal of the Menopause Society): “HT may enhance outcomes by improving sleep, mood, and motivation to stay active – all crucial in long-term weight management. This advantage is why I now consider combination therapy a frontline option for eligible patients.
Sounds impressive, right? What she doesn’t mention:
- The study lasted three months
- It involved 16 women on hormone therapy and 90 women not on hormone therapy
She’s getting dragged for this kind of flimsy sourcing online right now, so I won’t pile on further. Just know that while the study might be promising, it’s not a one to hang your hat on, at least not without providing context.
Some other important context: One of the study’s authors is Mayo Clinic gastrointestinal physiology researcher Dr. Andres Acosta. He discloses being a stockholder in two GLP-1 companies (Gila Therapeutics and Phenomix Sciences) and a consultant for Amgen and Boehringer Ingelheim, both of which are developing next-gen peptides.
Meanwhile, in the UK
In June, the British Menopause Society (BMS) published new guidance for doctors prescribing GLP-1s alongside hormone therapy. Dr. Annice Mukherjee, an endocrinologist and early guest on the Hotflash Inc Podcast – is one of the practitioners who helped develop the tool.
The BMS advises doctors to monitor women taking HT and GLP-1s (and other peptides) carefully. Just as they slow gastric emptying, they can also slow absorption of oral micronized progesterone. Since estrogen must be paired with progesterone or progestin to protect the uterine lining, this is no small issue. The risks include bleeding, endometrial hyperplasia and endometrial cancer.
They suggest women on oral micronized progesterone either raise their dose, or switch to a hormonal coil (progestin).
From the Daily Mail: “Professor Annice Mukherjee, of the society’s medical advisory council, who led on the guidance, said an imbalance in hormones, particularly in women with obesity, would put them ‘at increased risk of womb cancer’. But she stressed that the biggest risk factor for womb cancer is obesity and so overall the weight-loss jabs were a positive tool to reduce weight and cancer risk.”
Back in the US, more influencing
Kim Constable (The Sculpted Vegan) has been raving for weeks in Reels to her 4.4M Instagram followers about her HT–microdosed GLP-1 stack, particularly for sleep and inflammation. On June 27, she posted that her hip pain and sleep issues had returned, explaining: “The GLP-1 stopped working because the product deteriorates over time once opened.” She later posted that a new batch solved everything.
Then there’s Jenn Reed, a powerlifting convert who’s been struggling to optimize hormone therapy for a decade. She’s now on the HT + GLP-1 + NAD++ stack, walking followers through it in real time. Wielding a syringe in a Reel for her 109k Instagram followers, her caption also sounds like an infomercial: “I’ve spent the last 10 years on a journey… dialing in the tools in my menopause toolbox including strength training, tracking macros, optimizing my HRT, sleep & supplements. But it still felt like something was missing. I was feeling inflamed, sleep & recovery weren’t where I wanted them & I had brain fog and low energy.”
Spoiler alert: she’s “feeling amazing”.
The 4th wave of menopause commercialization
Over the weekend, Dr Jen Gunter piped up from the back of a car on Instagram, calling this hormone therapy/GLP-1 trend: “A winner in the 4th level of menopause commercialization.”
I often don’t agree with the way the author of The Menopause Manifesto presents information. But in pointing out that first it was estrogen, then it was testosterone, then it was more estrogen, on this on point, she’s bang on.
My bottom line (for now)
Personally? I’ve been curious, especially with peptides for gut health. But after years of IBS, SIBO, and leaky gut, the last thing I want is to mess with my motility.
And commercialization yes. This is a big issue for midlife women. And the way these all sound so, sort of, similar is reminiscent of a larger narrative; a greater force, if you will.
But what bugs me most is that for a few years now Doctor Menopause Gurus like Mary Claire Haver and other influencers have been touting hormone therapy as not only an answer but the answer. And for many women, that’s true.
But now? Actually… it’s not quite the whole answer? Now there’s another thing? Now we’re layering on a prescription we might be on for the rest of our life? Also:
- We don’t know enough about this “stack”.
- Being human is hard. Any quest for perfection is a losing game.
- Some people seem way too obsessed with their outsides and insides.
- It gives me cringe to see people gleefully shooting up on camera.
- A lot of people don’t know what they don’t know – and they’re very sure about it.
- If you’ve got pain or trauma you don’t acknowledge, no “stack” will fix it.
Editor’s note
If you are still reading, thank you. After obsessively thinking about this for the last two weeks, I spent the last half of my Abu Dhabi–Toronto flight writing it. I think I can go on my vacation now.
This article was first published on Ann Marie’s Substack.
Find out more about Ann Marie’s work at HotFlash Inc.