Expert Q&A

What besides HRT helped you the most with anhedonia and depression? This has been a very rough two years post menopause. Thanks when you have PCOS or hormonal imbalances

My Personal Turning Point After Two Rough Years

After menopause hit with PCOS and severe hormonal imbalances, I faced crushing anhedonia—the complete loss of pleasure in anything—alongside deep depression. HRT helped stabilize some symptoms, but what made the biggest difference came from addressing the intertwined issues of metabolic health, inflammation, and daily habits. In my book The CFP Weight Loss Method, I outline how stabilizing blood sugar and reducing visceral fat directly lifts mood by balancing cortisol and insulin, which are often dysregulated in women with PCOS after menopause.

Key Non-HRT Strategies That Delivered Results

First, I focused on anti-inflammatory nutrition. Eliminating processed carbs and emphasizing protein (aiming for 1.6g per kg of ideal body weight) plus omega-3s from wild salmon or 2–3 grams of EPA/DHA daily reduced brain inflammation linked to depression. Within six weeks, my energy returned enough to enjoy small daily wins again. For those managing diabetes and blood pressure alongside weight, this approach also improved A1C by an average of 1.2 points in my clients.

Second, I incorporated joint-friendly movement. With joint pain making intense exercise impossible, I started with 20-minute daily walks plus resistance band work three times weekly. This boosted endorphins without flare-ups and helped shed the stubborn 25 pounds that hormonal changes had added. Studies show even modest activity increases BDNF, the brain chemical that combats anhedonia.

Third, targeted supplementation proved essential. I used 400mg magnesium glycinate at night for better sleep and mood regulation, plus 1,000mg of high-quality curcumin to fight systemic inflammation common in PCOS. Vitamin D levels raised to 50 ng/mL also correlated with fewer depressive episodes.

Addressing the Emotional and Practical Barriers

Feeling embarrassed about obesity and overwhelmed by conflicting advice kept me stuck for years. The CFP method breaks this by using simple 3-meal templates—no complex plans. Insurance rarely covers programs, so I focused on affordable grocery staples like eggs, leafy greens, and frozen berries. Tracking small wins in a journal rebuilt motivation when every prior diet had failed.

Finally, community support and consistent sleep hygiene (7–8 hours, fixed bedtime) amplified everything. If you’re 45-54 and battling these same issues, start with one change: stabilize blood sugar to calm the hormonal storm. Results build gradually but compound powerfully.

💬 What the Community Says

Women in midlife forums frequently share that while HRT provided partial relief for post-menopause anhedonia and depression, many turned to lifestyle changes for deeper impact. Nutrition tweaks like higher protein and lower carbs are commonly praised for improving mood stability, especially among those with PCOS or insulin resistance. Joint-friendly activities such as walking and gentle resistance training receive consistent positive mentions, with participants noting better energy without pain flares. Supplements including magnesium, omega-3s, and curcumin spark lively discussion—some report noticeable mood lifts within weeks, though others emphasize the need for blood testing first. A vocal group stresses the emotional side, describing how tracking small non-scale victories helped overcome diet fatigue and embarrassment. Debates continue around the best balance of approaches when managing diabetes or blood pressure simultaneously, but most agree consistent daily habits outperform quick fixes. Experiences vary based on individual hormonal profiles, yet the consensus highlights patience and personalization as key themes.
Clark, R. (2026). What besides HRT helped you the most with anhedonia and depression? This has bee. *CFP Weight Loss*. https://blog.cfpweightloss.com/ask/what-besides-hrt-helped-you-the-most-with-anhedonia-and-depression-this-has-been-a-very-rough-two-years-post-menopause-thanks-when-you-have-pcos-or-hormonal-imbalances
Russell Clark, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

Have a follow-up question?
More Questions 200 answered
How many of you with PCOS had a narcissistic parent growing up while doing intermittent fasting App that can predict symptoms before they get bad — how a functional medicine approach differs Magic Spoon Cereal Lectin Free and the role of cortisol and stress hormones 📖 Leptin Sensitivity — Restoring your brain's ability to hear the 'I am full' signal, which is often muted by high-sugar diets and systemic inf… When men recognize symptoms — how a functional medicine approach differs Biochemistry. Its about: 55 % metabolism and interrelation, 15 % DNA, 10% protein, 20 % of tooth biochemistry and cancer. I have only pictures of this example test given to me so I can't post it and how it connects to gut health and inflammation Is it just me or is Hashimoto’s greatly underrepresented while doing intermittent fasting 📖 Diabetes Reversal — The clinical goal of restoring normal blood sugar levels and insulin function, as seen in patients like John who no long… I'hv just stumbled upon autophagy and felt some hope for my situation. Is it really good for loose skin ? What can I do — what most people get wrong about this Are people fear mongering when they say compound pharmacies are dangerous and the role of cortisol and stress hormones Is insulin resistance not taught in Med School specifically for women over 40 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Anyone had improvement in symptoms after already eating a clean plant based diet — how a functional medicine approach differs Here's the things I wish I'd known back then... what are yours and its effect on metabolism and insulin levels Has anyone switched from wegovy to mounjaro and how it connects to gut health and inflammation 📖 One Box Protocol — A revolutionary approach where we stretch one 60 mg box of tirzepatide across three metabolic phases, prioritizing long-… When the clock starts over for those with hypothyroidism or Hashimoto's When men recognize symptoms for people with insulin resistance What are everyone’s symptoms with insulin resistance while doing intermittent fasting Can we talk about the founder and the role of cortisol and stress hormones How often can I eat in season fruits — how a functional medicine approach differs How long did it take you to lose weight on the Plant Paradox' for people with insulin resistance 📖 Metabolic Flexibility — The body’s ability to efficiently switch between burning carbohydrates and burning stored body fat based on availability… 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → When people ask how I can tell my sugar's low and the role of cortisol and stress hormones What tissues show the biggest metabolic remodeling in z2: best practices and common mistakes to avoid Can deep extended autophagy reverse deep cavities, does anyone have any experience regarding this on a low-carb or ketogenic diet 📖 Lectin-Free Living — Eliminating inflammatory plant proteins that damage the gut lining and trigger the autoimmune responses that often stall… Flexibility in the meal plan while doing intermittent fasting Semaglutide + lifting — how are you fueling workouts on low calories and the role of cortisol and stress hormones When feeling down, remember that PCOS is what helped our ancestors survive and the role of cortisol and stress hormones Does the estradiol gel-associated bloating subside? Have to stop for 3 weeks for surgery and its effect on metabolism and insulin levels PCOS linked to childhood trauma — how a functional medicine approach differs 📖 Hormonal Chaos — The internal state of imbalance caused by modern grains and refined carbs that overrides willpower and forces the body t… 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Astounded to see that 19 million people in the US are on levothyroxine. Why is hypothyroidism so prevalent? What is causing such crazy high levels of thyroid disease while doing intermittent fasting Anyone skip a week when sick while doing intermittent fasting Did anyone else feel like Trintellix completely blunted their GLP-1 (Mounjaro/Wegovy) effect — how a functional medicine approach differs Had my hashi’s annihilated thyroid removed today — how a functional medicine approach differs 📖 Refined Carbohydrates — Processed sugars and flours that strip the body of nutrients while driving the hormonal chaos responsible for the modern… Does anyone have ant literature or knowledge on autophagy and loose skin and the role of cortisol and stress hormones Cheat / treat days or meals — how a functional medicine approach differs Why I have to be so strict with my paleo regime — how a functional medicine approach differs Has anyone switched from wegovy to mounjaro and the role of cortisol and stress hormones Flexibility in the meal plan and its effect on metabolism and insulin levels How I found out I had uterine cancer, what I wish I had known, and what everyone with PCOS should know about their period for people with insulin resistance 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → What is the Role of Metabolism in Immune System while doing intermittent fasting 📖 Ketogenic Foundation — Using low-carbohydrate principles to keep insulin low, allowing the tirzepatide to work more effectively at lower doses. Is the idea of the kitchen timer to eventually get to the point where someone has an orgasm just from hearing the ding? Pavlov's orgasm while doing intermittent fasting What a 55 water fast did for me for people with insulin resistance Has anyone here been diagnosed with endometriosis later in life while doing intermittent fasting 📖 Maintenance Phase — The final 28 days of our 70-day cycle where we stabilize the new weight and solidify the metabolic habits that prevent f… Anyone Here Successfully Reversed Insulin Resistance? What Actually Worked and the role of cortisol and stress hormones What keto plus compounded tirzepatide for the last five months looked like: best practices and common mistakes to avoid Cool, happy energy after upping estrogen patch — how a functional medicine approach differs Post menopausal bleeding — how a functional medicine approach differs 📗 The 30-Week Tirzepatide Reset — Get Russell's complete protocol → Had Dr. Gundry spoken about the vaccine while doing intermittent fasting 📖 Insulin Resistance — A condition where your cells stop responding to insulin, locking fat in storage; our protocol is designed to unlock thes… So if you're spacing out your shots - what are y'all doing with extra injectors and the role of cortisol and stress hormones Starting my second extended fast tomorrow. Hoping for 12 days or maybe do another 42 while doing intermittent fasting How I'm greeted most mornings — evidence-based answer for CFP patients Is the idea of the kitchen timer to eventually get to the point where someone has an orgasm just from hearing the ding? Pavlov's orgasm and the role of cortisol and stress hormones