hormone replacement therapy in ann arbor, MI
When Hormones Shift, Your Mental Health Feels It
Hot flashes, mood swings, brain fog, and fatigue don’t have to be “just part of aging.” For many women, these symptoms signal a deeper issue: hormonal imbalance during perimenopause and menopause. And when your hormones are out of tune, your mental health can be too.
That’s where Bioidentical Hormone Replacement Therapy (BHRT) comes in.
WHAT IS BHRT?
Hormones don’t just affect your body — they play a huge role in how you feel day to day. Mood swings, brain fog, disrupted sleep, irritability, and even new or worsening anxiety and depression can all be tied to hormone shifts in perimenopause and menopause.
That doesn’t mean therapy or medication “didn’t work” — it just means there may be more to the story. BHRT can complement the tools you already use for your mental health, addressing one of the root causes so you can finally feel like yourself again.
Does any of this sound familiar ?
When estrogen, progesterone, and testosterone decline, it isn't just your body that’s affected—their dips can disrupt mood, sleep, and mental clarity. this can lead to:
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Why it happens: Hormonal changes in perimenopause increase the risk of new or worsening mood symptoms. In fact, research shows women are 40% more likely to experience depression during perimenopause compared to before menopause. Estrogen and progesterone fluctuations affect neurotransmitters like serotonin and GABA, which regulate mood and calm the nervous system.
How BHRT helps: By restoring hormonal balance, BHRT may stabilize mood swings, ease irritability, and reduce anxiety—addressing the root cause, not just the surface symptoms. -
Why it happens: Hormonal shifts often disrupt sleep cycles and reduce energy regulation, making rest feel ineffective.
How BHRT helps: Hormone balance supports better sleep, consistent energy levels, and renewed mental clarity—so fatigue becomes less of a barrier. -
Why it happens: It’s not “just in your head”—around 60% of women report memory or concentration problems during the menopause transition, as estrogen plays a direct role in maintaining verbal memory and cognitive function. Research shows that starting estrogen therapy near menopause is linked to improved verbal memory and cognition.
How BHRT helps: By addressing hormone imbalances directly, BHRT can improve focus, reduce brain fog, and help you stay sharp at work, home, and in relationships.
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Why it happens: Sleep disruptions are extremely common in perimenopause and menopause. Night sweats, shifting cortisol, and hormone changes all play a role. Studies show poor sleep and depression often go hand in hand during this stage of life.
How BHRT helps: By stabilizing hormonal fluctuations, BHRT improves sleep quality—so rest becomes restorative, not fragmented.
Hormonal shifts aren’t just physical—they deeply affect emotional and cognitive well-being.
If you’ve been told these symptoms are a “normal” part of aging, you should also know that they’re not inevitable—and they don’t have to be managed alone. BHRT addresses the root cause—helping stabilize mood, mental energy, sleep, and clarity—not just patching symptoms.
Why People Choose Hive for Medication Management
Because we believe mental health care should feel human.
Medication is just one tool in a much bigger toolbox—and we’ll never treat it like the only one. Our approach is:
Collaborative – You’re the expert on your life. We bring knowledge and options so you can make the decisions that feel right for you.
Whole-Person – We consider your health, lifestyle, identity, and goals—not just symptoms.
Neuro-Affirming – We understand and respect brain differences like ADHD and autism. Our goal is to support you, not “normalize” you.
Supportive Beyond Meds – We offer psychotherapy and practical strategies so you have tools that work for real life.
Our providers are here to listen to your concerns, answer your questions, and guide you every step of the way. If medication is right for you, we’ll make it easy. If it’s not, we’ll help you find what is.
Meet our Providers
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Hannah Frankel, PMHNP-BC
Virtual + Ann Arbor
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Rachel Mould, FNP-C, PMHNP-C
Virtual + Ann Arbor
Not Sure If Medication Is Right for You? Let’s Talk.
It’s normal to feel uncertain. You might be asking:
Do I really need medication?
What if it changes me?
Will I have to take it forever?
Those questions are valid—and that’s exactly why we start with a conversation, not a prescription. Our job isn’t to put you on medication. It’s to help you feel better in the way that fits your life, your goals, and your comfort level.
Sometimes medication is part of the plan. Sometimes therapy alone does the trick. Sometimes it’s a combination. The important thing? You have options—and you’re in control every step of the way.
If You’re On the Fence, Here’s What You Should Know:
You’re always in charge – No pressure, ever.
Medication isn’t forever for most people – Many use it short-term while building skills and stability.
Your identity matters – Our approach honors who you are, including your neurodivergent brain.
We take a big-picture view – Your mental health is about more than symptoms—it’s about your quality of life.
You don’t have to decide everything today. You just have to take the first step—and we’ll help with the rest.
Frequently
Asked
Questions
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A PMHNP is a Psychiatric Mental Health Nurse Practitioner—a licensed, board-certified clinician who can diagnose mental health conditions, prescribe medication, and provide supportive therapy. PMHNPs take a holistic approach, considering your overall health, lifestyle, and personal goals—not just your symptoms.
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Both PMHNPs and psychiatrists can diagnose mental health conditions and prescribe medication, but their training backgrounds are different:
Psychiatrists are medical doctors (MDs) who complete medical school and specialize in psychiatry. They often focus primarily on medication management.
PMHNPs are advanced practice nurses with graduate-level training in mental health care. In addition to prescribing, they often integrate supportive psychotherapy and practical strategies into treatment.
Many clients choose PMHNPs because they appreciate a whole-person, collaborative approach that blends medication management with ongoing support.
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Yes! We provide secure telehealth sessions for clients anywhere in Michigan.
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No. Our goal is to give you options—not ultimatums. Our PMHNPs take a holistic, whole-person approach, which means medication is never the only answer. While they can prescribe when it’s helpful, their focus is on creating a plan that supports your overall well-being—whether that includes medication, therapy, lifestyle strategies, or a combination.
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That’s what follow-ups are for. We’ll check in and adjust as needed. You’re never stuck.
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Yes. Our PMHNPs are experienced in pediatric and adolescent mental health care and use evidence-based approaches for safe, effective treatment.
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Yes, when clinically appropriate. We follow all safety and monitoring guidelines to make sure the medication is the right fit for you.
