Hormone Therapy in Long Beach – Why “Normal” Labs Don’t Tell Your Full Story | Novel U Wellness

Hello, My Dears –

In my Novel U Wellness and Med Spa office in Long Beach, CA, I often see the confusion and frustration in my patients’ eyes when they tell me: “Dr. Shahnoos, I’ve got hot flashes, mood swings, and brain fog, but my doctor says my hormone levels are normal. Am I going crazy?”

As a board-certified internist specializing in hormone replacement therapy and wellness medicine in Southern California, I can tell you with confidence, you are not going crazy. What you’re feeling is real, valid, and more common than you might think. After years practicing internal medicine and now the director of Novel U Wellness and Med Spa with a specialization in bioidentical hormone replacement therapy (BHRT) and integrative wellness, I’ve learned our bodies are more complex than what any single lab result can capture.

My extensive training in internal medicine, plus advanced training in hormone therapy, has shown me that real, lasting successful treatment comes from understanding both the science behind hormonal changes and the individual patient’s experience. That’s why women throughout Long Beach, Southern California, and beyond seek our comprehensive approach to menopause treatment and perimenopause management.

The Limitation of “Normal” Lab Values in Hormone Replacement Therapy

When we discuss hormone therapy in my office, many of my patients focus on exact numbers: “My estradiol is X, my progesterone is Y.” But our bodies are not a spreadsheet. They are dynamic systems that are always changing, influenced by countless factors every day, through cycles, and across life stages.

Think of it this way: if I asked you to describe how you feel today based only on your blood pressure this morning, you’d probably laugh. You might feel great at 8 a.m. and exhausted by 3 p.m. Your blood pressure reading is not able to capture your full daily experience. The same principle applies to your hormones.

Premenopausal symptoms and early menopause symptoms can occur even when your hormone levels fall within what labs call “normal.” That’s because your hypothalamic-pituitary-ovarian axis, which is the communications system between your brain and your ovaries, can become less sensitive over time. It’s like having a conversation where one person starts speaking more softly, but the other person’s hearing isn’t quite as sharp as it used to be.

This is where BHRT can make a big difference for women experiencing perimenopause and menopause throughout California.

The Science Behind Your Symptoms

As we age, especially through our reproductive years, our hypothalamic-pituitary feedback system changes significantly. What this means in practical terms is that your normal estradiol level might not be enough to suppress your luteinizing hormone (LH) secretion the way it used to. This disruption in your body’s delicate communication system can lead to those frustrating hot flashes and mood changes, even though your lab work looks “perfect” on paper.

I want to validate the symptoms that many of my hormone therapy patients experience: the fatigue, headaches, anxiety, and brain fog. These symptoms aren’t reliably predicted by absolute hormone levels. They reflect a complex mix of neuroendocrine signaling, neurotransmitter interactions, and how sensitive you are to hormonal changes.

Every woman’s body has its own signature way it responds to hormonal fluctuations. Some are incredibly sensitive to small changes; others ride out bigger swings with fewer symptoms. Neither response is wrong, they are just different. That’s why we tailor our approach to you, not just your numbers

Understanding Premenstrual Symptoms Through a New Lens

Premenstrual Syndrome (PMS) and premenstrual dysphoric disorder (PMDD) aren’t necessarily caused by abnormal hormone concentrations. Research suggests they often come from increased sensitivity to the normal monthly shifts in estrogen and progesterone. Think of your hormones as music playing in the background of your life. For some, it’s barely noticeable. For others, the same tune at the same volume feels loud and disruptive. The music hasn’t changed; your sensitivity has.

This understanding has profound implications for how we approach treatment. Instead of chasing “the right” hormone level, we focus on helping your body respond more comfortably to its natural rhythms.

Early Perimenopause: When Normal Becomes Complicated in HRT

Early perimenopause is a perfect example of why we look beyond isolated hormone measurements. You might see fluctuating LH and reduced progesterone while estradiol stays in the normal range. Those shifts can spark those dreaded vasomotor symptoms: the hot flashes that seem to come from out of nowhere and sleep disrupting night sweats.

This is a perfect example of how symptom-driven care informed by dynamic hormonal changes and feedback disruption beats a static hormone numbers-only approach to your individualized treatment plan. Your body is responding to patterns and feedback changes, not just a single value.

A Board-Certified Internist’s Different Approach to Hormone Evaluation

At Novel U Wellness in Long Beach, I’ve learned to take a different approach when listening to my patients than the traditional approaches taught in med school when it comes to treating perimenopause and menopause. When you describe your symptoms, I focus on your pattern and your menstrual history, not just lab results. This comprehensive approach to bioidentical hormone therapy aligns with recommendations from the American Board of Internal Medicine Foundation and reflects what I’ve seen work best for my patients across Southern California.

During our consultation, I want to know: When do you feel your worst? Which time of your cycle brings the most challenges? How has your energy changed over the past year? These questions often provide me with more valuable insights than any single lab test.

That doesn’t mean lab testing isn’t important – it absolutely is. But it’s just one piece of a bigger puzzle. Your symptoms, cycle patterns, sleep quality, stress levels, nutrition, and yes, your hormone levels all work together to create the full picture of your health that guides our BHRT recommendations.

Moving Forward With Compassion and Science in Long Beach Hormone Therapy

If you’ve been dismissed because your labs were “normal,” please know your menopause symptoms deserve real attention. I’m a board-certified internist who specializes in hormone replacement therapy in Southern California, and I believe real healing happens when we blend cutting-edge science and medical knowledge with genuine compassionate patient care. We have sophisticated BHRT tools and treatments that can help you feel better, even when conventional approaches fall short.

Your body is telling you something important. Sometimes it speaks in a language that standard lab work can’t fully translate, but that doesn’t make its message any less valid for perimenopause treatment and menopause management.

At Novel U Wellness in Long Beach, we combine the latest medical technology with a deep respect for how uniquely each woman experiences hormonal changes. Our approach to BHRT isn’t just about lab values: it’s about your whole health picture. Because while the science of hormones is universal, your personal experience of them is uniquely yours.

Feeling better isn’t about chasing perfect lab numbers. It’s about reaching a state of well-being where your body feels harmonious and your menopause symptoms no longer stand in the way of the life you want to live.

You deserve to feel your best, and there are paths forward, even when the standard approach doesn’t give you the answers you’re seeking. If you’re experiencing unexplained symptoms in Long Beach, Southern California, or beyond, a comprehensive hormone replacement therapy evaluation might be the missing piece of your health puzzle.

Wishing You Light and Love,

Dr. Shahnoos

Board-Certified Internal Medicine
Director, Novel U Wellness & Med Spa
Long Beach, California