Estrogen, Dopamine & Cognitive Performance: What the New Research Means for You

Following the recent updates removing black-box warnings from many hormone therapies, a new study adds even more clarity on why estrogen matters far beyond hot flashes. Researchers have now shown that estrogen directly enhances learning by boosting dopamine activity in the brain’s reward circuits. This reinforces what we see clinically at 77 Wellness: hormone optimization is not just symptom control — it is brain health, motivation, and cognitive resilience.

In the study, when estrogen levels were elevated, rats learned significantly faster. They responded more accurately to cues and demonstrated stronger reward-based learning. Mechanistically, estrogen enhanced dopamine signaling, particularly the “reward-prediction error” signal that drives how the brain consolidates new information. When estrogen signaling was blocked, learning slowed, even though general decision-making remained intact. This highlights a targeted cognitive effect: estrogen supports the learning centers of the brain through dopamine modulation.

For women in perimenopause or menopause, these findings align with real-world complaints — brain fog, reduced motivation, slower learning, and decreased mental stamina. This research helps explain why. As estrogen declines, dopamine pathways lose efficiency. Supporting hormonal balance can restore cognitive vitality and improve day-to-day function, especially when paired with sleep, exercise, targeted nutrition, mitochondrial support, and hormone-informed neuromodulators.

At 77 Wellness, this strengthens our integrated approach: optimizing hormones means optimizing brain performance. When hormone therapy is individualized, monitored, and delivered as bioidentical formulations, it supports not only metabolic and cardiovascular health but also motivation, resilience, and learning capacity. This is the future of women’s brain-based hormone care — rooted in physiology, backed by emerging evidence, and tailored to each patient.

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References

    1.    Medical Xpress. Estrogen’s role in boosting dopamine and cognition. https://medicalxpress.com/news/2025-11-estrogen-role-boosting-dopamine-cognition.html

    2.    University of Arizona Neuroscience Study (referenced within article): Estrogen modulation of dopamine reward-prediction circuitry.

    3.    Additional foundational references on estrogen’s neurocognitive effects:

    •    Brinton RD. Estrogen regulation of glucose metabolism and mitochondrial function: therapeutic implications for prevention of Alzheimer’s disease. 2016.

    •    Becker JB et al. Sex differences in dopaminergic function. J Neurosci Res.

Women’s Hormone Health Update

For decades, women have been misled about hormone therapy—largely because of the 2002 Women’s Health Initiative (WHI) study. That study was originally designed to evaluate cardiovascular disease prevention, not hormone therapy safety. Yet it became the defining narrative against hormones for women. Importantly, the WHI used synthetic progestins and synthetic estrogens, not the bio-identical progesterone and estradiol we use today. The data that followed unfairly painted all hormone therapy as risky.

Fast forward to now—the FDA has announced the removal of the “black-box” warning from more than twenty hormone-based therapies used for menopause symptoms such as hot flashes and night sweats. This marks a major shift in women’s health policy and public understanding. Modern evidence shows that, for many women—especially those who begin therapy before age 60 or within 10 years of menopause—the benefits of hormone therapy far outweigh the risks. Properly balanced hormones protect cardiovascular health, bone density, mood stability, cognition, and overall quality of life. In fact, remaining without these critical hormones may be more detrimental than using them under appropriate supervision.

At 77 Wellness, we treat hormone optimization as part of whole-body care. Hormone therapy is never one-size-fits-all—it’s personalized based on timing, dosage, delivery method (patch vs pill), and individual health background such as cardiovascular risk or breast-cancer history. For women in perimenopause or menopause experiencing hot flashes, insomnia, fatigue, mood swings, or bone loss, we review both hormonal and non-hormonal options, along with integrative therapies, bio-identical replacement, and lifestyle interventions.

This FDA decision is a step forward in empowering women with accurate information and individualized treatment choices. At 77 Wellness, we remain committed to evidence-driven, root-cause-focused hormone care—for women and men alike—because balanced hormones are essential for longevity and vitality.

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References

    1.    The Women’s Health Initiative Steering Committee. JAMA. 2002;288(3):321-333.

    2.    Manson JE et al. Menopausal hormone therapy and health outcomes during the intervention and extended post-stopping phases of the WHI trials. JAMA. 2013;310(13):1353-1368.

    3.    Hodis HN, Mack WJ. Timing hypothesis and cardiovascular protection with estrogen therapy. Menopause. 2020;27(7):802-810.

    4.    North American Menopause Society (NAMS) Position Statement. Menopause. 2022;29(7):767-794.

    5.    FDA Press Release. FDA removes boxed warning for certain hormone therapy products. 2025.

Gut Health & Medication: Protecting Your Microbiome

Our gut microbiome—the trillions of bacteria and microorganisms living in your digestive tract—acts as the command center for your immune system, metabolism, and even brain health. When it’s balanced, you feel energetic, resilient, and clear-minded. When it’s disrupted, you’re more likely to face inflammation, fatigue, mood changes, digestive issues, and chronic illness.

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How Medications Disrupt the Gut

A recent large-scale study confirmed that many common prescriptions—not just antibiotics—can disturb your gut’s natural ecosystem. Of the 186 drugs analyzed, 167 altered microbiome balance, and 78 caused long-term disruption.

Medications linked to microbiome imbalance include:

    •    Antibiotics

    •    Antidepressants

    •    Antipsychotics

    •    Beta-blockers

    •    Biguanides (Metformin)

    •    Proton-pump inhibitors (PPIs)

    •    Benzodiazepines

Even short-term use can shift microbial diversity and affect digestion, metabolism, and immune defense.

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Restoring Balance — The 77 Wellness Approach

1. Medication Review

We evaluate each prescription for necessity, duration, and alternatives. Many medications—such as long-term PPIs or benzodiazepines—can often be tapered under supervision once the root cause is addressed.

2. Nourish & Rebuild

    •    Diet: Eat fiber-rich, plant-based foods to feed healthy bacteria.

    •    Probiotics: Restore balance with clinically proven strains like Lactobacillus rhamnosus or Saccharomyces boulardii.

    •    Prebiotics: Include onions, garlic, leeks, asparagus, and resistant starch.

    •    Repair nutrients: Glutamine, zinc carnosine, and butyrate support gut lining recovery.

3. Lifestyle Support

Stress reduction, quality sleep, hydration, and movement all directly influence gut health and microbiome diversity.

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The Bottom Line

Medication can heal—but it can also harm when overused. Protecting your gut means protecting your foundation for health. If you’ve been on antibiotics, antidepressants, or PPIs, it may be time to check your gut’s resilience and rebuild from the inside out.

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References

    •    Lang K. “Antibiotics and 6 other medications linked to disrupted gut microbiome.” Medical News Today, Nov 2025.

    •    Yang L et al. “The varying effects of antibiotics on gut microbiota.” Frontiers in Microbiology, 2021.

    •    “Do antibiotics harm healthy gut bacteria?” Medical News Today, 2023.

Inflammation: The Silent Saboteur of Health

You’ve probably heard the word inflammation, but few realize how quietly it drives fatigue, weight gain, joint pain, anxiety, and even hormone imbalance. It’s not just something that happens when you twist an ankle—it’s a body-wide signal of imbalance.

At 77 Wellness, we see it every day: patients with “normal labs” who still feel exhausted, foggy, or puffy. That’s low-grade inflammation. It builds slowly, often triggered by processed foods, poor gut health, environmental toxins, chronic infections, or constant stress.

Early warning signs include:

    •    Morning stiffness or swelling

    •    Brain fog or low mood

    •    Bloating or food sensitivities

    •    Fatigue that no amount of sleep fixes

Left unchecked, these signals evolve into autoimmunity, thyroid dysfunction, insulin resistance, and premature aging.

The good news—inflammation is reversible.

Through targeted lab testing (CRP, homocysteine, ferritin, food sensitivity panels, gut mapping) and lifestyle interventions—anti-inflammatory nutrition, restorative sleep, movement, and stress regulation—you can calm the immune system and restore balance before disease develops.

Root-cause care isn’t about suppressing symptoms—it’s about asking why they exist.

If you’re ready to discover the “silent saboteur” behind your symptoms, schedule a functional evaluation at 77 Wellness (https://77wellness.com)

References:

    1.    Calder, P. C. (2017). Health relevance of the modification of low-grade inflammation in ageing. Mechanisms of Ageing and Development, 165, 31-37. https://doi.org/10.1016/j.mad.2016.11.006  

    2.    Cronin, J. G., & Martin-odrez, P. (2024). Systemic inflammation in midlife is associated with late-life functional limitations. Scientific Reports, 14, 17434. https://doi.org/10.1038/s41598-024-68724-w 

    3.    Khatib, M., et al. (2025). Systemic Chronic Inflammation: Integrative Strategies for Health Improvement and Prevention of Inflammatory Receptor Overexpression. Receptors, 4(1), 5. https://doi.org/10.3390/receptors4010005  

    4.    Puga-Olguín, A., Hernández-Hernández, M. F., Fernández-Demeneghi, R., López-Miranda, C. I., & Flores-Aguilar, L. Á. (2025). Systemic Chronic Inflammation: Integrative Strategies for Health Improvement and Prevention of Inflammatory Receptor Overexpression. Receptors, 4(1), 

    5.    Schmidt, J. M., & Cart, C. (2025). Stress, inflammation, and the functional medicine model. Institute for Functional Medicine. https://www.ifm.org/articles/stress-inflammation-and-the-functional-medicine-model

Functional Approach to Healing:

Inflammation is reversible. By identifying the root cause, we help your body return to balance. Common functional markers include CRP, homocysteine, ferritin, food sensitivity panels, gut mapping, and cortisol rhythms.

Our protocols combine:

    •    Anti-inflammatory nutrition (whole foods, clean proteins, healthy fats)

    •    Targeted supplementation (Omega-3s, curcumin, NAC, antioxidants)

    •    Movement and recovery strategies to regulate stress and improve circulation

    •    Gut and detox optimization to eliminate hidden inflammatory triggers

When we reduce inflammation, energy returns, hormones rebalance, and brain clarity improves.

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Why It Matters:

Root-cause medicine isn’t about silencing symptoms—it’s about asking why they exist and preventing disease before it starts.

Your Labs Are Normal - So Why Do You Feel Terrible?

It’s a scenario we hear every week at 77 Wellness: you go to your doctor, get the standard blood work back, and everything is “within normal range.” Yet you still feel tired. Foggy. Frustrated. What gives?

1. “Normal” doesn’t necessarily mean optimal

Lab reference ranges are based on large population samples — they’re designed to detect disease, not to define thriving health. For example, one article points out that standard normal ranges are too broad to catch early dysfunction. drdaniel.com+1 At 77 Wellness, we look beyond “within range” to the narrower optimal zones that often reveal root-cause dysfunction before full disease sets in.

2. Hidden dysfunctions beyond what standard labs catch

Here are some of the subtle patterns we routinely find when everything appears “normal”:

• Insulin resistance can show up long before glucose is flagged. Conventional labs may call a fasting glucose of 99 mg/dL “normal,” yet functional insight shows this may be a warning sign. Activated Health & Wellness+1

• Thyroid markers like TSH might be inside range, but if they’re at the high end of “normal,” many patients still feel fatigue, cold intolerance or brain fog. Grace Vitality & Wellness

• Low-grade inflammation (such as elevated hs-CRP) or subtle nutrient deficiencies often lurk under the radar of standard testing. Fullscript+1

3. How integrative/functional care at 77 Wellness picks up where conventional labs leave off

At our clinic in Layton, we follow a proactive, root-cause model:

• We use functional labs and interpret them with tighter “optimal” ranges not just the broad “normal” ones. Functional Diagnostic Nutrition+1

• We look at patterns across systems (hormones, metabolism, detox, immune) not just one isolated number.

• We integrate your symptoms, lifestyle, environment and lab pattern to identify dysfunction early — before you’re told a diagnosis or “everything looks fine.”

4. Don’t wait for a diagnosis; take steps now

Your health doesn’t pause for the seasons — whether you’re gearing up for a busy winter or mitigating the effects of less daylight and lower activity, now is the moment.
If you’re still feeling off despite “normal labs,” it’s not time to ignore it. It’s time to get ahead of what’s silently evolving.

At 77 Wellness, we offer the membership model that gives you unlimited visits, functional testing, hormone balance support and whole-body wellness without the insurance hassle.

Feeling stuck? Let’s get you unstuck. Schedule your appointment at 77Wellness.com or call us in Layton today. Because “normal labs” aren’t enough — you deserve optimal health.

References

• Bland JS. “Systems Biology Meets Functional Medicine.” PMC. 2019. PMC

• “Why Standard Blood Tests Miss What’s Really Wrong With You.” HelixSportOKC blog. 2025. Helix Spine & Sport

• “Why Normal Is Not Optimal When Analyzing Blood Test Results.” ODX Research blog. 2021. optimaldx.com

Preparing Your Body and Family for Fall

At 77 Wellness, we call this time of year the Season of Subtraction — less sunlight, less movement, less margin in our routines. Left unchecked, those subtractions add up: lower energy, disrupted sleep, mood swings, and a subtle sense of “off.”

But fall doesn’t have to mean a decline in how you feel. It just means your inputs need to match the season. Here are five powerful, research-backed ways to protect your energy and emotional resilience as we move into darker months.

1. Red Light for Energy and Repair

As UVB and sunlight exposure drop, so does mitochondrial function. That means lower cellular energy, slower recovery, and often, lower mood. Red and near-infrared light therapy (600–850nm) has been shown to support ATP production, anti-inflammatory pathways, and emotional well-being — all critical in fall.

Try this: 10–15 minutes of red light therapy in the morning or early evening using a high-output LED panel. Even better? Pair it with breathwork or morning journaling.

Barolet & Boucher, 2010 — Red light therapy modulates mitochondrial performance and circadian rhythms.

2. Happy Light to Sync Your Circadian Clock

Shorter days delay your body’s natural cortisol release, making it harder to wake up energized and regulate mood. Enter the Happy Light — a 10,000 lux full-spectrum light box clinically shown to help reset your internal rhythm, especially for those prone to seasonal affective symptoms or AM sluggishness.

Try this:

• Use a 10,000 lux light box for 20–30 minutes within 30–60 minutes of waking.

• Place it ~16–24 inches from your face at a slight downward angle (not staring directly into it).

• Pair it with breakfast or morning emails to stack the habit. Works as a great vanity light.

Terman et al., 2006 — Bright light therapy shown to significantly improve seasonal mood disorders and energy levels.

LeGates et al., 2014 — Morning light exposure regulates melatonin suppression and cortisol rhythms.

3. Cold Exposure to Activate Dopamine & Resilience

Even brief cold exposure increases dopamine, norepinephrine, and immune readiness. It’s a natural way to “turn on” your body when you feel foggy or flat.

Try this: End your shower with 30 seconds of cold. Work up to 2–3 minutes. Breathe through it. Bonus: It may help with brown fat activation and glucose regulation.

4. Nourish Neurotransmitters — Not Just Cravings

Lower daylight can dysregulate serotonin and dopamine, leading to more sugar cravings and afternoon crashes. That’s why we’re focusing this fall on foods and supplements that help stabilize mood.

Consider:

• L-tyrosine in the AM (dopamine precursor)

• Magnesium glycinate PM (sleep + mood)

• Saffron extract 15–30mg daily (mood + anti-inflammatory)

• Prebiotic-rich foods for gut-serotonin support

5. Build a Morning Cortisol Window

If you’re waking groggy or wired-tired, your cortisol peak may be misaligned. Your brain needs light, movement, and consistency to keep your rhythm sharp.

Try this:

• Step outside within 30 minutes of waking

• Get real sunlight (even on cloudy days)

• If you can’t get outside — combine your Happy Light + light movement indoors

• Add grounding (barefoot on concrete or grass for 2 minutes) to support HRV

What We’re Seeing at 77 Wellness

• Normal labs but tired, foggy patients (stay tuned — next week’s topic)

• Low morning cortisol and sluggish circadian rhythm

• Fatigue tied to serotonin/dopamine imbalance — not just “too busy” schedules

• Vitamin D deficiency already climbing across both adults and kids

Final Thought

You can’t wait for spring to feel like yourself again. Fall health isn’t about avoiding illness — it’s about adding intentional inputs to counter what nature subtracts.

Try one: Happy Light, Red Light, Cold Water, Morning Light, or Neuro-Support
Then tell us what shifts for you.

Next Week:

“Your Labs Are Normal — So Why Do You Feel Terrible?”
We’ll unpack the myth of “normal ranges,” hidden dysfunctions we see every week, and how functional care picks up where standard testing leaves off.

Your health doesn’t pause with the seasons — and neither should your care.
Don’t wait until symptoms start. Come see us or schedule your appointment now to get ahead of the season and feel your best.

This content is for informational purposes only and does not constitute medical advice. Please consult your provider for personalized recommendations

Two-Minute Tuesdays with Kim

The Season of Change

Every week in clinic, I see the same pattern — small daily habits make the biggest impact on how we feel. That’s why I created Two-Minute Tuesdays: short, science-based insights you can read in under two minutes to help you take better care of yourself and your family. Each post will give you something simple and useful — tips on nutrition, hormone balance, immune support, supplements, and everyday wellness that you can actually apply. I’ll also share what I’m noticing season-to-season in our 77 Wellness community — what nutrients we’re low on, what routines are helping people feel their best, and practical ways to stay healthy in Utah’s changing climate.

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Why Two Minutes

Because wellness shouldn’t feel overwhelming. You don’t need another hour-long podcast or endless article — you need trusted guidance, delivered simply. My goal is to make 77 Wellness not just where you get care, but where you learn how to care for yourself.

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Coming Up Next Tuesday

Preparing Your Body (and Family) for Fall
How to protect energy, immunity, and sleep as sunlight fades.

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Stay Connected

Each week, you’ll find a new Two-Minute Tuesday post right here on the blog — quick, science-backed tips you can actually use to feel your best. If you’d like more personalized guidance, learn how Direct Primary Care at 77 Wellness can help you stay healthy year-round. Visit 77Wellness.com to explore membership options or schedule your first visit.

Prevention isn’t seasonal—it’s personal

Kimberly Greaves, FNP-C
Founder, 77 Wellness Direct Primary Care