12 | When Your Hormone Therapy Isn't Working: A Deep Dive into Optimization with Dr. Jila Senemar

Have you been on hormone therapy for months (or even years) but still feel terrible? If you're dealing with brain fog, 3 AM wake-ups, energy crashes, and that stubborn weight around your middle despite being on HRT, this conversation is exactly what you need to hear.

I sat down with Dr. Jila Senemar, and honestly, this interview changed how I think about hormone optimization. We talked about why so many women are being undertreated, why your doctor might not be checking your levels, and what truly optimal hormone therapy looks like.

Are you ready to awaken your sensuality and feel more empowered in your body? Access the FREE Pleasure Upgrade Bundle at https://www.pleasureinthepause.com/gift.

Dr. Jila Senemar, M.D., FACOG is a board-certified obstetrician and gynecologist with over 20 years of experience who has become one of the leading voices in menopause optimization. She's the founder of JilaMD, a concierge practice in Miami specializing in personalized hormone therapy, metabolic optimization, and longevity science. Dr. Jila is also the founder of the Miami Menopause Collective, where she collaborates with women to create truly individualized treatment plans. What sets Dr. Jila apart is her commitment to helping women thrive—not just manage symptoms—in their second half of life through evidence-based, personalized care.

Highlights from our discussion include:

• The four pillars of HRT - estrogen, progesterone, testosterone, and vaginal estrogen - and why each one matters
• What to do when HRT isn't working - Dr. Jila's detective process for troubleshooting failed hormone therapy
• The controversial truth about hormone levels - why so many women are actually undertreated and what optimal ranges really look like
• How to personalize and optimize your protocol as your body evolves through different life stages
• The metabolic connection - cutting-edge insights on how hormones and metabolism work together
• The holistic approach - why lifestyle factors and emotional healing are just as important as the hormones themselves
• How to advocate for better care and ask the right questions to get the optimization you deserve

If you're seeking to reclaim your pleasure and vitality, join Gabriella at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

CONNECT WITH DR. JILA:

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Instagram

LINKS MENTIONED:

The Menopause Society

Dr. Mary Claire Haver

CONNECT WITH GABRIELLA ESPINOSA:

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LinkedIn

Work with Gabriella!

Full episodes on YouTube.