Menopause &Perimenopause Care

Perimenopause can start in your late thirties and run for a decade before your last period, and most of it happens while routine bloodwork still looks unremarkable. Estrogen and progesterone do not fall in a straight line, they swing, and the swing is what produces the sleepless nights, the temper you do not recognise and the weight that arrives around the middle without any change in how you eat.

Signals Worth Testing

• Hot flashes, night sweats or waking at two in the morning
• Periods that shorten, lengthen, vanish and return
• Anxiety or irritability that feels chemical rather than situational
• Brain fog, lost words, trouble holding a thread
• Weight gain concentrated around the abdomen
• Vaginal dryness, low libido or discomfort with intimacy
• Joint aches and skin or hair changes

What Gets Measured

Evaluation starts with a panel covering estradiol, progesterone, FSH, LH, testosterone and DHEA, alongside a full thyroid panel, fasting insulin and inflammatory markers. Thyroid and hormone symptoms overlap heavily in this decade, and treating one while the other is off is the most common reason women stay symptomatic.

How It Gets Treated

Where testing supports it, bio-identical hormone replacement therapy restores levels toward an optimal range using doses calibrated to your labs and revisited at every re-test. Where it does not, the answer is usually thyroid, insulin, adrenal or nutrient related, and the plan goes there instead. The point of testing first is to find out which conversation you are actually having.

Common Questions