Journal
Hormones, symptoms and the research behind them, written so they make sense even when you are reading at 3am. Every article cites its sources and says when to see a GP.
A heart that suddenly races at 3am, or thuds during a hot flush, is one of the most frightening perimenopausal symptoms and one of the least talked about. What is going on, and when to get it checked.
Twenty years of headlines have left most women confused about HRT. This is a plain summary of what the studies found, what changed on reanalysis, and how UK prescribing looks now.
It is the symptom cluster nobody mentions to their GP, and it does not improve with time. It is also one of the most treatable parts of the whole transition.
For the first time there are drugs that stop hot flushes at the source in the brain without using hormones. How they work, what the trials found, and who they might suit.
"Your bloods are normal" is one of the most common and least helpful sentences in perimenopause. A single hormone reading can't settle the question. This explains why, and which tests are worth asking for.
Testosterone is the hormone most often left out of the perimenopause conversation. Here is what it does in women, how it declines, and where the evidence for replacing it starts and stops.
Wired but tired. Jolted awake before dawn. Overreacting to small things and unable to switch off. Cortisol is doing what it always did. What changed is what used to hold it in check.
Most people expect periods to fade out. For many women they get dramatically heavier first. The explanation is a cycle without ovulation, and it is worth understanding.
Stiff hands in the morning, a shoulder that will not lift, knees that complain on the stairs. In 2024 researchers proposed a name for this cluster and made the case that it is hormonal.
"It'll pass" is not a plan. The SWAN study followed thousands of women for decades and put numbers on how long the transition, and its symptoms, really last.
Nothing is wrong, and yet your heart is going and your mind is racing. Perimenopausal anxiety has a mechanism, and it starts with a progesterone metabolite most people have never heard of.
The word is on the tip of your tongue and then it is gone. Brain fog is one of the most alarming perimenopausal symptoms, and one of the best studied. The research is more reassuring than you might expect.
If your worst week keeps arriving just before your period, you are watching the late luteal phase at work, and in perimenopause it gets louder. Why that happens, and what to do with the pattern.
A hot flush starts with the brain's thermostat, and the skin only reports it. Your brain's tolerance for small changes narrows, and the fix is to widen it again.
For years, perimenopause means erratic oestrogen, with peaks above anything you had in your thirties and crashes to match. The swing is what you feel.
CBT sounds like an odd hot flush treatment. Two UK trials and the 2024 NICE guideline say it works. What it involves, and what it can and cannot do.
Wide awake at 3am, heart going, mind racing. There is an overnight sequence that produces it, and once you can see it, it makes sense.
Long before oestrogen drops, progesterone quietly goes missing. It is the hormone behind a surprising amount of early perimenopause, and the one least often talked about.
Magnesium is suggested for sleep more than almost anything else. The evidence is real but modest, and the details matter: the form, the amount, and whether you test it properly.
Perimenopause is a stretch of years, often starting in your early forties, when your hormones change long before your periods stop.
Hormones explained
Progesterone, oestrogen, cortisol and testosterone, explained one at a time.
7 articles
Symptoms
What is happening when you wake at 3am, forget a word, or feel your heart race.
6 articles
Research & findings
New papers, new drugs and updated guidelines, explained in everyday language.
4 articles
Treatments
HRT, CBT, supplements and the other options, weighed against the evidence.
3 articles
Living with it
Practical ways to make the years before your last period easier.
0 articles
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