When you're a woman in your 40s diving deep into your hormones, you are ahead of the game. That's HOT. You are in the critical window for intervention, which is exactly the point of the article. You do not have to wait until things get worse or until someone finally decides you qualify for help, because we all know that's ridiculous, dismissive, and unacceptable.

On the question of finding a practitioner... the short answer is: look for someone who is willing to treat you, not just follow an outdated protocol. Someone with curiosity and open mindedness, i.e., willing to change their mind based on new data or information. You want a clinician who takes symptoms seriously, understands perimenopause, knows the difference between oral and transdermal therapy, thinks about sleep, mood, cognition, bone, metabolism, and sexual health together, and is willing to titrate rather than leave you stranded on a starter dose forever.

I would interview them the way you would interview anyone joining an important team. Ask how they approach perimenopause, whether they prescribe transdermal estradiol and micronized progesterone when appropriate, how they use testosterone in women, and what they do when symptoms persist despite “normal” labs.

A good clinician will not get defensive when you ask informed questions. They will get thoughtful.

This Sunda, I will talk more about this topic in our LIVE at 4pm PT. I’m writing more soon on how to find the right practitioner, because far too many women are having to solve this alone and that must end.