A woman went to her doctor in her late 30s. Not sleeping, anxious in ways that felt unfamiliar, sad without knowing why, felt old before her time. Her doctor offered her an antidepressant, and the birth control pill. No hormone panel or conversation about what perimenopause does to the brain.

That woman was me.

I am not saying I didn't need help, I am saying the question of whether my symptoms had a hormonal explanation was never asked. That set me on this path to change how women are cared for from 35 on because those are different failures with different solutions.

Today's essay is about what was missing from that appointment, what the science actually tells us, and how we find a better way.