Editorial Health Guides

Evidence-based health guides

16+ articles by hormonal health. Reviewed by board-certified OB/GYNs. Updated quarterly.

Menopause

5 guides

Stages of menopause: a complete timeline

Menopause unfolds in 3 stages: perimenopause (cycles change, can last 5-10 years), menopause (12 consecutive months without period), and postmenopause (everything after).

Hot flashes: what causes them and how to manage

Hot flashes result from estrogen-driven dysfunction in the hypothalamus, your body's thermostat. Triggers include caffeine, alcohol, spicy food, and stress.

How long does perimenopause last?

Perimenopause lasts on average 4-8 years. Some women have a shorter 2-year transition; others experience symptoms for 10+ years before final menstrual period.

HRT eligibility: are you a candidate?

Most healthy women under 60 OR within 10 years of menopause are candidates. Contraindications: active breast cancer, recent VTE, unexplained vaginal bleeding, active liver disease.

Non-hormonal menopause treatments

Paroxetine 7.5mg (only FDA-approved). Fezolinetant (Veozah) — NK3 antagonist, 60-65% VMS reduction. SSRIs/SNRIs off-label. Gabapentin for night sweats specifically.

Perimenopause

4 guides

First signs of perimenopause: what to expect

The earliest signs are shorter cycle length, heavier flow, sleep disruption, and mood changes. Hot flashes come later for most women.

Why perimenopause causes weight gain (and what to do)

Declining estrogen redistributes fat from hips to abdomen, insulin sensitivity drops, and muscle mass declines ~1% per year — all compound to make weight gain easier and harder to reverse.

Perimenopause sleep issues: why and what to do

Fluctuating estrogen disrupts circadian rhythm and serotonin/melatonin balance. Night sweats wake you 1-3× per night. Anxiety + brain fog compound difficulty falling back asleep.

Birth control during perimenopause

Yes — ovulation continues unpredictably up to 12 cycle-free months. Combined OC suppresses symptoms + provides contraception. IUD + mini-pill alternatives for women with cardiovascular risk.

HRT

3 guides

Estrogen types: patch vs gel vs pill vs ring

Transdermal (patch/gel) bypasses liver and has lowest clot risk. Oral estrogen is convenient but increases clot risk. Vaginal rings and creams treat local symptoms without systemic effects.

HRT side effects: common, rare, and serious

Common (>10%): breast tenderness, bloating, spotting, mood changes — usually resolve in 1-3 months. Serious but rare: VTE (transdermal lowest risk), gallbladder issues, breast cancer increase with long-term combined therapy.

How long can you stay on HRT?

NAMS 2022: continue as long as benefits outweigh risks. Most women 5-10 years. No fixed stop date. Re-evaluate annually with clinician.

PCOS

2 guides

The 4 PCOS phenotypes: which one are you?

PCOS has 4 Rotterdam-defined phenotypes (A, B, C, D) based on combinations of androgen excess, ovulatory dysfunction, and polycystic ovaries. Phenotype affects treatment choice.

Insulin resistance in PCOS: testing and treatment

Fasting insulin >10 µIU/mL, HOMA-IR >2.5, or OGTT with 2-hour insulin >75. Phenotype A (full Rotterdam) has highest IR rates — 70-95%.

GLP-1

2 guides

GLP-1 side effects month-by-month: what to expect

Month 1-2: nausea peaks (60-80% of users), then resolves. Month 3-6: GI mostly settles, weight loss accelerates. Month 6+: side effects rare; maintenance dose.

GLP-1 weight loss plateaus: what to expect

Most users plateau at 12-18 months as appetite suppression equilibrates. Average weight loss caps at ~15% (semaglutide) or ~22% (tirzepatide). Continued therapy maintains loss.

Red flags reference Treatment timeline A-Z index