Tired? Perimenopause. Irritable? Perimenopause. Can't remember why you walked into the kitchen? Obviously perimenopause.
But sometimes it is perimenopause. And sometimes you are sleep deprived, iron deficient, chronically stressed, dealing with subclinical thyroid dysfunction, or enjoying a delightful combination platter of all of the above. And that is why the investigation cannot stop at the first answer that sounds plausible.
This is the woman I increasingly see in clinic. Late 30's or early 40's. Exhausted in a way that more sleep does not fix. Reactive. Foggy. Achy. Her cycle has changed. Her body does not feel like hers anymore. She has googled it, Instagram has gotten involved, and within approximately fourteen minutes she has perimenopause. She might be right. But I don't want the investigation to stop there.
In this episode:
What perimenopause actually is and why it can start earlier than most women realise
Why perimenopause is increasingly colliding with active motherhood, and why the timing is tricky to make a diagnosis
The full symptom picture, including the ones nobody warned you about
What else can look exactly like perimenopause
Why I don't want us to replace "of course you're tired, you have kids" with "of course you feel terrible, you're in perimenopause" - you deserve a more thorough answer than that
What I actually investigate in clinic before landing on a diagnosis
The boring stuff that really helps
Why protein becomes particularly important at this stage and what target I work towards
The soy conversation, what the evidence actually says, and why she has been wrongly accused of several crimes
Why resistance training specifically matters for muscle mass, bone density, and metabolic health
Where HRT fits
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