The Perimenopause & Hormone Guide — What Nobody Told You About Your Hormones and What to Do About It

Perimenopause is not a disease. It is a biological transition — one that medicine has been slow to explain to women. Most spend years experiencing its symptoms without knowing what is happening, why, or that there is a great deal they can do about it. This is the information you should have been given at 35.

UPDATED JULY 2026 — now includes the FDA's removal of the boxed warning from menopausal hormone therapy, from the November 2025 announcement through to the first approved label changes in February 2026, and what that does and does not mean.

WHAT'S INSIDE

What perimenopause is and when it starts — the SWAN study timeline, why symptoms can begin in your mid-30s, and the six primary symptoms explained by their hormonal mechanisms: sleep disruption, anxiety, brain fog, irregular cycles, body composition change, and hot flushes.

Hormone therapy — the evidence you were never given — what the 2002 WHI study actually tested, why its findings were applied far more broadly than the data supported, what the 2019 Lancet meta-analysis of over 100,000 women found, and the 2025–26 labelling change in full. Low-dose vaginal oestrogen is covered separately, because its risk profile is genuinely different.

Lifestyle medicine for hormonal transition — resistance training, protein, phytoestrogens, supplementation with published safety limits stated plainly, and the single most impactful modifiable factor most women overlook.

Conversations to have with your doctor — the specific questions to ask, written out, so you walk in prepared.

Every claim is referenced. Where the evidence is thin or contested, the guide says so. Written by a woman who read the research, not a clinician — and it says that on page two.

THIS GUIDE IS FOR YOU IF

• You are in your late 30s or 40s and your body has changed without explanation
• You have been told your symptoms are normal, or just stress
• You want to understand your hormones before your next appointment
• You are considering hormone therapy and want the current evidence rather than the 2002 headlines

Please note: the healthcare access section is written for the United States. The biology, evidence and questions apply anywhere.

Instant download. 12 pages, A4, black and white. Print at home or read on screen. Educational only — not medical advice.