Symptoms & Diagnosis

Menstrual migraine is triggered by estrogen falling, not by its level — which is why perimenopause is often the worst phase. Why these attacks resist treatment, and the short-term prevention most women are never offered.

Morning facial puffiness and evening ankle swelling are different mechanisms with different fixes. How to identify your pattern in a week, what the drainage industry gets wrong, and the signs that need a doctor.

Adrenal fatigue is not a recognised diagnosis — but the exhaustion is real. What is usually happening is a flattened cortisol curve with normal total output, and that shape is what produces tired-but-wired.

TSH runs to 4.5 in most labs while over 95% of genuinely healthy people sit below 2.5. What subclinical hypothyroidism means, the two tests usually missing, and the symptoms that lean thyroid over perimenopause.

Bloating that builds through the day means something different from bloating that tracks your cycle. Four distinct mechanisms, how to tell which is yours in one week, and the red flags that need a doctor.

Waking at 3am with clockwork consistency is not random insomnia. Three mechanisms drive it — a nocturnal glucose dip, alcohol rebound, and the progesterone-GABA effect — and each has a different fix.

Perimenopause commonly starts around 40, and the early phase is erratic hormone output rather than steady decline. The early signs at 40, what needs assessment instead, and why blood tests rarely answer the question.

Estrogen dominance describes a ratio, not a level — and in your forties it is usually progesterone falling rather than estrogen rising. Which symptoms genuinely indicate it, which prove nothing, and how to test properly.