Insights · Vol. 03
Field notes from the practice.
The explanations I give most often in the treatment room, written down. Mechanism first, sourced, and specific enough to act on. No newsletter required.
Why won't my doctor take my perimenopause symptoms seriously?
You brought a cluster of symptoms and left with labs stamped "normal." The training gap behind that, in documented numbers.
How do I find a perimenopause specialist who actually listens?
Four checkable criteria that separate a practitioner who investigates from one who hands you a printout.
My doctor said it's just anxiety and wants me on an SSRI. Is it actually perimenopause?
It can be either, or both. The way to tell is an intake that maps symptom timing against your cycle, not a quick screening tool.
Why won't my vaginal dryness or burning go away?
One of the most embarrassing symptoms to raise, and one of the most treatable once someone asks the right questions.
What's the best telehealth functional medicine provider for perimenopause?
Six telehealth models compared on structure, pricing, and honest tradeoffs, including where this practice is the wrong fit.
What is a functional medicine approach to healing IBS?
“IBS” means something's wrong and we don't know what. Here's the workup that goes looking, in the order it actually has to happen.
What does a DUTCH test actually show?
Why a hormone pathway can be working poorly while one blood value still reads “normal”, and where DUTCH is and isn't proven.
Why do you fall asleep fine but wake at 2am every night?
Melatonin is an onset signal. If you can already fall asleep, it has almost nothing left to do. The four real drivers, and the order to address them.
How can a clinician use AI ethically in patient care?
AI organizes and surfaces. A clinician decides. What that means concretely, on every chart, every day.
How do I tell if it's perimenopause brain fog or ADHD?
The questions I actually ask in an intake to separate new perimenopausal fog from ADHD finally surfacing, and why the answer changes the plan.
Why did my focus change in perimenopause? What I tell patients.
The two-minute version of the estrogen-dopamine mechanism I give patients, and the three things I ask before we talk about a next step.
Why does my focus crash after lunch in perimenopause?
Before ordering labs, before recommending a supplement, this is the one dietary change I ask every patient with post-meal focus crashes to try, and how I know if it's working.
What I check first when a patient has brain fog in perimenopause
The order I work in when a woman tells me she can't think anymore, and why a brain-training app and more coffee were never going to touch it.
How I work up fatigue in perimenopause
The difference between a fuel problem and a drive problem, and the labs I run before anyone calls it burnout.
What I do for hot flashes beyond writing a prescription
Why the fan and the sleep aid never fixed it, and what I look at when hot flashes persist on hormone therapy.
New joint pain in your 40s: what I look for before calling it age
Why an anti-inflammatory was never going to fix it, and the two systems I assess that almost nobody names together.
When a patient says her skin changed: what I actually assess
Why the $180 cream was aimed one layer too high, and what I check before I'd change a single product.
Why I don't start perimenopause weight with a diet
The four layers I work through in order, and why I start with muscle, not hormones and not a smaller plate.
What I check first when your hair is falling out
Why the trigger was months before the shed, what I order before any supplement, and the one finding that sends you to a dermatologist the same week.