Anne-Marie shares the brutal perimenopause story that pulled her into this beat — years of nightmares, anxiety, gut issues, ER visits for chest pain and headaches, and a parade of doctors who never said the word "perimenopause." She and the Hindmarshes unpack why this is a clinical diagnosis, not a lab diagnosis, and why a single hormone panel is a snapshot of a movie that's swinging wildly day to day. The conversation lands hard on a key point: if your life was working a year ago and now it isn't, you don't need a blood test — you need someone to guide you through it.

From there, the episode digs into the hormone-therapy pendulum. Anne-Marie walks through at least ten different prescribing belief systems — from estradiol-maximalists to Ray Peat-style progesterone-first practitioners to rhythmic physiologic dosing — and why the claim that HRT prevents dementia and cardiovascular disease isn't supported by the evidence (the 2024 Lancet Commission on Dementia notably did not recommend it). They tackle the relative-risk-vs.-absolute-risk shell game that lets influencers and clinicians dress up modest data as "whopping" reductions, the cradle-to-grave logic problem of birth control followed by lifelong HRT, and why doctors-as-influencers is becoming a public health concern of its own. The episode closes with the unglamorous fundamentals — sleep, nervous system regulation, fascia work, and finding a clinician who treats the whole person — and where to find Anne-Marie's reporting.

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