When we think about hormone balance, it's easy to focus on how much estrogen your body is making. Equally important, however, is how well your body metabolizes and eliminates estrogen. Healthy estrogen clearance depends on three major systems working together
If you’ve reached perimenopause and suddenly feel like you just can’t handle stress the way you used to, you’re not imagining it. Maybe you’re waking up at 3:00 a.m. with your mind racing. You’re exhausted in the afternoon but somehow get a “second wind” at bedtime. Your anxiety feels heightened, your body composition is changing, or you simply feel more easily overwhelmed by things that wouldn’t have rattled you a few years ago. There are many reasons this can happen during the menopause transition, but one important piece of the puzzle is cortisol.
In this blog, I share my inside story on perimenopause. At Tendwell, we can. help.
A lot of my patients in their 40s and 50s have progesterone-releasing IUDs such as Mirena, Liletta, Kyleena, or Skyla. These devices can be incredibly helpful during the reproductive and perimenopausal years, but one question comes up frequently in my practice . . .
If you’ve lived with premenstrual dysphoric disorder (PMDD), you already know how powerful hormone shifts can be on mood, energy, and cognition. Then perimenopause begins—and many women are caught off guard when their symptoms change.
Understanding that difference between vaginal and transdermal estradiol can make hormone therapy feel much clearer and more intentional.
If you’re in perimenopause or menopause and feel like you’ve been told “you’re fine” — but you don’t feel fine — you’re not crazy. Find out why many doctors are not properly trained to help.
If you’re wondering whether hormone therapy is right for you, we’re here to guide you through the decision with nuance, safety, and personalization.
At Tendwell, we spend a lot of time helping women understand what’s actually happening hormonally in their 40s (and sometimes late 30s), and how hormone therapy can help when used thoughtfully, individually, and at the right time.
Life is marked by transitions—some expected, others abrupt. New roles, shifting hormones, changing responsibilities, and evolving priorities all ask something different of our bodies. At Tendwell, we see these transitions not as problems to fix, but as invitations to listen more closely to what your body needs now.
When we talk about menopause, we often focus on hot flashes, sleep disruption, or weight changes. But there’s another category of symptoms that deserves far more attention: mood changes.
As women move through perimenopause and menopause, one of the most common changes we see on lab work is a noticeable rise in cholesterol levels—sometimes for the first time in a woman’s life. This shift can feel surprising or concerning, but it’s actually a well-documented and physiologically understandable part of the menopausal transition.
As estrogen levels begin to fluctuate and drift downward in perimenopause, many women notice changes they didn’t expect—more irritation, new (or recurrent) yeast infections, increased discharge, or episodes of bacterial vaginosis (BV) that feel out of nowhere. These symptoms can be frustrating, uncomfortable, and often surprising, especially for women who never struggled with vaginal health before.
Bone health becomes a key focus during perimenopause and menopause, when declining estrogen levels can lead to bone loss and a higher risk of osteoporosis. Many women are now asking about vibration plates (also called whole-body vibration therapy) — do they really work?
With all the changes our bodies experience during the menopause transition, one issue raises more questions, frustrations, and self-doubt than almost any other: the new accumulation of fat around the midsection — often called belly fat.
Recently a popular media piece (e.g., in the The New York Times “Sunday Read”-style coverage) spotlighted women receiving testosterone pellets and portrayed it in very dramatic terms. Yes, there are real benefits of testosterone (T) for women — especially in the context of perimenopause/menopause — but the “miracle cure” narrative is misleading and may gloss over important risks and proper practice.
Perimenopause is one of the most transformative stages in a woman’s life. It’s a time when hormone patterns begin to shift, the body starts to recalibrate, and symptoms can emerge that make you feel — quite simply — different than you used to.
Too many women are still being denied hormone therapy, even in 2025. I hear heartbreaking stories all the time: women in their 40s and 50s with classic menopausal symptoms—hot flashes, night sweats, insomnia—turned away by their clinicians.
When women think about hormone replacement in menopause, the conversation often centers on estrogen. Estrogen therapy can reduce hot flashes, protect bones, and support overall wellbeing. But what about progesterone?
Have you been struggling with vague, persistent symptoms — brain fog, fatigue, sinus congestion, anxiety, dizziness, gut issues — and have been told, “Your labs are fine” or “It’s just stress”? If that sounds familiar, you’re not alone — and it’s possible that mold exposure is part of the picture.