@stephanie_misanik: It’s World Menopause Day, October 18, and here’s what I want every woman in her 40s to hear: you’re not imagining it. Perimenopause isn’t just hot flashes. It can show up as sleep that falls apart, new anxiety or a body that suddenly recovers differently. What I wish more women knew: Your hormones start shifting long before your last period. A Nature Medicine study of more than a million women found estradiol starts falling about 12 years before the final period. Still getting a period doesn’t rule out perimenopause. 40 to 60% of women report sleep problems around menopause. Bone loss speeds up about a year before your last period. Testosterone matters for women too. By 40, levels can be about half of what they were at 21. Estrogen, progesterone and testosterone all shift, and all three deserve a look. Good care tests them, trends them over time and treats to optimal levels, then checks whether you actually feel better. Comment LABS and I’ll send you the full lab list. Nava’s discounted intake bundle is $249 through the link in bio. It includes 70+ labs, 1 hour with a medical provider and 1 hour with a licensed nutritionist. Our medical providers and licensed nutritionists have over 13 years of experience in hormones and root cause medicine. Sources: doi:10.1038/s41591-026-04614-0 doi:10.1210/jc.2011-3362 doi:10.1016/j.jsmc.2018.04.011 doi:10.1002/jbmr.534 Zumoff B, et al. J Clin Endocrinol Metab. 1995;80(4):1429-1430. PMID 7714119 #worldmenopauseday #perimenopause #menopause #womenshealth #hormonehealth

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