Guides

63 in-depth guides — written by Rose as she lives through perimenopause herself. Evidence-graded, honest, and specific.

Rose

"These are the pages I wish had existed when I needed them. Start with the serotonin page if your mood has changed. Start with the HRT story if you have been told to be afraid of hormones. Start with Start Here if everything feels overwhelming."

⭐ Essential reading

12 guides

Start here — these pages explain the most important things first

What stage am I in? — Take the quiz

Six questions. Rose tells you whether you are in perimenopause, late perimenopause, or postmenopause — with personalised next steps.

Your personalised priority plan

11 questions. Rose builds you a specific action plan — your top three priorities, the right guides to read, and a supplement shortlist matched to your symptoms.

Perimenopause symptoms checklist

All 64 perimenopause symptoms in one interactive list. Tick what you experience, email it to yourself, and bring it to your appointment.

Perimenopause symptoms checklist

All 64 symptoms in one interactive list. Tick what you are experiencing, print it, and bring it to your appointment.

Start here — the three stages

Perimenopause, menopause, postmenopause — what each stage means, when it starts, and what to expect.

Is this perimenopause?

Anxiety overnight, sleep disrupted, mood changed, periods different. The complete guide if you are in your 40s and things feel different.

What is happening to my periods?

Heavier, lighter, flooding, skipped — the #1 first sign of perimenopause. Rose explains exactly what is happening and why.

Your gut makes your mood

95% of serotonin is made in your gut. When menopause disrupts the gut it disrupts mood, anxiety, sleep, and brain fog.

Your gut bacteria are recycling your estrogen

The estrobolome reactivates estrogen your liver packages for disposal. Antibiotics, parasites, and poor diet disrupt it — costing you estrogen twice.

The HRT story — what really happened

The 2002 study that scared women away from HRT had serious flaws. The full story in plain language.

HRT and breast cancer risk — the honest numbers

The fear that stops women getting treatment. What the absolute risk actually is, why formulation matters enormously, and what the evidence says for women with a breast cancer history.

Ferritin — the test your doctor probably skipped

Exhausted, hair thinning, brain fog, cold all the time — your lab says normal. But normal ferritin (12+) is survival level. Optimal is above 70. Most women are nowhere near it.

🧠 Body and mind

27 guides

Understanding what is happening at every stage

Postmenopause — life after the transition

What changes after 12 months without a period — what eases, what needs attention, the five health priorities, and HRT questions answered.

Emotional health

Mental health and emotional support

Anxiety, depression, rage, and mood swings — what is happening neurologically and what evidence-backed approaches help.

Gut health and digestion

Bloating, the estrobolome, gut permeability — how menopause disrupts the microbiome and what actually helps.

Skin, hair and nail changes

Collagen falls 30% in five years. Hair thinning, skin changes, brittle nails — the hormonal cause and evidence-backed interventions.

Early menopause and POI

Before 45 and before 40 — causes, long-term risks, and why HRT is essential not optional for younger women.

Surgical menopause

Menopause from oophorectomy, chemotherapy, or radiation is immediate and severe. HRT afterwards is essential health protection.

High cholesterol and menopause

LDL rises 10-20% at menopause as estrogen reduces liver LDL clearance. Transdermal HRT reduces it by 10-15%. The mechanism, the markers, and the interventions.

Hypertension and menopause

Blood pressure rises sharply at menopause as estrogen reduces nitric oxide and activates RAAS. HRT, exercise, DASH diet, and why ACE inhibitors are the better antihypertensive choice.

Adrenal and HPA axis dysfunction in menopause

The 3am wake, morning anxiety, fatigue sleep does not fix, abdominal weight — these are a connected picture of HPA dysregulation. Rose explains the cortisol story fully.

Osteoporosis and bone health at menopause

1 in 2 women over 50 will fracture. Bone loss begins silently in perimenopause. HRT, resistance training, vitamin D, and DEXA — the full prevention picture.

Pelvic floor health at menopause

Leaking, urgency, prolapse — affecting more than half of menopausal women and massively undertreated. Specialist physio reduces incontinence 70%. Rose covers everything.

Thyroid and menopause — the overlap that is constantly missed

Fatigue, brain fog, cold intolerance, hair loss — both hypothyroidism and perimenopause. TSH alone misses the picture. Rose covers the right tests and every treatment.

Fibromyalgia and menopause

Widespread pain worsening at perimenopause — driven by estrogen loss removing pain-modulatory support. HRT, exercise, SNRIs, and the sleep connection.

ADHD and menopause

Estrogen compensates for ADHD's dopamine deficit. When it falls, coping strategies collapse. Undiagnosed ADHD is unmasked. Rose covers the full picture.

Endometriosis and menopause

Women with endometriosis can usually take HRT — but formulation matters. Continuous combined with micronised progesterone. The nuanced picture most women are never given.

Weight gain and metabolism at menopause

The abdominal weight gain of menopause is hormonal — estrogen loss, insulin resistance, reduced metabolic rate. HRT, resistance training, and protein are the tools.

Dementia prevention at menopause

2 in 3 dementia cases are in women. HRT within 10 years of menopause, exercise, sleep, and MIND diet all reduce risk. The timing window is now.

Brain fog — the neurological symptom nobody explains

Forgetting words mid-sentence, walking into rooms not knowing why. Brain fog is neurological not psychological, has specific causes, and is almost entirely reversible.

Hormonal acne in perimenopause

Jawline cysts appearing in your 40s are hormonal — driven by relative androgen excess as estrogen falls. Causes and every evidence-graded treatment.

Frozen shoulder and menopause

Adhesive capsulitis is 3-4x more common in women, peaks at 40-60, and is driven by estrogen loss — but almost never connected to menopause by doctors.

Restless legs and menopause

The crawling urge to move your legs at night — worse in perimenopause. Iron, dopamine, progesterone, and what actually helps including why normal ferritin is not enough.

Burning mouth syndrome and menopause

A scalding sensation on the tongue and lips with no visible cause. Driven by estrogen loss, B12, iron, and central pain changes — and rarely diagnosed correctly.

Body odour changes in menopause

A different, unfamiliar smell — not a hygiene problem. Hot flash sweat, skin pH shifts, and vaginal microbiome changes. What is happening and what helps.

Dental and gum changes in menopause

Bleeding gums, dry mouth, jaw bone loss, and tooth loss are all driven by estrogen. Women on HRT have 30-40% lower tooth loss rates — almost nobody is told this.

Recurrent UTIs and menopause

UTIs that keep coming back are driven by estrogen loss. Vaginal estrogen reduces recurrence by 50-70% and outperforms antibiotics — and most women are never told this.

Histamine intolerance and menopause

Wine that used to be fine now gives headaches. Flushing, palpitations, sinuses. Histamine intolerance worsens in perimenopause — the estrogen-DAO connection explained.

Temperature dysregulation — feeling cold in menopause

The flip side of hot flashes nobody talks about. Post-flash chills, cold sensitivity, temperature oscillations — one destabilised thermostat, both directions.

💪 Lifestyle

6 guides

The daily habits and choices with the strongest evidence

Strong evidence

Exercise and strength training

The single most evidence-backed lifestyle intervention — resistance training, aerobic exercise, HIIT, and yoga.

Sleep — why menopause breaks it and how to fix it

Night sweats, 3am waking, cortisol spikes, lost progesterone. Six causes, a full nightly protocol, and every intervention.

Alcohol, refined sugar, ultra-processed food, caffeine — how these specifically worsen your symptoms and what to do instead.

Alcohol and menopause — the honest picture

Alcohol worsens hot flashes, sleep, mood, anxiety, weight, and breast cancer risk. The mechanisms, the evidence, and how to reduce it.

Dietary patterns for menopause

Mediterranean, Galveston, low-glycaemic — the approaches with the strongest evidence and what each one emphasises.

Simple recipes built around the foods Rose recommends — each tagged by what it helps and explained by why it works.

💗 Relationships and life

4 guides

Navigating menopause in the context of your work, relationships, and daily life

Vaginal dryness and GSM

The most underreported menopause symptom. Affects 50% of postmenopausal women. Unlike hot flashes it worsens without treatment — and is fully reversible with local estrogen.

Relationships and menopause

Libido changes, painful sex, emotional distance — what is happening, what is treatable, and how to have the conversations.

The partner's guide to menopause

For your partner — what is happening, what to say, what not to say, and how to actually help.

Menopause at work

Brain fog in meetings, hot flashes in presentations. Managing symptoms, whether to disclose, and your legal rights.

🩺 Medical and tools

14 guides

Navigate the medical system, understand your options, and read your results

Types of HRT — patches, gels, body-identical progesterone

Patches vs gel vs tablets, micronised progesterone vs synthetic progestins — the differences matter. Rose explains every formulation.

Progesterone — the hormone that drops first

Your natural sleep aid, anxiety buffer, and mood stabiliser. It drops before estrogen — and its loss drives some of the hardest early symptoms.

HRT and mood — the neurological case

Anxiety, rage, and depression in perimenopause are neurochemistry — not psychology. Why HRT is often the most direct treatment, and the conversation to have before antidepressants.

Estrogen — E1, E2, E3 and what happens when estradiol falls

Estrogen is three hormones not one. Estradiol drives bone, heart, brain, skin, and mood. Rose explains each type and why the formulation in HRT matters.

Testosterone — the hormone nobody tells women about

Energy, libido, muscle, mood, cognition — testosterone drives all of it. It declines at menopause and is almost never offered.

Doctor conversation guides

Exact language for six essential conversations — HRT, antidepressants, vaginal dryness, thyroid, testosterone.

Finding a doctor who actually helps

"My doctor dismissed me." Rose's practical guide to finding menopause-literate care and what to say when you are not being heard.

Essential reading

Understanding your lab results

Normal is not optimal. TSH, ferritin, vitamin D, testosterone — what optimal looks like for menopausal women.

Lab reference ranges tool

Enter your result and see instantly where you fall on the standard range vs the optimal range — with what to say to your doctor.

Blood panel analysis tool

Upload your blood panel and Rose reviews results against menopause-specific optimal reference ranges. Free.

Prescription medications

HRT, vaginal estrogen, SSRIs, gabapentin, ospemifene — honest evidence grades and questions to ask your doctor.

All treatment approaches

HRT, acupuncture, CBT, pelvic floor therapy, resistance training — honestly graded by evidence.

Prescription medications

HRT, vaginal estrogen, SSRIs, gabapentin, ospemifene — honest evidence grades and questions to ask your doctor.

All treatment approaches

HRT, acupuncture, CBT, pelvic floor therapy, resistance training, peptide therapy — honestly graded by evidence.

Not sure where to start?

Tell Rose what you are experiencing and she will point you in the right direction.

Start here → Ask Rose a question →