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by Everyday Wellness
Looking for the latest strategies for dealing with menopause, hormones and midlife health issues? You're in the right place! Cynthia Thurlow is a nurse practitioner, host of the Everyday Wellness podcast, author and international speaker, with over 15 million views for her second TEDx talk (Intermittent Fasting: Transformational Technique). With over 25 years experience in health and wellness, Cynthia is a globally recognized expert in perimenopause/menopause and intermittent fasting, and has been featured on ABC, FOX5, KTLA, CW, Medium, Entrepreneur, and The Megyn Kelly Show. Her mission is to help empower women to live their most optimal lives in perimenopause and beyond.
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Today, I’m honored to speak with Dr. Eleonora Teplinsky, a board-certified medical oncologist specializing in breast and gynecologic cancer, with over a decade of practice. She is Head of Breast and Gynecologic Medical Oncology at Valley Mount Sinai Comprehensive Cancer Center in Paramus, New Jersey, and a clinical assistant professor of medicine at Icahn School of Medicine at Mount Sinai. She also hosts the Interlude podcast, where she shares stories from people affected by cancer, and is the author of Beyond the Pink: Navigating Life, Health, and Breast Cancer. In our conversation, we discuss breast cancer risk, genetic testing, cancer incidence in older and younger women, and treatment options following a new diagnosis, including surgery, chemo, and medication therapies. Dr. Teplinsky shares her approach to fertility preservation, menopause after cancer, body image, and the emotional aspects of diagnoses and care. We also explore lifestyle factors, survivorship, long-term cardiovascular risk after cancer treatment, DEXA scans, lipids, coronary artery calcification scoring, and the importance of advocacy, quality of life, and long-term goals. Stay tuned for a thoughtful conversation about breast cancer and breast cancer survivorship, informed by Dr. Teplinsky’s expansive approach to care. Her book, Beyond the Pink, is one of the most thoughtful books I’ve read on breast cancer and survivorship, and a beautiful testament to the quality of care she provides. IN THIS EPISODE, YOU WILL LEARN: Common misconceptions about breast cancer risk The future of personalized breast cancer screening How genetic testing can help clarify breast cancer risk and inform screening decisions What may be contributing to the increase in breast cancer among younger women How Dr. Teplinsky approaches a new breast cancer diagnosis and treatment planning How Dr. Teplinsky helps patients navigate body image, grief, and surgery How Dr. Teplinsky approaches fertility preservation and treatment for younger women Which options are available, and which remain debated, when navigating menopause after breast cancer How cancer treatment side effects can make it difficult to start or maintain an exercise program How patients can advocate for themselves and how loved ones can provide support Bio: Dr. Eleonora Teplinsky is a board-certified medical oncologist specializing in breast and gynecologic cancers. Through her clinical work, media presence, and digital platforms, she has built a reputation for translating complex medical information into clear, compassionate, and actionable insights—empowering women to navigate cancer, survivorship, and long-term health with confidence. Her forthcoming book, Beyond the Pink, represents a critical shift in how breast cancer is understood, discussed, and lived through—moving beyond diagnosis and treatment to address the full scope of survivorship and long-term health. The book fills a significant gap in patient education by focusing on what happens after cancer care ends. Blending clinical expertise with patient-centered guidance, Beyond the Pink offers a comprehensive, actionable roadmap for navigating menopause, fertility, cardiovascular health, sexual health, mental well-being, and life after cancer. ** For more information about Cynthia's upcoming retreat, visit https://www.cynthiathurlow.com/ and click the Events tab. Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Eleonora Teplinsky On all social media: @drteplinsky Beyond the Pink: Navigating Life, Health, and Breast Cancer is HERE.
I am honored to connect with Esther Blum today! She is the bestselling author of "Cavewomen Don’t Get Fat," "Eat, Drink and Be Gorgeous," and most recently, "See Ya Later, Ovulator!" Esther currently maintains a busy virtual practice where she helps women balance hormones, lose stubborn body fat, and treat the root cause of health struggles. Today we speak about medical gaslighting, how weight gain does not have to be a part of aging, andropause and menopause, and the Women’s Health Initiative. We dive into physical changes and significant symptoms during perimenopause and menopause, the role of the pelvic floor, deciphering what the dreaded “menopot” is, what does not work, and advocacy in terms of testing and hormones. We also address constipation, weight loss resistance, and how our tolerance for alcohol changes as we age, especially when using bioidenticals or hormone replacement therapy. I hope you love today’s conversation with Esther Blum as much as I did! IN THIS EPISODE YOU WILL LEARN: How women can redefine their experience and continue having an active sex life after menopause. How to surrender, lean in, and take the pressure off yourself while going through perimenopause and menopause. Why is there so much misinformation and medical gaslighting in our society? Why Esther wrote See Ya Later, Ovulator! Some common symptoms of perimenopause. Risks women may face after a hysterectomy. Changes that happen in the vaginal canal and pelvic floor during menopause. The significant and profound impact of the decline of sex hormones. How to avoid weight gain in menopause. What can menopausal women do to prevent fatty liver and digestive problems? Lab tests women should ask their healthcare providers for. Why should perimenopausal women avoid alcohol? Some simple ways to address constipation. Esther’s quotes: “You don’t have to gain weight in menopause.” “The better your gut health, the better your transition through menopause will be.” “Hormones are like a symphony. They’re not a solo act.” “Even if you have gained weight, even if you have cellulite and wrinkles and hair loss, it does not have to be permanent at all.” “You can have an active sex life, you can have absolute arousal, you can still have raging orgasms, even after menopause!” Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Esther Blum On her website Facebook, Instagram, LinkedIn Get your free copy of Esther’s Happy Hormone Cocktail Esther’s books, including See Ya Later, Ovulator!, are available HERE.
Today, I’m delighted to reconnect with Dr. Bill Rawls, a physician with over 30 years of medical experience. His personal battle with chronic Lyme disease led him to explore holistic and herbal therapies. After restoring his health, he became a leading voice in cellular wellness and modern herbology. He founded Vital Plan, where he developed the RESTORE180 Herbal Protocol to help others reclaim their health, and he is the best-selling author of Unlocking Lyme and The Cellular Wellness Solution. In our conversation, Dr. Rawls and I discuss midlife vulnerability, including the loss of stress resilience, the impact of peak fertile years, perimenopause, and menopause, and how these directly impact cellular and lifestyle stressors. We explore chronic illness as a cellular problem, how we live in a state of managed illness, and five stress factors that add to cumulative cellular stress. We discuss tick-borne illnesses, adaptations and dormancy, how autophagy may impact cellular stress, detoxification, inflammation, sympathetic tone, and key herbs to support detoxification. Dr. Rawls also shares his love for adaptogens, especially ashwagandha, and their impact on stress resilience, along with his recommendations for nutrition, intermittent fasting, and books. Stay tuned for a truly invaluable conversation about why many women in midlife, despite being on optimal hormone therapies, still don’t feel any better—and how it all goes back to cellular stress and mitochondrial health. IN THIS EPISODE, YOU WILL LEARN: How mitochondrial dysfunction and cellular aging contribute to symptoms midlife women and men may experience Why perimenopause may cause cellular stress and dysfunctional cellular messaging What happens to our cells and mitochondria as we begin to age? Dr. Rawls explains why he describes chronic illness as a cellular problem The five major stress factors that impact cellular health How certain microbes, including tick-borne microbes and herpes viruses, can remain dormant in the body and reactivate with stress, menopause, or aging Why Dr. Rawls describes autophagy as an essential cellular housekeeping process Why detoxification requires far more than a periodic cleanse or detox Dr. Rawls describes his process for integrating adaptogens into the lifestyles or protocols of midlife women and men Dr. Rawls shares some critical strategies for healthy aging Bio: Dr. Bill Rawls is a physician with over 30 years in medicine whose own battle with chronic Lyme disease led him to explore holistic and herbal therapies. After restoring his health, he became a leading voice in cellular wellness and modern herbology. He is the bestselling author of Unlocking Lyme and The Cellular Wellness Solution, and the founder of Vital Plan, where he developed the RESTORE180 herbal protocol to help others reclaim vibrant health. ** For more information about Cynthia's upcoming retreat, visit https://www.cynthiathurlow.com/ and click the Events tab. Connect with Cynthia Thurlow Check out Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Bill Rawls On his website Vital Plan Dr. Rawls’s most recent book, The Cellular Wellness Solution Recommended Books: Adaptogens: Herbs for Strength, Stamina, and Stress Relief by David Winston Adaptogens in Medical Herbalism: Elite Herbs and Natural Compounds for Mastering Stress, Aging, and Chronic Disease by Donald Yance Books by Rosemary Gladstar
Welcome to the latest Midlife Minute. In today’s episode, I answer listeners' questions about cortisol testing, trauma, and the HPA axis. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: How generalized stress-related dysregulation differs from clinical conditions involving cortisol excess or deficiency Why cortisol testing should be anchored to a person's actual sleep schedule rather than the clock Why a single random cortisol blood draw means almost nothing when assessing HPA axis function How cortisol can shift from an elevated response to a lower, blunted response as stress and trauma persist Why a low or flat cortisol curve in someone with trauma or PTSD does not automatically mean adrenal insufficiency How chronic stress can disrupt the negative feedback loop that keeps cortisol regulated The adaptogen with the strongest evidence for lowering morning cortisol How chronic psychological stress is associated with measurably lower ovarian reserve Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line
Today, I’m excited to connect with Dr. Tanya Beaubrun, a family medicine physician specializing in functional integrative medicine, and a certified wellness and transformational coach. Dr. Beaubrun is also a motivational speaker and the author of Held and Healed. In our conversation, we discuss burnout and hormones, exploring how many women treat being busy as a badge of honor, and why it's important to reframe midlife and beyond. We unpack how the HPA axis regulates the body’s stress response, and look at metabolic health, the importance of advocacy, and the markers Dr. Beaubrun uses to manage her patients’ metabolic health. We also cover nutrition, Doctor TikTok, reframing menopause as power, and how this empowering time in women’s lives can help them come to terms with aging and longevity, and allow the younger generations to see what is possible. Stay tuned for today’s delightfully personal and highly informative conversation with Dr. Tanya Beaubrun. IN THIS EPISODE, YOU WILL LEARN: Why burnout can often go unrecognized in high-functioning women Dr. Beaubrun explains how she assesses metabolic health and the testing she uses How hormonal decline in midlife can affect the way women experience stress What the HPA axis is designed to do in the body How women need to be listened to by their clinicians without judgment The metabolic and cardiovascular changes that women experience in midlife How Dr. Beaubrun helps women to focus on protein and nutrient density when they are busy Why healthy eating does not mean you have to avoid all the foods you love How healthcare providers can move from a paternalistic approach to a collaborative relationship with patients Reframing menopause as a powerful stage of life Bio: Dr. Tanya Beaubrun is a Functional and Integrative Medicine physician, wellness educator, speaker and author of Held and Healed. After more than 30 years in medicine—and following her own journey through burnout and recovery—she now helps women reconnect with their health by addressing the root causes of stress, hormonal imbalance and metabolic dysfunction. Through her signature More Joy Method®, Dr. Tanya combines evidence-based medicine with compassionate whole-person care, empowering women to realize they are not broken—they simply need the right support to heal, thrive and rediscover joy. Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Tanya Beaubrun On her website Instagram Dr. Beaubrun’s new book, Held and Healed
I am thrilled to welcome the extraordinary Dr. Stephanie Estima back to the show today to join me in facilitating many questions from listeners. She was with me last on Episode 272, and before that, on Episode 123. Dr. Estima’s perspective aligns very closely with mine within the health and wellness space. She is an exceptionally knowledgeable and well-informed clinician specializing in female metabolism and body composition. She authored the invaluable resource known as the Betty Body and hosts The Better! podcast, where I have had the privilege of being her guest. Today, we answer questions from both our communities, covering topics ranging from managing hormones during breastfeeding while coping with insufficient sleep to issues concerning preconception and methods for cycle tracking. We dive into the best contraceptives for younger women, strategies for supporting detoxification, addressing fibrocystic breasts, navigating autoimmune conditions and fibromyalgia, and determining the intensity of workout routines. There were also many questions about weight training, preferred pre-workouts, favorite supplements tailored for perimenopause and menopause, hormesis, and much more. Dr. Estima's insights are as enlightening as ever, making today’s conversation a must-listen for anyone on a journey toward optimal well-being. IN THIS EPISODE YOU WILL LEARN: How breastfeeding can delay menstrual cycles without causing infertility Dr. Stephanie discusses fertility and the importance of evaluating both male and female factors Contraceptive options for younger women The importance of understanding the side effects and implications of long-term oral contraceptives The benefits of green leafy vegetables for fibrocystic breasts Supplements for breast health The potential drawbacks of mammograms Perimenopause and autoimmune conditions, including Hashimoto's, thyroiditis, and fibromyalgia How trauma contributes to the dysregulation of the immune system and autoimmune conditions Supplements for middle-aged women How cold plunges and saunas benefit physical and mental well-being Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Stephanie Estima On Instagram On her weekly podcast, Better! With Dr. Stephanie, where she explores the human potential, hormones, metabolism, and a life well-lived. Get a copy of Dr. Stephanie Estima’s #1 bestselling book, The Betty Body: A Geeky Goddess’ Guide to Intuitive Eating, Balanced Hormones, and Transformative Sex Previous Episodes featuring Dr. Stephanie Ep. 123 – Menstruation, Muscle, Maternity, & Metabolism: What Every Woman Should Know with Dr. Stephanie Estima Ep. 272 Understanding Women’s Health: Answering Your FAQs featuring Dr. Stephanie Estima
I am thrilled to welcome board-certified neurologist and six-time New York Times best-selling author Dr. David Perlmutter back to the Everyday Wellness Podcast for the third time. He is a fellow of the American Nutrition Association and serves on the board of directors. His most recent book is Brain Defenders. In this conversation, we discuss microglia, the brain’s immune cells, and explore their role in immune regulation, metabolism, and immunometabolism. We also examine why brain health prevention needs to start decades earlier, environmental threats, emerging therapies, lifestyle influences, especially alcohol consumption, and current brain-health research. Stay tuned for another invaluable conversation with Dr. David Perlmutter. I loved his latest book, which clarifies the role of immunometabolism — especially in midlife. IN THIS EPISODE, YOU WILL LEARN: How microglia support the neurons and nurture synaptic connections Why microglia can shift from being supportive to becoming destructive Dr. Perlmutter explains what immunometabolism means How metabolic issues can affect brain health decades before any cognitive symptoms appear Why Dr. Perlmutter considers exercise “brain medicine” The value of aerobics and resistance training for supporting brain health How chronic stress and environmental threats can affect brain health Dr. Perlmutter shares practical ways to reduce environmental threats to brain health The link between alcohol consumption and Alzheimer’s risk What emerging research shows about GLP-1s and neurodegenerative diseases Bio: About Dr. Perlmutter: Dr. David Perlmutter is a Board-Certified Neurologist and seven-time New York Times bestselling author whose work focuses on the intersection of neurology, nutrition, and brain health. A Fellow of the American College of Nutrition, he serves on its Board of Directors and on the Editorial Board of the Journal of Alzheimer’s Disease. His books, including the #1 bestseller Grain Brain, have been published in 32 languages and sold over a million copies. Dr. Perlmutter lectures globally at leading institutions and has been featured on major media outlets including 20/20, CNN, The Today Show, and Oprah. His contributions have earned him numerous national and international awards for clinical innovation and leadership. His upcoming book, Brain Defenders, focuses on the pivotal role of microglia, the brain’s immune cells, in protecting, repairing, and reprogramming the brain for lifelong resilience, and is available now. ABOUT THE BOOK: Brain Defenders New York Times bestseller Brain Defenders reveals the powerful story of your brain's immune guardians (microglia) and how lifestyle choices can turn them into either fierce protectors or hidden saboteurs. The book directly challenges the notion that we now have meaningful treatments for diseases like Parkinson’s and Alzheimer’s. Despite FDA approval for drugs that reduce beta-amyloid, the book reveals that these drugs are not impactful and are actually profoundly dangerous. Packed with cutting-edge science and practical steps, Brain Defenders helps readers take charge of their long-term brain health and unlock lasting cognitive vitality. Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. David Perlmutter Brain Defenders Book On his website
Welcome to this week’s Midlife Minute. Today I’m answering listeners’ questions related to acne, melasma, and neurotoxins. Stay tuned for more! IN THIS EPISODE, YOU WILL LEARN: Why acne is usually hormonal even when blood work looks normal The mechanism that lies behind the connection between sugar, dairy, and acne The circumstances where blood testing is warranted for acne How women can have acne and completely normal-looking labs and regular cycles, and still have PMOS-level hormone activity occurring The value of screening for PMOS rather than just treating the skin How melasma differs from acne Two factors that cause melasma when both are present Can Botox trigger autoimmune disease or cause autoimmune flares? How to reduce the risk of problems when using Botox Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia’s website. Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Reference List: Acne, Melasma, and Neurotoxins Acne References A1. Elhassan YS, Hawley JM, Cussen L, et al. Society for Endocrinology Clinical Practice Guideline for the Evaluation of Androgen Excess in Women. Clinical Endocrinology. 2025. A2. Bienenfeld A, Azarchi S, Lo Sicco K, et al. Androgens in Women: Androgen-Mediated Skin Disease and Patient Evaluation. Journal of the American Academy of Dermatology. 2019. A3. Briganti S, Flori E, Mastrofrancesco A, Ottaviani M. Acne as an altered dermato-endocrine response problem. Experimental Dermatology. 2020. A4. Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of Care for the Management of Acne Vulgaris. Journal of the American Academy of Dermatology. 2024. A5. Moradi Tuchayi S, Makrantonaki E, Ganceviciene R, et al. Acne vulgaris. Nature Reviews Disease Primers. 2015. (Sentinel reference for acne pathophysiology) A6. Liu YT, Wang YW, Tu C, et al. Recommendations for managing adult acne and adolescent acne based on an epidemiological study conducted in China. Scientific Reports. 2024. A7. Xia J, Ding L, Liu G. Metabolic syndrome and dermatological diseases: association and treatment. Nutrition & Metabolism. 2025. A8. Cussen L, McDonnell T, Bennett G, et al. Approach to androgen excess in women: Clinical and biochemical insights. Clinical Endocrinology. 2022. A9. Melnik BC, Schmitz G. Role of insulin, insulin-like growth factor-1, hyperglycaemic food and milk consumption in the pathogenesis of acne vulgaris. Experimental Dermatology. 2009. A10. Chang J, Nock MR, Cohen JM, Bunick CG. Acne accounts for an almost 2.5-fold higher proportion of dermatology visits among adult females compared to adult males in the United States. PLoS One. 2022. A11. Rao Y, Lei Z, Chen S, et al. Differential plasma proteome analysis reveals key proteins associated with insulin resistance in acne vulgaris patients. Scientific Reports. 2025. A12. Roster K, Fleshner L, Karatas TB, et al. Menopause and Common Dermatoses: A Systematic Review. American Journal of Clinical Dermatology. 2026. (Shared reference, also cited in melasma section) A13. Eichenfield DZ, Sprague J, Eichenfield LF. Management of Acne Vulgaris. The Journal of the American Medical Association. 2021. A14. Costa CS, Bagatin E, Yang Z, et al. Systemic pharmacological treatments for acne: an overview of systematic reviews. Cochrane Database of Systematic Reviews. 2021. A15. Hebert A, Thiboutot D, Stein Gold L, et al. Efficacy and Safety of Topical Clascoterone Cream, 1%, for Treatment in Patients With Facial Acne: Two Phase 3 Randomized Clinical Trials. JAMA Dermatology. 2020. A16. Zaenglein AL. Acne Vulgaris. The New England Journal of Medicine. 2018. A17. Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. The Journal of Clinical Endocrinology and Metabolism. 2023. A18. Yesiladali M, Unluhizarci K, Attar E, Kelestimur F. Where are we in the diagnosis and treatment of hirsutism? A narrative review. Reviews in Endocrine & Metabolic Disorders. 2026. A19. Committee on Practice Bulletins, Gynecology. ACOG Practice Bulletin No. 194: Polycystic Ovary Syndrome. Obstetrics and Gynecology. 2018. A20. Martin KA, Anderson RR, Chang RJ, et al. Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism. 2018. (See full list of references at https: https://www.cynthiathurlow.com/.
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Looking for the latest strategies for dealing with menopause, hormones and midlife health issues? You're in the right place! Cynthia Thurlow is a nurse practitioner, host of the Everyday Wellness podcast, author and international speaker, with over 15 million views for her second TEDx talk (Intermittent Fasting: Transformational Technique). With over 25 years experience in health and wellness, Cynthia is a globally recognized expert in perimenopause/menopause and intermittent fasting, and has been featured on ABC, FOX5, KTLA, CW, Medium, Entrepreneur, and The Megyn Kelly Show. Her mission is to help empower women to live their most optimal lives in perimenopause and beyond.
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