Ministry of Menopause

Your Thyroid, Your Hormones, and Perimenopause. The Triple Overlap Nobody Is Joining Up. | Dr Golda Parker

PRIMARY DESCRIPTION:

If you have been unwell for months or years, seen multiple doctors, and still do not have an answer that fully explains how you feel, this episode is the one that might finally change that. Dr Golda Parker, GMC-registered GP, explains the clinical overlap between perimenopause, thyroid dysfunction, and low ferritin, why the three frequently occur together in women in their forties, and why normal blood test results are not the same as optimal ones.

LONG DESCRIPTION:

Thyroid dysfunction, low ferritin, and perimenopause are three of the most commonly missed and most commonly co-occurring conditions in women in midlife. Their symptoms overlap so substantially that each one can mask the other, creating a clinical picture that is confusing, frustrating, and almost impossible to resolve when each condition is investigated and treated in isolation.

In this episode Dr Golda Parker explains why thyroid dysfunction becomes more common in perimenopause, the clinical relationship between oestrogen and thyroid hormone transport, the role of ferritin in hair loss, energy, and cognitive function, and why a result that falls within a normal reference range is not necessarily a result that is optimal for a symptomatic woman.

She covers exactly which investigations to ask for, why the full thyroid panel matters more than TSH alone, and what the difference between normal and optimal means in practice. This is the joined-up clinical conversation that most appointments do not have time for.

TARGET KEYWORDS:

thyroid perimenopause, hypothyroidism perimenopause, ferritin hair loss women, perimenopause thyroid symptoms, low thyroid women 40s, oestrogen thyroid connection, perimenopause fatigue, normal thyroid but still tired, ferritin and hair loss, perimenopause symptoms UK, thyroid and hormones women, menopause thyroid UK, free T3 free T4 women, perimenopause blood tests, TSH normal but symptomatic

WHAT YOU WILL LEARN:

Why thyroid dysfunction and perimenopause so frequently occur together and the clinical mechanism behind it. Why ferritin, not just haemoglobin, is a critical investigation for perimenopausal women. Why normal reference ranges are not the same as optimal levels for a symptomatic individual. The exact blood tests worth asking for and why each one matters. What joined-up clinical care looks like and how to ask for it.

LINKS:

Join the free weekly email list: https://drgolda.myflodesk.com/q0iv4ooge8

Join the clinic waitlist: https://drgolda.myflodesk.com/q0iv4ooge8

Listen on Apple Podcasts: https://podcasts.apple.com/us/podcast/ministry-of-menopause/id1834366246

Instagram: @doctorgolda

TikTok: @dr.golda

Website: https://www.drgolda.com

The clinic is coming. One doctor. Always Dr Golda. Join the waitlist now at https://drgolda.myflodesk.com/q0iv4ooge8

Any patient stories shared in this podcast are fictional and used for illustrative purposes only. Any resemblance to real persons is entirely coincidental. The content shared in this podcast is for informational and educational purposes only and does not constitute medical advice. Listening to this podcast does not create a doctor-patient relationship. Always consult your own doctor or qualified healthcare professional regarding any health issues.

The rage that arrives without warning. The tears with no trigger. The woman you do not recognise in the mirror. In this episode Dr Golda Parker explains the neurological mechanism behind emotional dysregulation in perimenopause, why it is not a mental health crisis, and why it responds to hormonal support in a way that managing symptoms alone never fully does.

Emotional dysregulation in perimenopause is one of the most distressing and least discussed aspects of the hormonal transition. Women who have been patient, stable, and emotionally regulated their whole lives find themselves experiencing rage, tears, and overwhelm that feel completely alien. In this episode Dr Golda Parker explains the GABA, serotonin, and amygdala mechanisms that drive this pattern, why hormonal fluctuation rather than steady decline is the key factor, and what the clinical response looks like.

KEYWORDS: perimenopause rage, emotional dysregulation perimenopause, perimenopause crying, perimenopause anger, GABA oestrogen women, mood changes perimenopause, perimenopause mood swings, oestrogen serotonin women, perimenopause emotional symptoms, menopause mood UK

LINKS:

Join the email list: https://drgolda.myflodesk.com/q0iv4ooge8

Join the clinic waitlist: https://drgolda.myflodesk.com/q0iv4ooge8

Listen on Apple Podcasts: https://podcasts.apple.com/us/podcast/ministry-of-menopause/id1834366246

Instagram: @doctorgolda · Website: https://www.drgolda.com

The patient stories shared in this content are fictional and used for illustrative purposes only. Any resemblance to real persons is entirely coincidental.

The content shared in this podcast is for informational and educational purposes only and does not constitute medical advice. Listening to this podcast does not create a doctor patient relationship. Always consult your own doctor or qualified healthcare professional regarding any health issues.

New term, new timetable, new hormones. In this episode of Ministry of Menopause, GP and dual board certified women's health doctor Golda Parker unpacks why the back to school season hits so differently when you are in perimenopause. She walks through the real physiology behind September overwhelm, covering fluctuating oestrogen and progesterone, HPA axis and cortisol, histamine and mast cell sensitivity, and gut and estrobolome health, and explains why these four systems compound each other the moment routines get disrupted.

This episode is a practical, upbeat guide to surviving the September reset without adding another thing to your to do list. Golda shares realistic, evidence based strategies for supporting hormonal health during the new school term, from morning light exposure and protecting one non negotiable pocket of your day, to feeding your gut microbiome with protein and fibre, protecting sleep, and knowing when it is time to talk to your GP about options including hormone replacement therapy. Whether you are managing hot flushes, night sweats, brain fog, mood changes, or just a bone deep exhaustion that started the same week term began, this episode will help you understand what is happening in your body and what actually helps.

Topics covered: perimenopause symptoms, menopause and hormonal health, back to school stress, new school term anxiety, oestrogen and progesterone fluctuation, cortisol and the HPA axis, histamine and mast cell sensitivity in perimenopause, gut health and the estrobolome, brain fog, hot flushes, night sweats, sleep disruption, midlife women's health, self-care for busy mothers, and hormone replacement therapy.

Follow along and join the conversation at doctorgolda on Instagram, and join the waitlist for one to one consultations at drgolda.com.

#Perimenopause #MinistryOfMenopause #SeptemberReset

Medical disclaimer: This podcast is for general information and educational purposes only and does not constitute medical advice. It should not replace individualised care from your own doctor or a registered healthcare professional. Every woman's experience of perimenopause and menopause is different. If you are experiencing symptoms or have concerns about your health, please book an appointment with your doctor. In an emergency, always call emergency services or attend your nearest Emergency Department.

Perimenopause brain fog is real, measurable, and one of the most frightening symptoms patients bring to me — usually asking, quietly, if this is the start of dementia. It isn't dementia for the vast majority of women, but it is a genuine neurological change, not "in your head" and not something to just push through. This episode breaks down exactly what's happening in your brain, why it happens, and — importantly — when memory changes need proper medical review rather than reassurance.

In this episode:

• The real neuroscience behind oestrogen's role in memory, focus, and word-finding
• Why perimenopause memory loss is usually temporary — and how I explain that to frightened patients
• The difference between hormonal brain fog and cognitive changes that need urgent review
• Practical, evidence-informed tools I use in both my UK and Canadian practice
• Why brain fog is chronically under-discussed — and what that's quietly doing to women's confidence and careers

Listen & connect:

Sign up to my email list and join the clinic waitlist at drgolda.com

Follow along on Instagram @doctorgolda

General education only — not personalised medical advice. Listening to this podcast does not create a doctor - patient relationship. Please speak to your own doctor about any health issues.

Hot flashes and night sweats affect the vast majority of women at some point in the menopause transition, yet almost nobody is taught what's actually happening in the body. Today I'm breaking down the real mechanism behind vasomotor symptoms and the full range of options available — no judgement, no one-size-fits-all advice.

In this episode:

• The precise brain mechanism behind a hot flush, explained simply
• Why hot flashes and night sweats vary so wildly between women in frequency and intensity
• Practical triggers worth tracking — and the ones that are genuinely overrated
• The full range of options for menopause hot flashes, from lifestyle to medical, without judgement either way
• Why vasomotor symptoms deserve to be taken seriously at work, not laughed off

Listen & connect:

Full episode references and my flush-tracking template at drgolda.com/podcast

Sign up to my email list and join the clinic waitlist at drgolda.com

Follow along on Instagram @doctorgolda

General education only — not personalised medical advice. Listening to this podcast does not create a doctor-patient relationship. Please speak to your own doctor about any health issues.

Menopause weight gain is one of the most upsetting symptoms I treat, mainly because so many women are told it's simply about willpower. This episode explains the real hormonal and metabolic science behind midlife weight change, and why 'eat less, move more' stops working.

This episode is for you if:

• You're eating and exercising exactly as before but your shape keeps changing
• Weight is now settling around your middle in a way it never used to
• You're starting to doubt your own honesty about food, and feeling ashamed of it

In this episode:

• Why the same diet and exercise routine that used to work suddenly stops working
• The real link between falling oestrogen and where your body stores fat
• Why muscle mass is the most underrated lever in midlife metabolism
• What I actually recommend before anyone talks about calorie counting
• Medicolegal-safe truth: there is no single fix, and anyone selling you one is selling you something

menopause weight gain, menopause belly fat, why can't I lose weight in perimenopause, menopause metabolism, hormonal weight gain women, perimenopause weight loss, menopause diet, insulin resistance menopause, muscle loss menopause, menopause exercise, visceral fat menopause, weight gain in your 40s

Listen & connect:

Loved this episode? My private clinic is opening soon in the UK, bringing together evidence-based UK medicine with an integrative, whole-person approach from my years practising on Canada's west coast. Join the waitlist and get first access to booking, plus my weekly newsletter, at www.drgolda.com. Follow along and get in touch on Instagram @doctorgolda.

MEDICAL DISCLAIMER: This episode is for general education and information only. It is not personalised medical advice, and it does not replace an individual consultation with your own doctor, who can properly assess your history, symptoms, and any tests or treatment that may be right for you. Listening to this podcast does not create a doctor-patient relationship between you and Dr Golda. For any medical issues, symptoms, or concerns, please contact your own healthcare professional directly. Always speak to a qualified healthcare professional before starting, stopping, or changing any treatment, supplement, or medication. If you are experiencing a medical emergency, contact emergency services immediately.

Perimenopause insomnia and waking at 3am are two of the most common, and most dismissed, complaints I hear from patients across the UK, Canada and the US. If your sleep has fallen apart for no obvious reason, this episode explains exactly why, and what genuinely helps.

This episode is for you if:

• You fall asleep fine but wake at 2, 3 or 4am wired and can't switch off again
• Your usual sleep hygiene tricks have completely stopped working
• You're exhausted, foggy, and starting to dread bedtime itself

In this episode:

• Why falling progesterone and oestrogen change your actual sleep architecture, not just 'hot flushes waking you up'
• The cortisol connection nobody explains properly, and why 3am is not a random time
• What I tell patients in Vancouver versus what I tell patients in Manchester, and where the advice is identical
• Three things that move the needle before you reach for medication
• When sleep trouble is a sign of something else and needs proper review

perimenopause insomnia, menopause sleep problems, why can't I sleep in perimenopause, waking up at 3am menopause, menopause insomnia treatment, progesterone and sleep, cortisol and sleep menopause, hot flashes at night, night sweats and sleep, how to sleep through menopause, perimenopause sleep hormones, menopause fatigue

Listen & connect:

Loved this episode? My private clinic is opening soon in the UK, bringing together evidence-based UK medicine with an integrative, whole-person approach from my years practising on Canada's west coast. Join the waitlist and get first access to booking, plus my weekly newsletter, at www.drgolda.com. Follow along and get in touch on Instagram @doctorgolda.

MEDICAL DISCLAIMER: This episode is for general education and information only. It is not personalised medical advice, and it does not replace an individual consultation with your own doctor, who can properly assess your history, symptoms, and any tests or treatment that may be right for you. Listening to this podcast does not create a doctor-patient relationship between you and Dr Golda. For any medical issues, symptoms, or concerns, please contact your own healthcare professional directly. Always speak to a qualified healthcare professional before starting, stopping, or changing any treatment, supplement, or medication. If you are experiencing a medical emergency, contact emergency services immediately.

Why Every Perimenopausal Woman Needs to Know About Lymphatic Drainage Massage, with Sophie of Good Habit

I have wanted to do this episode for such a long time.

On this week's Ministry of Menopause I am joined by Sophie, a registered massage therapist who trained in Vancouver and now runs her practice, Good Habit, in Marylebone, London. Sophie specialises in lymphatic drainage massage, and if you have been following me for a while you will know how much I rate this as part of a holistic approach to hormone health.

We talk through what lymphatic drainage massage actually is, how the lymphatic system supports hormone balance, detoxification and immune function, and why so many women in perimenopause and menopause are walking around with a sluggish lymphatic system without ever realising it. Bloating, puffiness, fluid retention, brain fog, low energy and even breast tenderness can all have a lymphatic component, and Sophie explains in beautifully simple terms how this gentle, rhythmic massage technique works with the body rather than against it.

We also get into the Vancouver connection, since Sophie trained on the West Coast of Canada where integrative and manual therapies sit comfortably alongside conventional medicine, something close to my own heart given my dual practice between the UK and Canada. Sophie brings that same evidence informed, whole body philosophy to her London clinic.

What we cover in this episode

The difference between lymphatic drainage massage and a regular deep tissue massage Why the lymphatic system matters more than most women realise during perimenopause and menopause How lymphatic drainage massage can help with bloating, fluid retention and that puffy, heavy feeling in the body The connection between lymph flow, hormone metabolism and detoxification Who lymphatic drainage massage is suitable for, and when to seek advice before booking What to expect in a first session with a registered massage therapist Sophie's training in Vancouver and how North American manual therapy informs her practice in Marylebone Simple things you can do at home to support your lymphatic system between treatments

About Sophie and Good Habit

Sophie is a registered massage therapist trained in Vancouver, Canada, now based in Marylebone, London, where she runs Good Habit, a practice dedicated to lymphatic drainage massage and manual therapy. She takes a gentle, considered and highly skilled approach, and it was such a pleasure to sit down with her and talk shop.

If you are in London and want to experience lymphatic drainage massage for yourself, here is where to find Sophie.

Website: https://www.goodhabitldn.com/

Book an appointment: https://www.goodhabitldn.com/contact

Free videos and symptom tracker: https://www.goodhabitldn.com/freehabits

Instagram: https://www.instagram.com/goodhabitldn

If you are outside London and looking for a specialist in manual lymphatic drainage near you, Sophie also pointed us to the MLD UK therapist finder, a wonderful resource for tracking down a qualified practitioner wherever you are: https://mlduk.org.uk/find-a-therapist/

A note on this episode

This episode is for general information and education only and is not a substitute for individualised medical advice. Please speak to your doctor about your own symptoms before starting any new treatment, including any form of massage therapy.

Whatever you are going through in life, never ever quit, keep on going and don't let them win.

Dr Golda

#MinistryOfMenopause #LymphaticDrainageMassage #PerimenopauseSupport

If you have just realised that something has changed in your body and you do not know where to start, start here. This is the episode of the Ministry of Menopause designed for the woman who has just typed “what is perimenopause” into a search bar at two in the morning and needs someone to sit her down, look her in the eye, and tell her the truth without overwhelming her. Dr Golda strips away the noise and delivers the five essential truths she would share with her best friend if she had five minutes to change the way that friend understood everything she was going through.

Truth one: what you are feeling is real and it has a name. Too many women spend months or years apologising for their symptoms, assuming they are stressed, assuming they are not coping, assuming the problem is in their head. Perimenopause is a major hormonal transition that can begin in the late thirties and last for up to ten years. Its symptoms go far beyond hot flushes. Anxiety, insomnia, rage, brain fog, joint pain, heart palpitations, histamine intolerance, gut changes, skin changes, hair changes, and changes to the way you process stress are all connected to the fluctuation and decline of oestrogen, which has receptors in virtually every system in your body. You are not losing your mind. You are losing oestrogen. And those are very different things.

Truth two: start tracking your symptoms now. When you walk into a consultation with a daily record of what you have been experiencing, when it started, how it relates to your cycle, and how it has changed over time, you move from vague descriptions to clinical data. Data gets taken seriously. Dr Golda built the Known by Dr Golda symptom tracker at drgolda.com for exactly this reason. It tracks 36 perimenopause and menopause symptoms daily, maps them into a heat map of your patterns, and generates a consultation report you can take to your GP or specialist.

Truth three: sleep is not a luxury, it is the foundation. When perimenopause takes your sleep, almost everything else deteriorates. Your mood, your cognitive function, your resilience, your immune system, your metabolic health. Sleep is the multiplier and getting it back is a clinical priority, not an afterthought. Dr Golda created Dr Golda Sleep at sleep.drgolda.com with audio tools designed specifically for the way perimenopause and menopause disrupt sleep architecture, including sleep stories, breathing exercises, body scans, sleep science education, and wind down sessions built for women whose cortisol spikes at 3am because their HPA axis is dysregulated by fluctuating oestrogen.

Truth four: you deserve proper clinical care. Not a ten minute appointment and a blood test that tells you nothing. A proper, thorough assessment that includes your symptoms, your cycle history, your family history, your stress load, and your overall health picture. Dr Golda explains her integrative four pillar model, shaped by training at Vancouver Coastal Health in Canada, which assesses hormonal status, HPA axis and cortisol regulation, mast cell activation and histamine intolerance, and gut health including the estrobolome.

Truth five: this is not the end of you. Perimenopause is not a closing door. It is a passage. And on the other side of it there is a woman who knows herself better than she ever did, who has stopped tolerating what does not serve her, and who has rebuilt on foundations entirely her own. This episode is the starting point. It is the episode to listen to first and the episode to send to someone you love who is scared, confused, and does not yet know what is happening to her body.

This Episode Answers

What is perimenopause? What age does perimenopause start? Can perimenopause start in your thirties? What are the first signs of perimenopause? How long does perimenopause last? Is perimenopause the same as menopause? What is the difference between perimenopause and menopause? Can perimenopause cause anxiety? Can perimenopause cause insomnia? Why can I not sleep during perimenopause? Can perimenopause cause brain fog? Can perimenopause cause rage? Can perimenopause cause joint pain? Can perimenopause cause heart palpitations? Can perimenopause cause histamine intolerance? Can perimenopause affect your gut? What is the estrobolome? What should I do if I think I am in perimenopause? Do I need HRT? What does HRT do? Is HRT safe? What is NICE guideline NG23? How do I track perimenopause symptoms? What is a perimenopause symptom tracker? What does proper menopause care look like? Why can I not sleep at 3am in perimenopause? What is the HPA axis? What is cortisol dysregulation in menopause? Is there a menopause sleep app? What are the best perimenopause podcasts? Where do I start with perimenopause? How do I know if it is perimenopause?

Topics Covered in This Episode

An introduction to perimenopause for women who are newly symptomatic or newly aware of the hormonal transition. The full range of perimenopause symptoms beyond hot flushes and irregular periods including anxiety, insomnia, brain fog, rage, joint pain, heart palpitations, histamine intolerance, gut changes, skin and hair changes, and stress processing changes. Why oestrogen receptors in virtually every body system explain the breadth and complexity of perimenopausal symptoms. The critical importance of daily symptom tracking and how it transforms the quality of a clinical consultation. The Known by Dr Golda symptom tracker and its 36 symptom daily tracking, heat map visualisation, and GP consultation report. Why sleep is the non negotiable foundation of perimenopause management and what happens when it is disrupted. Dr Golda Sleep and its audio tools designed specifically for menopausal sleep disruption including sleep stories, breathing exercises, body scans, and wind down sessions. What proper perimenopause clinical care should include and what it should not. Dr Golda’s integrative four pillar assessment model: hormonal assessment, HPA axis and cortisol regulation, mast cell activation and histamine intolerance, and gut health including the estrobolome. NICE guideline NG23 and what it says about menopause care in the UK. Why perimenopause is not the end but a passage to a stronger, clearer version of yourself. The importance of community, sharing, and breaking the silence around perimenopause and menopause.

Mentioned in This Episode

Known by Dr Golda symptom tracker with 36 symptom daily tracking, heat map dashboard, and downloadable GP consultation report at drgolda.com. Dr Golda Sleep with audio tools for menopausal sleep disruption including sleep stories, breathing exercises, body scans, sleep science education, and wind down sessions at sleep.drgolda.com. Dr Golda’s integrative four pillar assessment covering hormonal assessment, HPA axis and cortisol regulation, mast cell activation and histamine intolerance, and gut health including the estrobolome. NICE guideline NG23 on the diagnosis and management of menopause. Vancouver Coastal Health integrative clinical training. Full resources, clinical information, education, and support at drgolda.com. Daily perimenopause and menopause content, community, and conversation on Instagram @doctorgolda.

Share This Episode

This is the episode to share. It is the starting point, the entry point, the episode designed to reach the woman who does not yet know what is happening to her. Send it to the woman in your life who just told you she cannot sleep. Send it to your group chat. Send it to your sister, your colleague, your mother, your daughter. Screenshot your favourite moment and tag @doctorgolda on Instagram. Post it in your stories with the line “you are not losing your mind, you are losing oestrogen” and watch what happens. Leave a review on Apple Podcasts or Spotify so the algorithm puts this in front of more women who are searching right now. The Ministry of Menopause grows one share at a time and every share matters.

About Dr Golda

Dr Golda is a medical doctor with over twenty years of clinical experience across the UK and Canada. She holds dual board certification in both the UK & Canada, and the Management of Menopause Certificate with the British Menopause Society. She trained at Vancouver Coastal Health in British Columbia, where she developed her integrative approach combining evidence based medicine with holistic, whole person care. She is the host of the Ministry of Menopause podcast and the founder of drgolda.com, where she is building a clinical and educational platform for women in perimenopause and menopause worldwide.

This podcast provides general health information and is not a substitute for individual medical advice. Always consult your own healthcare provider for personal medical decisions.

You went to your GP with anxiety. Or brain fog. Or insomnia that came out of nowhere. Or heart palpitations that sent you to A and E. Or a fatigue so deep that no amount of sleep made any difference. Your blood tests came back normal. You were told there was nothing wrong. You were offered antidepressants. And at no point, in any of those appointments, did anyone say the word perimenopause. If this is your story, you are not alone. You are one of hundreds of thousands of women whose perimenopause has been misdiagnosed as depression, anxiety, or stress, and this episode of the Ministry of Menopause explains exactly why it happened, what the science says, and what you can do about it now.

Dr Golda is a practising GP herself and she is clear that this is not about blaming doctors. It is about naming a systemic gap in training and awareness that is leaving women undiagnosed for years. Perimenopause can begin in the late thirties. Its symptoms extend far beyond hot flushes and irregular periods. Anxiety, panic attacks, brain fog, insomnia, rage, heart palpitations, fatigue, joint pain, histamine reactions, and cognitive changes are all well documented features of the perimenopausal hormone transition. Yet many GPs are still relying on a single FSH blood test to rule perimenopause in or out, despite the fact that FSH fluctuates so wildly during this stage that a single reading is clinically unreliable. Women are being told their bloods are fine when the blood test itself was never the right diagnostic tool in the first place.

In this episode, Dr Golda walks through what the misdiagnosis pattern looks like in practice, tells the story of a typical woman in her early forties whose symptoms were dismissed, and explains what NICE guideline NG23 actually says about antidepressants versus HRT as first line treatment for menopause related mood symptoms. She also explains her integrative four pillar assessment model, shaped by training at Vancouver Coastal Health in Canada, which looks beyond hormones alone to include cortisol and HPA axis dysregulation, mast cell activation and histamine intolerance, and gut health including the estrobolome. This is the episode that arms you with the knowledge to walk into your next appointment and advocate for the assessment you deserve.

Dr Golda also discusses why she built the Known by Dr Golda symptom tracker, available at drgolda.com, which tracks 36 perimenopause and menopause symptoms daily, generates a visual heat map of your patterns over time, and produces a consultation report you can take to your doctor. Because when you walk into an appointment with data instead of descriptions, you change the entire dynamic of that consultation. Data gets taken seriously. Vague feelings get dismissed. This episode explains why tracking is the single most powerful act of self advocacy you can take right now.

This Episode Answers

Can perimenopause be misdiagnosed as depression? Why did my doctor give me antidepressants instead of HRT? Are blood tests accurate for perimenopause? Why was my FSH test normal when I have every symptom of perimenopause? What should a proper perimenopause assessment include? Can I ask my GP for HRT? What does NICE guideline NG23 say about menopause treatment? Is it perimenopause or anxiety? Can perimenopause cause panic attacks? Why does my doctor not believe I am in perimenopause? Can perimenopause cause heart palpitations? Is brain fog a symptom of perimenopause or depression? Should antidepressants be first line for menopause? What is the difference between perimenopause anxiety and generalised anxiety disorder? Can perimenopause start at 38? Can perimenopause start at 40? What is an integrative approach to menopause? What is the HPA axis and how does it relate to perimenopause? Can perimenopause cause histamine intolerance? What is the estrobolome? How do I advocate for myself at the GP? Should I get a second opinion about perimenopause? Why are so many women in perimenopause being put on antidepressants? Can you have perimenopause with regular periods?

Topics Covered in This Episode

The widespread misdiagnosis of perimenopause as depression, anxiety, and stress across the UK and internationally. Why a single FSH blood test is clinically unreliable during the perimenopausal transition and should not be used to rule perimenopause out. The story of a typical woman in her early forties whose symptoms were dismissed and who was prescribed antidepressants without a hormonal assessment. What NICE guideline NG23 says about first line treatment for menopause related mood symptoms and why it is still not being consistently followed in primary care. The difference between clinical depression that exists independently of hormonal change and mood symptoms driven by the perimenopausal hormone transition. The role of nuance in clinical decision making and why antidepressants are appropriate for some women in perimenopause but should not be the default first response when the hormonal picture has not been explored. Dr Golda’s four pillar integrative assessment model: hormonal assessment, HPA axis and cortisol regulation, mast cell activation and histamine intolerance, and gut health including the estrobolome. How training at Vancouver Coastal Health in British Columbia shaped Dr Golda’s whole person approach to menopause. The Known by Dr Golda symptom tracker and why daily symptom data transforms the quality of a clinical consultation. How to advocate for yourself at your next GP appointment including asking for a perimenopause assessment and referencing NICE guidelines. Why the misdiagnosis of perimenopause is not just a medical error but a message that tells women their experience is not real.

Mentioned in This Episode

NICE guideline NG23 on the diagnosis and management of menopause. The Society of Obstetricians and Gynaecologists of Canada menopause guidance. Known by Dr Golda symptom tracker with 36 symptom daily tracking, heat map visualisation, and downloadable GP consultation report at drgolda.com. Dr Golda’s integrative four pillar perimenopause assessment model. Vancouver Coastal Health integrative clinical training. Full clinical resources, education, and support at drgolda.com. Daily perimenopause and menopause content and community on Instagram @doctorgolda.

Share This Episode

If this episode explained what has been happening to you, share it. Share it with the friend who was sent home without answers. Share it with your WhatsApp group. Share it with your GP if you feel comfortable doing so. Post it in your Instagram stories and tag @doctorgolda. Leave a review on Apple Podcasts or Spotify so that the algorithm puts this episode in front of more women who need to hear it. Every share puts this information in front of another woman who is sitting in her kitchen right now wondering what is wrong with her when the answer is nothing. She is in perimenopause and she deserves to know.

About Dr Golda

Dr Golda is a doctor with over twenty years of clinical experience across the UK and Canada. She holds dual board certification in the UK and Canada, and the Management of Menopause Certificate with the British Menopause Society. She trained at Vancouver Coastal Health in British Columbia, where she developed her integrative approach combining evidence based medicine with holistic, whole person care. She is the host of the Ministry of Menopause podcast and the founder of drgolda.com, where she is building a clinical and educational platform for women in perimenopause and menopause worldwide.

This podcast provides general health information and is not a substitute for individual medical advice. Do not stop or change any prescribed medication without consulting your own healthcare provider.