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Hot flashes don’t keep a schedule, and neither do lab numbers. We sit down with Dr. Rachel Novik of Cleveland Clinic’s Center for Specialized Women’s Health to cut through the noise around perimenopause, menopause, and hormone testing—and focus on what actually helps you feel like yourself again.

We talk about why the most reliable “diagnosis” of menopause is still 12 months without a period, and when lab work like estradiol and FSH can be helpful for patients with hormonal IUDs or after hysterectomy. She breaks down common myths about the Dutch test and other urine hormone panels, explains why major medical societies don’t endorse them for menopause, and shows how chasing unvalidated numbers can drive unnecessary supplements and costs without improving outcomes.

If you’re overwhelmed by conflicting advice on “balancing hormones,” this episode offers a calmer path: collaborate with a clinician, align on goals, and judge success by how you feel, not a single number.

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