Hormone Balance

A single hormone panel drawn on one morning tells you very little. In perimenopause especially, FSH and estradiol can look completely different two weeks apart, so a normal result on day three means only that the number was normal on day three. Pattern over time beats any snapshot.

Progesterone is usually the first to fall, because ovulation becomes less reliable before anything else changes. Estrogen can still be high, even spiking, while progesterone is low. That combination looks like broken sleep, more anxiety, breast tenderness, heavier periods, and a shorter fuse. It is also why so many women lose the deep, easy sleep they used to take for granted.

What I stock here supports three things: how the body clears estrogen, how the adrenals hold up through the transition, and the thyroid picture underneath both. That third one matters more than people expect, since hypothyroidism produces nearly identical fatigue and weight change and a TSH alone will not catch it.

I also check the things that get skipped when someone decides a 45-year-old woman is just stressed: ferritin, because heavy bleeding drives iron down, and fasting insulin, because the metabolic shift in this window is real and worth catching early.

Two pieces worth reading first: what I track before the periods stop and why a TSH alone is not enough. If you are further along, the Menopause collection is the more specific set.