Perimenopause & menopause
Hot flushes: what they are and what actually helps
A narrowed thermoneutral zone in the hypothalamus, triggered by tiny temperature changes. Understanding the mechanism explains why some remedies work and most do not.
The Naked Journal
Women’s health, explained clearly.
Hormones, cycles, sleep, mood, fertility, perimenopause — and the patterns that connect them. Written to be read, not to be scrolled past.
Perimenopause & menopause
What happens to your bones around menopause
The fastest bone loss of your life happens in the few years either side of your last period. What you do in that window matters more than what you do at seventy.
Perimenopause & menopause
The menopause symptom almost nobody is offered treatment for
Vaginal dryness, painful sex and recurrent UTIs after menopause are progressive, extremely common, and treatable with something safe for nearly everyone.
Perimenopause & menopause
Hormone therapy: what actually changed after the WHI
A single 2002 trial reshaped how a generation was treated. Understanding what it found, and what it did not, is how you have a useful conversation about HRT.
Perimenopause & menopause
The perimenopause symptoms nobody lists
Frozen shoulder, tinnitus, dry eyes, itchy skin, palpitations, rage. Oestrogen receptors are everywhere, and so are the symptoms.
Perimenopause & menopause
Perimenopause can start in your late thirties
The transition runs for years before periods stop, and the first signs are usually sleep, mood and cycle length rather than hot flushes.
Fertility & pregnancy
Egg freezing, without the marketing
The odds depend almost entirely on your age at freezing and how many mature eggs you bank. Here are the numbers, the costs, and the questions to ask.
Fertility & pregnancy
The fourth trimester, and what recovery actually involves
The six-week check is a formality, not the end of recovery. Here is what is really happening in the first year, and what should not be dismissed.
Fertility & pregnancy
Postpartum depression, anxiety, and the rage nobody warns you about
The screening questionnaires ask about sadness. A large share of postpartum mental illness presents as anxiety, intrusive thoughts and anger instead.
Fertility & pregnancy
Early miscarriage is common, and almost never something you caused
Roughly one in five known pregnancies ends in miscarriage, and the great majority are chromosomal accidents that nothing could have prevented.
Fertility & pregnancy
How long it usually takes to get pregnant
Most couples conceive within a year, and the monthly odds are lower than almost everyone expects. Here are the real numbers and when to ask for help.
Perimenopause & menopause
What actually happens to your body in midlife
Menopause changes where fat is stored and accelerates muscle loss. The weight gain itself is mostly ageing and behaviour, which is better news than it sounds.
Fertility & pregnancy
What an AMH test actually tells you
It estimates how many follicles you have left. It does not predict whether you can get pregnant this year, and it is routinely sold as though it does.
Care & advocacy
Heart attacks present differently in women
Heart disease is the leading cause of death in women, the symptoms are frequently not the textbook ones, and the treatment gap is measurable.
Fertility & pregnancy
The fertile window is shorter than most people think
About six days a cycle, and the best days are the ones before ovulation, not the day itself. The arithmetic matters more than most fertility advice.
Sleep & energy
Your caffeine half-life is not the average one
Genetics change how fast you clear caffeine by a factor of several. Hormonal contraception roughly doubles how long it lingers. The standard advice is not written for you.
Care & advocacy
How to prepare for a ten-minute appointment
You get about ninety seconds to frame the problem before the direction is set. Here is what to put in them, and what to leave out.
Sleep & energy
Fatigue that sleep doesn't fix
If you are sleeping enough and still exhausted, the problem is elsewhere. Here is the list worth working through, roughly in order of likelihood.
Care & advocacy
Why women wait longer for a diagnosis
The delay is measurable across a wide range of conditions, and it has specific documented causes. Knowing them is the first step to working around them.
Sleep & energy
CBT-I is the first-line insomnia treatment, and almost nobody is offered it
It outperforms sleeping pills long-term, it takes about six weeks, and most of it is counterintuitive enough that people abandon it in week two.
Sex & intimacy
Painful sex is common, and almost always treatable
Dryness, pelvic floor overactivity, endometriosis, vulval skin conditions, scar tissue. Each has a different treatment, and enduring it is not one of them.
Sex & intimacy
Desire is responsive as often as it is spontaneous
The idea that wanting sex should arrive unprompted describes one pattern well and another badly. A great many women are diagnosing themselves with a problem they do not have.
Sleep & energy
The 3am wake-up, explained
Waking in the small hours has a short list of usual causes. Cortisol timing, alcohol, blood sugar and a warm body account for most of them.
Body & movement
Why so many women are iron deficient, and how to actually fix it
Menstrual loss outpaces absorption for a large number of women. Replacing it properly takes months and works better on alternate days than daily.
Sleep & energy
Why you sleep worse in the week before your period
Your core temperature is running half a degree warmer, and falling asleep depends on it dropping. That one fact explains most of it.
Body & movement
Most women eat less protein than they need
The official minimum was set to prevent deficiency, not to support muscle, bone or recovery. The number that does those things is considerably higher.
Sleep & energy
Why women have more insomnia than men
The gap opens at puberty and widens across life. Hormones explain part of it, but under-diagnosed sleep apnoea and unequal night-time labour explain more than most people expect.
Mood & mind
How to tell a bad week from something that needs help
Clinicians use three specific criteria: duration, function and change from baseline. You can apply them yourself.
Body & movement
The pelvic floor is a muscle group, and it can be trained
Leaking is common and not something to live with. But Kegels are the wrong answer for a substantial number of people, and doing them can make things worse.
Body & movement
Training around your cycle: what the evidence actually says
Cycle-based training is sold with a confidence the research does not support. Here is what is established, what is not, and what to do instead.
Mood & mind
What actually helps anxiety, ranked honestly
The interventions with the strongest evidence are not the ones with the biggest marketing budgets. Here is what the research supports, and what it does not.
Mood & mind
Why one drink wrecks the next day more than it used to
The next-morning dread has a mechanism: a rebound in the brain's excitatory system as alcohol clears, layered on top of sleep it has quietly destroyed.
Body & movement
Strength training does more for women than any other kind of exercise
Bone, muscle, metabolic health, mood, and independence in old age. Nothing else covers that much ground, and most women are still steered away from it.
Mood & mind
Does hormonal birth control affect your mood?
The population evidence is genuinely mixed. Your individual experience is not, and it is the only one that should decide what you take.
Mood & mind
Brain fog is a symptom, not a condition
The word covers at least six different problems with different fixes. Working out which one you have is most of the work.
Mood & mind
Why so many women are diagnosed with ADHD in their thirties
The diagnostic criteria were built on studies of hyperactive boys. What ADHD looks like in a woman who learned to compensate is a different picture entirely.
Mood & mind
Low ferritin, and feeling flat when your blood test was "normal"
You can be seriously iron-depleted with a completely normal full blood count. Ferritin is the test that finds it, and it is often not run.
Mood & mind
Why anxiety spikes in the week before your period
The mechanism runs through a progesterone metabolite that acts on the same brain receptors as alcohol and benzodiazepines. In some people it calms. In others it does the opposite.
Cycles & hormones
When your periods stop and you are not pregnant
Amenorrhoea is a symptom, not a diagnosis. Here are the common causes, in roughly the order a good clinician works through them.
Cycles & hormones
Endometriosis and the seven-year wait
The average delay from first symptom to diagnosis is measured in years. Here is why it happens, and what actually shortens it.
Cycles & hormones
How stress actually interrupts your cycle
"It's just stress" is usually said dismissively. It shouldn't be — the pathway from stress to a missing period is specific, physical and well described.
Cycles & hormones
What actually happens when you come off hormonal birth control
There is no detox and nothing to flush out. But your own cycle has to restart from scratch, and that takes longer than most people expect.
Cycles & hormones
PCOS is a metabolic condition that happens to involve the ovaries
The cysts are the least important part of the name. Insulin resistance and androgen excess are what actually drive it, and what treatment should target.
Cycles & hormones
PMS and PMDD are not the same thing
The line between them is not severity of bloating. It is whether the mood symptoms take a functioning week out of your life, every month, predictably.
Cycles & hormones
Period pain that isn't normal, and how to tell the difference
Cramps that respond to ibuprofen and let you get on with your day are ordinary. Pain that runs your life is a symptom, and it usually has a name.
Cycles & hormones
How heavy is too heavy, and what to do about it
Most people have no reference point for their own flow. Here are the practical markers clinicians use, and the causes worth ruling out.
Cycles & hormones
How to tell when you ovulate, and what each sign is worth
Cervical mucus, temperature, ovulation tests and mid-cycle pain all tell you something different. Only some of them tell you in time to be useful.
Cycles & hormones
The luteal phase, and why the two weeks before your period feel different
Progesterone raises your body temperature, changes your sleep architecture, shifts your appetite and alters your mood. None of that is in your head.
Cycles & hormones
Why your cycle length changes from month to month
A late period usually means a late ovulation, not a late period. Here is what pushes ovulation around, and when variation stops being ordinary.
Cycles & hormones
What a normal menstrual cycle actually looks like
The 28-day cycle is an average, not a standard. Here is the real range of normal, and the specific things that are worth a doctor's attention.