Perimenopause & menopause · United States
3:47 a.m.Again.
Awake, too warm, heart going. Then a whole day to get through on four hours of sleep. If your nights have changed and nobody has given you a straight answer yet — this is a decent place to start.
Nine questions, about two minutes. No account, no cost, and you get a written explanation at the end whatever you decide to do next.
In your own words
If you have said any of these out loud, you are in good company.
Sleep
“I fall asleep fine. It's two in the morning that gets me.”
Hot flashes
“The heat comes up out of nowhere and then I'm soaked.”
Mood
“I snapped at someone I love and didn't recognise myself.”
Brain fog
“I walked into the room and had no idea what I came for.”
None of that means something is wrong with you as a person, and none of it means you are simply getting older and should put up with it. It usually means something measurable is changing — and measurable things can be worked with.
You are not imagining it, and you are not doing this badly.
In the years before periods stop, oestrogen and progesterone do not glide gently downwards. They swing — sometimes higher than they have ever been, sometimes far lower, often inside the same month.
Those two hormones do a great deal more than run a cycle. They have a hand in how the body holds its temperature, how deeply it sleeps, how it handles stress, and how easily words arrive. So when the levels lurch, the first things to give way are often sleep, temperature, mood and memory — in roughly that order.
This stage can run for years. Most of us were told about it in one sentence, decades ago, in a pamphlet.
Which is how so many capable women arrive at this point convinced they have become unreliable, when what they actually have is an information problem.
If you have already tried
“Your bloodwork is normal. Are you under a lot of stress?”
A ten-minute appointment. Labs that came back unremarkable. An antidepressant offered before anyone asked a single question about your nights. If that is roughly how it went, you are not an unusual case — you are the most common case there is, and you are the reason this exists.
One of the nine questions asks exactly this: whether you have been already, and whether it helped. It is the answer we read most carefully.
Answer the nine questionsHow it works
Two minutes now, no obligation after.
01
Nine questions, in plain English
About how you actually feel — not a symptom checklist written for a chart. Roughly two minutes.
02
A readable explanation
What your answers line up with, what tends to sit behind it, and which parts are worth raising with a clinician.
03
You decide what happens next
Nothing at all, the waitlist, or a place in the first program. All three are fine with us.
What can actually be done
There is a great deal more available than most women are told.
These are the routes clinicians work with at this stage. Which of them belongs in your plan — if any — depends on your history, your timing and what is bothering you most. That is the conversation, and it is the part that keeps getting skipped.
Hormone therapy
The most studied route for hot flashes and night sweats, and the one most surrounded by confusion since a large 2002 study was widely misreported. The current picture is more nuanced than the headlines were: age, how long ago periods changed, and personal and family history all weigh on the decision. It comes in more forms than most people realise — patch, gel, spray, tablet, and a coil for the progesterone half.
Non-hormonal prescription options
For women who cannot take hormones, or would simply rather not, there are prescription medicines studied specifically for hot flashes — including a newer class that works on the temperature circuit in the brain rather than on hormones at all. Fewer people are offered these than could be.
Sleep, treated as its own problem
Broken sleep is not only a symptom here, it is an amplifier: it makes heat, mood and memory measurably harder to live with. Structured insomnia treatment — usually shortened to CBT-I — has a strong evidence base, and a plan that leaves sleep to sort itself out later tends to stall.
The unglamorous checks
Thyroid function and iron produce a strikingly similar picture and are missed all the time. Alcohol, timing of meals, and strength training all change how well everything else works. None of this is a substitute for treatment, and any site telling you it is has something to sell you.
What the 90 days look like
The part that usually goes missing is the second appointment.
Most women get one visit, one prescription and no way back into the room. Almost nothing lands perfectly the first time, so the programme is built around adjusting rather than around a single verdict.
Week 1
A first visit with room in it
Long enough to get through the whole history: what changed and when, what you have already tried, what a good day would even look like. Labs ordered where a question needs answering, not as a reflex.
Week 2
A written plan you can actually read
What to start, what to watch for, what to do if something feels wrong. In plain English, and yours to keep — including to show your own doctor.
Weeks 3–6
The first adjustment
Dose, form, timing. This is the step almost nobody gets, and it is usually where the difference between a plan that fits and one that does not gets sorted out.
Weeks 7–12
The second adjustment, and a plan that outlives us
Refine what is working, drop what is not, and finish with something you can carry on with — whether that is with us or back with your own clinician.
What we are building
Care that has time for the whole story.
We are being deliberately plain about where this stands: the program opens in November 2026, the clinical team is being assembled now, and the reservation is refundable for that exact reason.
First cohort · November 2026
The 90-Day Program
A clinician, a plan, and someone to answer you in between. Built for the years when sleep, temperature and mood stop behaving the way they used to.
A video visit with a licensed clinician
Licensed in your state, and long enough to actually talk. Not eight minutes with a hand on the door.
Lab work when it is useful
Ordered because a question needs answering — not as a default box to tick.
A written plan you can follow
In plain English, with what to try first and what to watch for.
Messaging in between
So you are not alone with it for three months between appointments.
Straight talk about the $20.
The first cohort starts in November 2026. We expect the program to be $250–$350, and the $20 comes off that price. It holds your place and nothing else. If you change your mind — or if we do not open on time — we refund it in full. No forms, no reason required, no phone call to get out of it.
Deposits open shortly. Join the waitlist and we will write to you first.
Reasonable questions
Asked before, answered straight.
How long does this stage go on for?
Longer than most women are led to expect. The transition commonly runs for several years — for some it is closer to a decade — and symptoms often peak while periods are still happening rather than after they stop. Hearing 'it will pass' is technically true and practically useless when nobody tells you the timescale.
Is hormone therapy safe? I heard it causes cancer.
That fear traces back to a single large study in 2002 whose findings were widely misreported, and the correction never travelled as far as the headline did. The honest answer today is that risk and benefit depend heavily on your age, how recently things changed, the form and dose used, and your own and your family's history — which is precisely why it is a conversation with a clinician rather than something anyone can settle on a web page, including us.
When does the program start, and who will I actually see?
The first cohort starts in November 2026. You will see a clinician licensed in your state, and the clinical team is being put together now — which is why the reservation is refundable in full at any point before then. We would rather tell you that on the page than have you find it out later.
What will it cost?
We expect $250–$350 for the 90 days. The $20 deposit comes off that price rather than being added to it, and it is refundable at any time by email.
I've had a hysterectomy, or I'm already on hormone therapy. Is this for me?
The quiz has a place for both. Women who have already started treatment and feel it is not doing the job are some of the people we most want to hear from — 'it is not working' is very often a question of dose, form or timing rather than a closed case.
I'm under 45. Should I bother?
Possibly. Changes can begin earlier than most people expect, and being told you are too young for this is a common way to lose several years. The quiz asks your age band and takes it into account.
Is the result a diagnosis?
No — it is an explanation. It describes patterns many women recognise, in plain English, so you have clearer language for what has been happening. Diagnosing takes a clinician who can see your history and examine you.
What happens to my answers?
They stay in our own records and are used to write your result. They are never sent to Meta, Google or any other advertising or analytics platform — not as parameters, not in a web address, not in a session recording. That is built into how the site works, not a sentence in a policy document.
It is two minutes, and it is yours to keep.
Whatever you decide afterwards, you will finish with clearer language for what has been happening — which turns out to be useful in a doctor’s office.
Start the 2-minute quiz