There is a sentence women say quietly, usually near the end of an appointment, usually while reaching for a coat: I think there is something wrong with my brain. The measured answer is more reassuring and more precise than either the fear or the dismissal. Women in late perimenopause stopped improving on repeated cognitive testing while every other group carried on, and then the curve came back. But underneath that sits a second question, about ADHD in this window, where a systematic review went looking for studies and found none.

For a long time the word I used was fine. Not well — I was never consistently well — but fine. The kind of fine that gets you through appointments where the doctor says your bloods look good and you nod and go home. The framework I eventually found — not in a clinic but in research papers — was low-grade inflammation. Chronic, systemic, subclinical. Below the threshold that conventional medicine calls concerning. Running quietly enough to be easy to miss. Pervasive enough to affect almost every system in the body.