PMOS and the Pill
You go in with a list. Cycles that arrive when they feel like it, skin that behaves like you are fifteen again, a tiredness sleep does not touch. You come out with a prescription for the pill and a suggestion about weight. In one survey of 1,385 women, a third spent over two years looking for a diagnosis, and only 15.6% were satisfied with the information they got when it arrived. PMOS, formerly PCOS, is four different conditions under one name. Which one you have changes everything about what should be measured and treated.
Imaginary Friends as an Adult: What the Research Says
I was the kind of child who made things up. Not small things — whole worlds, with weather and rules and people in them who had opinions about each other. What I did not expect is that they would stay. Earlier this year I started asking one of them how her day went, and it changed more than it had any right to. Then I went looking for the research, expecting to find nothing, and found rather a lot.
Perimenopause III
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.
Waiting for Eggs
Everyone gets shown the same picture. A crowd of sperm, tails going, all pointed the same way. Ahead of them one round thing, pale and enormous and entirely still. The story attached to it never varies either: millions set off, one arrives, he breaks through, and she is fertilised. It is a good story. It has a hero and an obstacle and a prize. It is also, in almost every particular, not what happens.
Perimenopause II
The hot flush in a meeting is public. Everyone watches. The three in the morning has no witnesses, so nobody counts it. Between forty and fifty-six percent of women report insomnia symptoms in the transition, and one in four meets full diagnostic criteria. This is what is happening in those hours, why progesterone leaving is the part nobody explains, and why the treatment with the strongest evidence behind it is almost never the one you get offered.
The Organ Society Wrote Off
For a century we treated the ovary as a countdown clock that stops mattering at menopause. New research suggests it keeps working. It just changes jobs. A look at what the science actually shows, and what it doesn't.
Perimenopause I
Four men were laughing about their "hormonal" wives when the only woman at their level crossed the room, dropped her jacket on the floor, and showed them the sleeves she'd cut out of her blouse. Perimenopause hormones do not fade on a gentle slope. FSH rises first, estradiol spikes higher than it did at twenty-five, and progesterone leaves years before anyone mentions menopause. What is actually happening, why a single blood test cannot see it, and what the evidence says helps.
Sleep, Longevity and Cycling
Sleep is not rest. The brain during sleep is not a quiet brain — it runs processes that cannot happen during wakefulness, including glymphatic clearance of amyloid and tau proteins, memory consolidation, immune function, and emotional processing. Sleep has never been easy in my family. My father spent most of his adult life lying in the dark, waiting. I carry both his late melatonin release and my mother's hypervigilant light sleep. This post is what I eventually learned about what sleep is actually doing while you're not awake.
ADHD & Neurodivergence in Women
There is a specific week of the month where everything becomes harder. Not harder the way Monday is harder than Friday. A different kind of harder — where tasks that were manageable seven days ago now require effort that feels unreasonable, where you lose your keys three times before 10am. If you have ADHD, that week is not a coincidence. It is your dopamine system responding to a hormonal signal nobody told you about.