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I have handed women normal lab results. I have reviewed a panel that fell within the standard reference range and delivered the news that everything looked fine — while the woman on the other side of the screen was exhausted in a way that sleep could not fix, gaining weight despite doing everything right, losing words mid-sentence. Normal is not the same as optimal. And for women in perimenopause, that gap is where years of unnecessary suffering live.

I still work in conventional medicine. I show up inside the system every single day, in the hospital, in urgent care before that and I watch, up close, the ways it fails the women who need it most. The women I see have often been to two or three providers before they find their way to a video visit with me. They have been told their labs look normal. That they should reduce stress. That this is just part of getting older.