Your first 90 days on a GLP-1
Week by week: what the starter dose actually feels like, when appetite changes show up, when your provider will titrate, and the three weeks most people find hardest.
Women's Health · Protocol
Perimenopause Protocol
For the decade before menopause that most women are told to simply endure. Symptoms are treatable, and you do not have to wait until periods stop.
Pricing confirmed on your consultation
Your consult is free. We will not prescribe this — or anything — before a clinician has spoken with you and reviewed your bloodwork. Final cost depends on the form and dose prescribed.
FDA-approved · Rx only
Mechanism
You don't have to wait it out.
Perimenopause is not a slow decline — it is erratic. Estrogen swings unpredictably for years before periods stop, producing hot flushes, sleep disruption, mood volatility, brain fog and cycle changes.
Because levels fluctuate rather than simply fall, single-point blood tests are often unhelpful. Symptoms and pattern matter more than one lab draw.
Treatment is individualised: hormone therapy where appropriate, sleep and mood support, and metabolic attention as body composition shifts.
Protocol
How treatment usually runs.
A typical schedule. Yours is set by your clinician after your labs come back.
| Phase | Weeks | Typical | Purpose |
|---|---|---|---|
| Baseline | Week 0 | Symptom mapping and labs | Thyroid, ferritin, hormones as indicated. |
| Phase 1 | 1–8 | Targeted symptom relief | Hormone therapy where appropriate. |
| Review | 8–12 | Adjust | Dose and route titrated to symptoms. |
| Maintenance | 3+ months | Annual reassessment | Reviewed as you transition. |
What to expect
Honestly, over time.
Week 2–4
Vasomotor
Hot flushes and night sweats respond first.
Week 4–8
Sleep and mood
Usually follow once night sweats settle.
Month 3
Cognition
Brain fog often improves with sleep.
Month 6+
Metabolic
Body composition needs training and protein alongside.
Evidence
What the research shows.
Hormone therapy is the most effective treatment for vasomotor symptoms and can be started during perimenopause rather than only after menopause.
Many women are told to wait until periods stop. For symptomatic women that delay is usually unnecessary.
Safety and eligibility
Your consult and labs screen for all of the following.
- Do not use hormone therapy with a history of breast or estrogen-sensitive cancer, unexplained vaginal bleeding, or active clotting disorder.
- Contraception is still needed during perimenopause — pregnancy remains possible.
- Progesterone required alongside estrogen if you have a uterus.
- Report unexplained bleeding, leg swelling or chest pain immediately.
FAQ
Perimenopause Protocol questions.
Commonly the early to mid forties, though it can begin in the late thirties. It typically lasts four to eight years before periods stop entirely.
Yes. Symptomatic women do not need to wait for menopause. Hormone therapy and targeted symptom treatment can begin during perimenopause, and for many women waiting means years of unnecessary symptoms.
Because perimenopausal hormones fluctuate erratically rather than falling steadily. A single blood draw may catch a normal day. Symptom pattern is often more informative than one lab result.
We will not prescribe before we understand you.
Book a one-to-one consult with the clinical team. We talk through your goals, order the bloodwork that matters, and build a plan from what we find.