Selfority

I got pulled over on the drive home this weekend.

It was, somehow, one of the best parts of my day.

There was a kind officer, an episode that had me laughing alone in my car, and an Ann Patchett audiobook so good I forgot I was driving at all. Four hours I didn't want to take turned into one of those days that has no plot and no point and left me smiling anyway.

I don't always write to you about the good stuff. Today I wanted to share some joy.

New substack is up, link in bio.

There's a trend right now where people list what they find chic about their industry. It made me thing of what I would say about mine.

Menopause care has been shaped by marketing for years. Wellness brands sell fear before they sell a fix, and women are the ones paying for it, both literally and with their trust.

So I started asking what I actually want to bring to this conversation instead.

I want to choose the person over the profit. I want to remember that menopause doesn't stay in the exam room, it follows women into every hallway of the hospital where they work too. I want to walk into rooms with actual data, the kind that makes funding menopause care look like the financial no brainer it is, not a favor anyone is doing women.

I want every woman to leave her appointment with the questions already in hand, because she asked for them.

I want her to know she is allowed to be first on her own list.

And I want to watch a man ask a real question about menopause and mean it.

That's not a wish list. That's Selfority.

Swipe through.

Tis but a scratch.
On perimenopause, internal violence, and the warzone women forget they are living in.

New on my Substack, Still Becoming. Link in bio.

Her mom's hip. Her son's sports physical. Her husband's cholesterol panel.

All on the calendar. All booked weeks ago.

Her mammogram? Still "next month."

Nearly 18 million midlife women are behind on a breast, cervical, or colorectal screening. Not because they don't know better. Because there's always someone else's appointment first.

I wrote about why for . Link in comments.

Go put your name on the calendar too.

FSH is not a perimenopause test. Here's what it actually is — and when it does and doesn't mean something.

As a board-certified OB-GYN and menopause specialist, I want to be clear about this because the misconception is widespread and it matters for how you advocate for yourself.

FSH — follicle-stimulating hormone — is released by your pituitary gland. Its job is to signal your ovaries to develop follicles. When the ovaries become less responsive during perimenopause, the pituitary compensates by producing more FSH. A rising FSH tells you the brain is working harder to get a signal through. It does not tell you where you are in the transition or what's driving your symptoms.

Here is what ACOG is clear about: in women over 45 with typical symptoms and cycle changes, perimenopause is a clinical diagnosis. Routine hormone testing including FSH is not needed. FSH testing has a more specific role — evaluating for premature ovarian insufficiency in women under 40, or occasionally in women aged 40–45 where the clinical picture is unclear.

One random FSH value on a random day during perimenopause means very little. The levels fluctuate too much to be reliable in isolation.

The question worth bringing to your appointment is not "can you check my FSH." It is "based on my symptoms and cycle history, where do you think I am in this transition?"

The full breakdown is in the free Selfority Understanding Your S*x Hormone Labs in Perimenopause | eBook. Link in bio.
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🔖 Save this before your next appointment.
🔗 Free hormone lab guide — link in bio.

Tomorrow's the day. 12pm ET.

Look at this lineup. Dr. Roberta Diaz Brinton studying the menopausal brain at the University of Arizona. Joy Calloway leading the Black Women's Health Imperative. Tamsden Fadal , who has done more than almost anyone to bring this conversation into the open. Lisa McDonald @.mcdonald from The 'Pause Life. Dr. Elizabeth Garner opening things up with the research that frames the whole briefing.

I am so honored to be in this room with them.

Here's the thing about a Congressional briefing: it only means something if people show up. Not just us on the panel. You.

If menopause has ever felt overlooked, underfunded, or like an afterthought in this healthcare system, tomorrow is your chance to say so, loudly, in a room policymakers are actually watching.

Come be part of it. Link in bio

Also: This event would not be happening if it wasn't for the amazing group, .advocates, lead by Liz Powell AND the amazing volunteer leaders Allison Lewin, Jaclyn Coleman, and Adrianne Musuneggi!

In two days, I am speaking at a congressional briefing on menopause policy. An actual one, in front of legislators and their staff, on a bill with a real number attached to it.

I have the pillar nobody finds exciting and I cannot stop talking about: doctors are sent into practice unprepared to care for women in the second half of their lives. Only about 6.8% of medical residents feel ready to manage menopause. Fewer than seven out of a hundred. Not bad doctors. Unequipped ones.

The fix is almost insultingly cheap, and we are choosing not to make it while the country spends billions a year on the confusion that follows.

I wrote about why I said yes to this, why I am glad the door is even open, and why I want you in the room. It is on my Substack now, link in bio.

Here is the part that depends on you. The briefing is July 23rd, noon Eastern, on Zoom, and it is open to anyone. You do not need a medical degree or a single fact ready. The size of that audience is the message. When a legislative team sees a full room, they hear the one thing that moves them, which is that people care and people are watching.

Register for this event through my substack piece. Come be a number. Come be a loud one.