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Timestamps 00:00 Cold open: 200 years of menopause medicine 03:23 Welcome and roadmap 04:20 The HPG axis, follicles, and the FSH lag 09:11 STRAW+10 staging and the timing of perimenopause 13:47 Austin: the 49-year-old with a hormone panel 20:00 Loraine: the OB-GYN workup 28:00 Symptom attribution: what menopause actually causes 33:46 Austin: the all-estrogen patient 37:58 VMS duration and the KNDy mechanism (Avis, SKYLIGHT) 43:53 Austin: who actually gets fezolinetant 47:22 The WHI 24-year correction (Manson, Chlebowski, Boardman) 01:00:15 Modern prescribing today 01:06:52 Where the menopause-content space gets it right and wrong 01:11:50 Testosterone, compounded bioidenticals, and DUTCH panels 01:24:13 Takeaways What we cover The HPG axis and the estrogen shield: what is happening across the 35-year reproductive era and what changes at perimenopause