- Amenorrhea
- Absence of menstrual periods. In midlife, expected as menopause approaches; outside that context it should be evaluated.
- Androgen
- A class of hormones — including testosterone and DHEA — produced by the ovaries and adrenal glands that contribute to libido, energy, and well-being in women.
- Anovulation
- A menstrual cycle in which no egg is released. Becomes more common in perimenopause and is a primary driver of progesterone deficiency.
- Aromatase Inhibitor (AI)
- A class of breast cancer medications (letrozole, anastrozole, exemestane) that suppress estrogen production. Causes severe estrogen-deficiency symptoms; systemic estrogen cannot be used.
- BHRT
- Bioidentical Hormone Replacement Therapy. Refers to therapy using hormones identical in structure to those the body produces. Includes both FDA-approved (preferred) and compounded preparations.
- BRCA1 / BRCA2
- Genetic mutations associated with increased breast and ovarian cancer risk. Carriers often undergo prophylactic oophorectomy, which causes immediate surgical menopause.
- DEXA Scan
- Dual-energy X-ray absorptiometry — the standard test for measuring bone mineral density and diagnosing osteopenia or osteoporosis.
- DHEA
- Dehydroepiandrosterone — an adrenal hormone that serves as a precursor to estrogen and testosterone. Declines with age.
- Diurnal Cortisol
- The natural daily rhythm of cortisol — high in the morning, low at night. Disruption is common in midlife and contributes to fatigue and sleep issues.
- Endometrial Hyperplasia
- Thickening of the uterine lining, often caused by unopposed estrogen. Can progress to endometrial cancer if untreated. The reason progesterone is required when estrogen is given to women with a uterus.
- Estrogen Dominance
- A clinical pattern of relatively high estrogen activity compared to progesterone — common in early perimenopause when progesterone declines first.
- GLP-1
- Glucagon-like peptide-1. The hormonal pathway targeted by semaglutide and tirzepatide for weight management and glycemic control.
- HOMA-IR
- A calculated index of insulin resistance derived from fasting glucose and insulin. Useful in midlife metabolic assessment.
- HPA Axis
- The hypothalamic-pituitary-adrenal axis — the body's central stress response system. Disruption contributes to fatigue, sleep, and weight changes in midlife.
- Oophorectomy
- Surgical removal of one or both ovaries. Bilateral oophorectomy causes immediate surgical menopause within 24-48 hours.
- Osteopenia
- Lower-than-normal bone mineral density that has not yet reached the threshold for osteoporosis. Common in early postmenopause.
- Progestogen
- An umbrella term covering both bioidentical progesterone and synthetic progestins.
- Tamoxifen
- A SERM used in hormone-receptor positive breast cancer treatment. Paroxetine and other strong CYP2D6 inhibitors should be avoided as they reduce its efficacy.
- Vaginal Atrophy
- A component of GSM — thinning, drying, and inflammation of vaginal tissue caused by estrogen loss. Highly treatable with vaginal estrogen.
- Veozah
- Brand name for fezolinetant — the first FDA-approved non-hormonal, non-SSRI medication specifically for menopause hot flashes.
- Allopregnanolone
- A neuroactive metabolite of progesterone that acts on GABA receptors and contributes to progesterone's calming and sleep-promoting effects.
- Atrophic Vaginitis
- Thinning, drying, and inflammation of the vaginal walls caused by reduced estrogen, common after menopause. Treatable with vaginal estrogen.
- Bioidentical Hormones
- Hormones identical in molecular structure to those the body produces naturally, including 17β-estradiol and micronized progesterone.
- BMD (Bone Mineral Density)
- A measure of bone strength. Estrogen loss accelerates BMD decline, increasing osteoporosis and fracture risk.
- Climacteric
- The medical term for the broader transition that includes perimenopause, menopause, and the early postmenopausal years.
- Compounded HRT
- Hormone therapy custom-made by a compounding pharmacy. Used when a commercial product is not appropriate, but FDA-approved bioidentical options are typically preferred.
- Conjugated Equine Estrogens (CEE)
- A horse-urine derived estrogen mixture used in older HRT formulations including the original Women's Health Initiative trial.
- Cortisol
- The primary stress hormone produced by the adrenal glands. Often measured when fatigue, sleep, or weight changes do not fit a clear menopause picture.
- Dyspareunia
- Painful intercourse, often caused by vaginal atrophy in postmenopausal women. Highly treatable with vaginal estrogen.
- Endometrium
- The lining of the uterus. In women with a uterus on systemic estrogen, progesterone is required to protect the endometrium.
- Estradiol (E2)
- The primary estrogen made by the ovaries during the reproductive years; the most potent of the three human estrogens.
- Estriol (E3)
- A weaker estrogen, dominant in pregnancy. Sometimes used in compounded vaginal preparations.
- Estrone (E1)
- The dominant estrogen after menopause, produced primarily from peripheral conversion of androgens.
- Fezolinetant
- An FDA-approved NK3 receptor antagonist used for moderate-to-severe vasomotor symptoms in women who cannot or do not want to use estrogen.
- FSH (Follicle-Stimulating Hormone)
- A pituitary hormone that rises during perimenopause and menopause. Useful but not definitive for diagnosis.
- GABA
- The brain's primary inhibitory neurotransmitter. Progesterone's metabolite allopregnanolone acts on GABA receptors and supports sleep.
- GLP-1 Receptor Agonist
- A class of medications (semaglutide, tirzepatide) that slow gastric emptying and reduce appetite. Used in chronic weight management.
- GSM (Genitourinary Syndrome of Menopause)
- A collection of symptoms — vaginal dryness, urinary urgency, dyspareunia — caused by reduced estrogen in genitourinary tissue.
- HRT (Hormone Replacement Therapy)
- Treatment with estrogen, progesterone, and sometimes testosterone to relieve symptoms of menopause and protect bone density. Also called MHT.
- Hot Flash
- A sudden sensation of intense heat often accompanied by sweating and flushing, caused by hypothalamic dysregulation as estrogen falls.
- Hypoactive Sexual Desire Disorder (HSDD)
- Persistent low sexual desire that causes distress. The most well-supported indication for low-dose female testosterone therapy.
- Hypothalamus
- The brain's temperature, hormone, and circadian regulator. Estrogen loss alters hypothalamic function and drives hot flashes.
- Insulin Resistance
- Reduced cellular response to insulin. Becomes more common in midlife and contributes to weight gain, especially around the abdomen.
- KNDy Neurons
- A group of hypothalamic neurons (kisspeptin/neurokinin B/dynorphin) that mediate hot flashes; the target of fezolinetant.
- LegitScript Certification
- A third-party verification that a telehealth provider operates legally and meets clinical and pharmacy compliance standards.
- LH (Luteinizing Hormone)
- A pituitary hormone that triggers ovulation; used alongside FSH in cycle and menopause assessments.
- Menopause
- Defined as 12 consecutive months without a menstrual period. Average age in the U.S. is 51.
- Micronized Progesterone
- Bioidentical progesterone in a finely milled formulation that improves oral absorption. The preferred progestogen in modern HRT.
- NAMS
- The North American Menopause Society — the leading clinical authority on menopause care in North America.
- NCMP
- NAMS Certified Menopause Practitioner — a credential indicating advanced training in menopause medicine.
- Night Sweats
- Hot flashes that occur during sleep. A leading cause of midlife sleep disruption.
- Osteoporosis
- A condition of low bone mineral density and increased fracture risk. Estrogen loss is a major driver in postmenopausal women.
- Perimenopause
- The transition period leading up to menopause, typically lasting 4-10 years, in which hormones fluctuate and symptoms often begin.
- Postmenopause
- The years after menopause has been reached. Symptom patterns and treatment goals shift in this phase.
- Premature Ovarian Insufficiency (POI)
- Loss of ovarian function before age 40. Associated with significant long-term health risks if untreated.
- Progestin
- A synthetic compound with progesterone-like activity (e.g., medroxyprogesterone acetate). Distinct from bioidentical micronized progesterone.
- SERM (Selective Estrogen Receptor Modulator)
- A medication (e.g., raloxifene, ospemifene) that selectively activates estrogen receptors in some tissues and blocks them in others.
- SHBG (Sex Hormone Binding Globulin)
- A protein that binds testosterone and estradiol; affects how much hormone is biologically active.
- SSRI / SNRI
- Classes of antidepressants. Some are FDA-approved or used off-label to reduce hot flashes when HRT is not appropriate.
- Surgical Menopause
- Menopause induced by surgical removal of both ovaries. Onset is abrupt and symptoms are often more severe.
- Testosterone
- An androgen produced by the ovaries and adrenal glands. Plays a role in libido, energy, and well-being in women.
- Transdermal Estrogen
- Estrogen delivered through the skin (patch, gel, cream). Bypasses the liver and is associated with lower clot risk than oral estrogen.
- Vasomotor Symptoms (VMS)
- The medical term for hot flashes and night sweats — the most well-studied and most treatable menopause symptoms.
- WHI (Women's Health Initiative)
- A landmark trial whose early reporting in 2002 dramatically misshaped public perception of HRT safety. Modern reanalysis paints a very different picture.