Perimenopause: The Missing Diagnosis

Perimenopause: The Missing Diagnosis

From Empowering Midlife Wellness with Dr. Susan by Dr. Susan Hardwick-Smith

April 22, 2026 · 23 min

About this episode

Dr. Susan Hardwick-Smith discusses the often misunderstood phase of perimenopause and the importance of comprehensive hormonal care.

Perimenopause is one of the most misunderstood phases in a woman’s life—and too often, it’s missed entirely. Every day, I see women who have been told they’re “too young,” that their labs are “normal,” or that what they’re experiencing is simply stress or something psychological. And yet, they know something is changing. Perimenopause is not a steady decline. It’s a phase of hormonal unpredictability—where estrogen can fluctuate significantly, progesterone declines, and testosterone gradually shifts. These changes can drive a wide range of symptoms that may seem unrelated, but are deeply connected. Yet many women find their symptoms are addressed in isolation—often without a comprehensive view of their hormonal landscape. I believe we can do better. This is where the concept of midlife baseline screening becomes essential. By measuring hormones thoughtfully and at the right time, we can move from assumption to clarity—and from generalized care to a more precise, individualized approach. In this video, I walk through: – Why perimenopause is often overlooked – What is actually happening hormonally – The limitations of symptom-only care – The role of baseline screening – How to find…

People in this episode

Host: Dr. Susan Hardwick-Smith

Topics covered

  • perimenopause
  • hormonal changes
  • women's health
  • midlife wellness
  • baseline screening

Keywords

  • perimenopause
  • hormonal unpredictability
  • symptoms
  • baseline screening
  • women's health

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