Sources & Evidence Base
Every claim on this site is grounded in peer-reviewed research or clinical guidelines. Click any title to read the original source.
The primary clinical guideline for hormone therapy in menopause. Updates the risk-benefit evidence and recommends individualised decision-making.
Evidence review of non-hormonal treatments for vasomotor symptoms — including fezolinetant, SSRIs, gabapentin, CBT, and others.
Defines the international staging system for reproductive ageing (STRAW+10). The foundation for how perimenopause is clinically classified.
26-year longitudinal study of 3,000+ multiethnic women through the menopause transition. The most comprehensive source of data on symptom timing, duration, and variation.
Identified four distinct hot flash trajectory groups. Average duration 7.4 years; 1 in 4 women experience symptoms starting 11+ years before their final period.
Showed that the perimenopause transition — not postmenopause — is the highest-risk period for new onset depression. Risk is 2–4× higher than reproductive years.
10-year SWAN mood findings. Late perimenopause confirmed as the critical window for mood vulnerability.
NAMS expert panel guidelines on cognitive symptoms. Confirms cognitive complaints are common and real, recommends assessment pathway, and addresses the evidence on HRT and cognition.
SWAN cognitive substudy. Demonstrated objective declines in memory and processing speed during the transition, with improvement post-menopause for most women.
Introduced the term GSM (Genitourinary Syndrome of Menopause) to replace 'vulvovaginal atrophy'. Emphasises that this condition is progressive and does not self-resolve.
Clinical practice guideline covering DEXA, bisphosphonates, denosumab, and other bone-protective strategies.
Comprehensive review of the timing hypothesis. HRT started in perimenopause or within 10 years of menopause has different cardiovascular outcomes than HRT started late.
The landmark (and frequently misapplied) WHI trial. Enrolled women averaging age 63 — mostly well past menopause. Results were incorrectly generalised to perimenopausal women.
International consensus on testosterone use in women — covers evidence for libido, sexual function, and notes gaps in evidence for other symptoms.
Describes the estrobolome — how gut bacteria regulate circulating estrogen via beta-glucuronidase activity. Dysbiosis can lower estrogen and amplify perimenopausal symptoms.
Phase 3 RCT of fezolinetant (NK3 receptor antagonist). Non-hormonal treatment FDA-approved in 2023 with strong efficacy for hot flashes and night sweats.
Systematic review of 283 trials covering vasomotor symptoms, sleep, mood, sexual function, and urogenital atrophy. The most comprehensive evidence synthesis available.
Explains the KNDy neuron hypothesis — how neurokinin B signalling in the hypothalamus drives hot flashes after estrogen withdrawal.