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Am I in menopause?

Am I in menopause?

in Articles

If you have found yourself thinking, “Why am I suddenly so hot?”,” Why am I waking up at 3am?” or “Why do I feel flat, foggy, irritable or just not quite like myself?” Please know that you are certainly not alone.

For many women, the years leading up to menopause can feel quite confusing. One month your cycle is normal, the next it is late. You may notice hot flushes, night sweats, poor sleep, mood changes, brain fog, itchy skin, lower libido or weight changes, and it can sometimes all feel as though it has come out of nowhere.  The truth is that menopause is not usually one sudden event. It is more often a transition, and that transition can start years before your periods stop completely.

Menopause is the point at which you have gone 12 months without a period. The stage leading up to that is called perimenopause, and this is often when many of the symptoms begin. During this time, hormone levels, especially oestrogen, do not simply fall in a straight line- they can fluctuate up and down, which is part of why symptoms can feel so unpredictable. Menopause most commonly happens between the ages of 45 and 55, with the average age often cited as around 51.

Once perimenopause begins, because hormone receptors are spread throughout the body, the effects are not just limited to periods and hot flushes alone. One woman may notice sleep changes first. Another may feel suddenly more anxious, foggy or emotional. Someone else may notice skin changes, joint aches or weight shifts before they even think about menopause. That is part of what can make this stage so confusing.  Why does it feel so different from woman to woman? Because it really is different from woman to woman. Some women have very few symptoms. Others feel as though they are asleep. Some women only notice changes in their cycle, while others experience a combination of hot flushes, night sweats, poor sleep, mood changes, forgetfulness, difficulty concentrating, pain during sex and joint or muscle pain. That is one reason why so many women say they did not realise they were in perimenopause at first. They were still having periods, or they expected menopause to only mean hot flushes.

The most common clue is usually a change in your cycle. Your periods may become more irregular before stopping altogether. Doctors usually diagnose menopause by looking at the whole picture ie your age, symptoms and changes in your menstrual cycle. In many women over 45, perimenopause or menopause can often be identified without routine blood tests, as hormone levels can fluctuate quite a lot during this stage. If symptoms begin earlier than expected, if periods stop at a younger age or if your doctor feels that something else may be contributing, they may suggest blood tests or further assessment. Depending on the individual, they may assess hormones such as oestradiol, progesterone, FSH, LH and testosterone, alongside other relevant blood tests (in some cases the DUTCH test). We have also put together a symptom checklist for you, which may help you connect some of the dots.

Changes in your cycle

  • Periods becoming more irregular
  • Periods becoming heavier or lighter
  • Longer gaps between periods
  • Periods stopping altogether

Temperature and sleep changes

  • Hot flushes
  • Night sweats
  • Waking in the early hours
  • Trouble falling asleep
  • Feeling tired during the day

Mood and brain changes

  • Feeling more anxious than usual
  • Lower mood
  • Irritability or a shorter fuse
  • Mood swings
  • Brain fog
  • Forgetfulness
  • Difficulty concentrating

Body and physical changes

  • Joint aches or stiffness
  • Muscle aches
  • Headaches or migraines
  • Palpitations
  • Weight changes
  • Fatigue or lower energy
  • Dry or itchy skin
  • Changes in hair texture or hair thinning

Intimate and urinary changes

  • Vaginal dryness
  • Discomfort during sex
  • Lower libido
  • Recurrent urinary discomfort or urgency

If you are nodding along to several of these, especially alongside changes in your cycle you may be experiencing perimenopause. 

These are all recognised menopause-associated symptoms, and NICE includes menstrual changes, hot flushes and night sweats, mood effects, vaginal dryness, musculoskeletal symptoms and sexual difficulties among common symptoms. The NHS (National Health Service) also lists brain fog, palpitations, headaches, joint and muscle pain, skin changes, weight gain and reduced sex drive.

If you would like some help, this is a great website where you can click on your symptom, and a brief explanation on why it is happening is provided. 

When should you speak to your doctor?
If your symptoms are affecting your quality of life, if your periods change significantly, if symptoms start earlier than expected or if you think you may be experiencing early menopause. It is also important not to assume that every symptom is “just menopause”. Thyroid issues, stress, low iron, poor sleep, medication changes and other health concerns can overlap with this stage of life, which is why choosing a doctor or healthcare professional who cares can be so helpful. This is also part of why good menopause care is not just about hormones, but about looking at the whole woman.

At Sally-Ann Creed, we are a woman-run, women-owned and women-focused company. Menopause education and support are very important to us. If you, or someone you know and love, needs nutritional guidance or help with where to go next, please feel free to contact us at admin@sallyanncreed.co.za 

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Things you need to know about female hair loss

Things you need to know about female hair loss

Losing hair is distressing in a way that goes beyond vanity, it can feel like your body is signalling that something is off. The good news is that in most cases, there are addressable reasons and once you find them things can most certainly improve. Hair loss in women is rarely caused by just one thing. It is worth approaching it with curiosity rather than panic, and always asking: what might my body be trying to show me? Common reasons women lose hair Nutrition first Low protein intake is one of the most overlooked contributors, particularly in women who eat very little animal protein or have been restricting calories. Hair is made almost entirely of protein, and your body will deprioritise hair growth when resources are limited. Low-fat diets are similarly problematic, as healthy fats are essential for hormone health and scalp integrity. Iron, B12 and nutrient stores Anaemia and low ferritin are among the most common and most correctable causes of hair shedding. If you have heavy periods, feel exhausted or eat little to no meat, this is worth looking into, especially if you have pale inner eyelids. Ask your doctor for ferritin, a full blood count including haemoglobin and C-reactive protein (to rule out infection, which can show raised ferritin levels), as well as vitamin B12 and not just a general iron test. Thyroid and hormones Thyroid changes, including raised thyroid antibodies, are a common and often missed cause of hair loss. Hormonal shifts including perimenopause, menopause, PCOS (also now referred to as PMOS) or changes in contraception, also play a significant role. Hormones in birth control can affect hair both during use and after stopping. Blood sugar and insulin In PCOS/PMOS-type patterns, high insulin and androgen levels (androgens are male sex hormones that women also produce naturally; in excess, they can shrink the hair follicle and shorten its growth cycle) directly affect the hair follicle. Addressing blood sugar regulation is an important and often underestimated part of the picture. Stress, sleep and life events The body treats hair as non-essential during periods of high stress, illness, poor sleep or major life upheaval. Shedding that follows a difficult period by two to four months is very common and is usually temporary. If you experienced a stressful event, illness or surgery and noticed hair loss some weeks later, this is likely the reason. Inflammation A diet high in sugar, ultra-processed foods and inflammatory oils can affect hair follicle health over time. This is one area where dietary change can really move the needle. Your hair routine matters too Not all hair loss starts from within. Sometimes the answers are closer to the surface. Heat styling Repeated use of blow dryers, straighteners and curling irons at high temperatures weakens the hair shaft over time, leading to breakage that can look a lot like shedding. The hair is not falling from the root, it is breaking along the shaft. Lowering the heat setting, using a heat protectant and allowing your hair to air dry where possible makes a real difference over time. Tight hairstyles High buns, tight ponytails, braids, cornrows and extensions that pull continuously on the hairline or scalp can cause a specific type of hair loss called traction alopecia. The follicle is repeatedly stressed by tension until it eventually stops producing hair. If you regularly wear your hair tightly pulled and notice thinning around the hairline or temples, this is worth reconsidering. Caught early, it is reversible. Left long enough, the follicle damage can become permanent. Aggressive brushing Brushing wet hair causes significantly more breakage than brushing dry hair, as wet hair is elastic and far more vulnerable to mechanical stress. If you brush immediately after washing, switching to a wide-tooth comb and working from ends to roots rather than roots to ends can noticeably reduce breakage over time. Hair products and chemical treatments Frequent colouring, bleaching, perming and chemical relaxing all weaken the hair shaft. Sulfate-heavy shampoos can strip the scalp of its natural oils, disrupting the environment the follicle depends on. Overuse of dry shampoo, particularly as a substitute for washing, can clog follicles and impair scalp health over time. This does not mean you cannot colour your hair. It means spacing treatments, choosing gentler formulations and giving your scalp the care it needs in between. A food-first foundation Before anything else, make sure you are eating enough. Enough protein, enough healthy fat, enough colour and variety in your vegetables. Skipping food groups, under-eating or over-restricting carbohydrates can all contribute to hair loss and no supplement will fully compensate for an inadequate diet. Prioritise whole, nutrient-dense food before reaching for anything else. It is the foundation everything else builds on. Supplements worth considering These are not quick fixes and individual needs vary. But where diet alone is not enough, or where specific deficiencies are confirmed, the following can meaningfully support hair health: Pure Hydrolysed Collagen: provides the amino acids that support the scalp, skin and connective tissue. One of the most impactful additions for many women, particularly those whose protein intake is insufficient. Biotin (B7): a B vitamin that supports keratin production. Worth considering where intake or status is low. Magnesium Citrate or Chelated Magnesium Premium: supports stress resilience, nerve health and insulin regulation. Chronically low magnesium affects many systems that indirectly impact hair. Zinc Picolinate: supports normal hair growth, skin, immune function and tissue repair. Berberine Complex: particularly useful where blood sugar imbalance and insulin resistance are part of the picture, as is often the case in PCOS or PMOS-type patterns. Gentle Daily Iron: worth considering if your ferritin is confirmed low. Iron deficiency is one of the most common and most correctable causes of hair shedding in women Omega-3: healthy fats are not optional when it comes to hair health. Omega-3 fatty acids support scalp health, reduce inflammation around the hair follicle and play a role in the hormonal environment that hair growth depends on. If your diet is low in oily fish such as sardines, mackerel or salmon, or seeds such as chia and walnuts, a supplement with good DHA and EPA levels is worth adding. One last thing Hair growth takes time. Even when you are doing everything right, it can take three to six months before you notice regrowth, because hair grows in cycles, and the follicle needs time to recover. Be patient with the process. And always remember, worsening or sudden hair loss deserves your time to investigate. The information above is supportive, but works best alongside an accurate understanding of what is actually driving the shedding. Blood tests, history and a conversation with your doctor or a caring health professional are always where to start. Hair’s to you! ❤ References 1. Thamotharan N, Harikumar MV, Sundaram M, Swaminathan A, Rangarajan S. Assessment of Serum Ferritin Levels in Female Patients With Telogen Effluvium. Cureus. 2025. doi:10.7759/cureus.100249. pmc.ncbi.nlm.nih.gov/articles/PMC12839778 2. Larrondo J, McMichael AJ. Traction Alopecia. JAMA Dermatology. 2023;159(6):676. doi:10.1001/jamadermatol.2022.6298. 3. Sunil M, Zacharia M. Clinical profile of female patients with chronic telogen effluvium and its association with serum ferritin level. Asian Journal of Medical Sciences. 2024;15(12):98–102. doi:10.3126/ajms.v15i12.70630. 4. Karadag AS, Bilgili SG, Onder S, et al. A comprehensive investigation of biochemical status in patients with telogen effluvium: Analysis of Hb, ferritin, vitamin B12, vitamin D, thyroid function tests, zinc, copper, biotin, and selenium levels. Journal of Cosmetic Dermatology. 2024. pmc.ncbi.nlm.nih.gov/articles/PMC11626366 This article is for educational purposes only and is not intended to replace medical advice. If you are experiencing hair loss, please consult a qualified healthcare practitioner who can investigate the underlying cause and advise accordingly.

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How to grow a useful veggie patch

How to grow a useful veggie patch

How to grow a useful veggie patch Growing your own food doesn’t have to start with a big garden or a perfectly planned patch. It can start with a few herbs on the windowsill, a tomato plant on the veranda or chives regrowing in an old container. Something quite extraordinary happens You slow down. You get your hands in the soil. You watch something you planted turn into something you eat. And in that — which takes just minutes a day — you get back something modern life has slightly stripped away: a real sense of connection to the earth and to what nourishes you. You don’t need a large garden, perfect weather, or a green thumb handed down through generations. You need a little space, a little patience and the right starting knowledge. 4.2% decrease in relative stress levels was associated with daily gardening compared with never gardening. Chalmin-Pui et al (2021) — survey of more than 6,000 adults A comprehensive 2024 meta-analysis reviewed 40 studies and found a significant, positive effect on wellbeing, quality of life and health status. Research from Michigan State University found that growing food increases vegetable and fibre consumption, encourages physical activity, and lowers perceived stress and anxiety. And here is a particularly wonderful part: growing food outdoors exposes you to Mycobacterium vaccae, a naturally occurring soil bacterium that research suggests may stimulate serotonin production in the brain. Quite literally — dirt is good for you. No garden? No problem A veggie patch is whatever space you have Here are the best ways to grow useful food, wherever you are. Apartment / Indoors Windowsill & indoor growing A sunny windowsill is a surprisingly productive space. Focus on compact, fast-growing plants in shallow containers. Water from the bottom and check moisture in hot South African summers. Good for: microgreens, basil, chives, lettuce, spring onions, spinach Balcony / Patio Balcony container garden Larger containers (20L+) allow stronger root systems. Railing planters use vertical space beautifully. Wind can be challenging on higher floors — choose bushy, compact varieties. Good for: pepper, tomatoes, kale, beetroot, radish, baby marrow, beans Garden / Backyard Raised bed or wooden box Easy to control soil, excellent drainage, and the defined space makes crop rotation simple. Even a 1.2m × 2.4m bed produces a remarkable amount of food. Warms up faster in spring. Good for: beans, carrots, garlic, leeks, broccoli, sweet potato, peppers, tomatoes Upcycled / Creative Tin cans & upcycled containers Growing food with almost zero budget. Anything that holds soil and has drainage potential becomes a vessel. Tins heat up quickly and suit heat-loving herbs beautifully. Good for: mint, parsley, coriander, chillies, strawberries, lettuce, spinach Flexible Grow bags Fabric grow bags air-prune roots naturally and drain well. Portable — move them to follow the sun. Perfect for renters or anyone wanting flexibility without permanent structures. Good for: potatoes, tomatoes, baby marrow, aubergine, cucumbers, lettuce Garden Straight into soil The simplest way, if you have access. Healthy soil is key — enrich regularly with compost. South Africa’s climate allows year-round growing in many regions with seasonal crop rotation. Good for: almost everything, with good compost and consistent watering Getting started The steps 1 Choose your space Before you choose plants, choose your spot. How many hours of direct sunlight does it get? Most vegetables need at least 6 hours. Herbs can manage with 4. 2 Start with good soil This is the most important investment you’ll make. A rich, well-draining compost-based potting mix is everything. 3 Pick a few plants to start Resist the urge to grow everything at once. Choose what you eat, and choose easy wins like lettuce, cherry tomatoes, herbs. Early success builds confidence and keeps you coming back. 4 Water consistently, not excessively Most new gardeners over-water. Push your finger 2cm into the soil — if it’s moist, leave it. Water at the base of the plant, not on the leaves. Morning is ideal. 5 Feed fortnightly if needed Container-grown plants need regular feeding as nutrients leach out with watering. A liquid seaweed or fish emulsion fertiliser every two weeks during the growing season makes a huge difference to yield and flavour. 6 Harvest regularly The more you harvest, the more the plant produces. Pick lettuce leaves from the outside in. Snip herbs regularly. Most important of all Gardening should bring back a little slice of childhood — good bacteria on our hands, sunshine, nutrition and confidence. You don’t need to start with 36 plants and a plan to never visit the grocery store again. Grow one pepper. Decide what’s for dinner based on that. That is the whole point. Favourite YouTube channels from our team ▶ Simon Akeroyd — youtube.com/c/SimonAkeroyd ▶ Gerald’s Veg — youtube.com/@GeraldsVeg References Chalmin-Pui LS et al. Why garden? Attitudes and the perceived health benefits of home gardening. Cities. 2021;112. Panțiru I et al. The impact of gardening on well-being, mental health, and quality of life: an umbrella review and meta-analysis. Syst Rev. 2024;13(1):45. Alaimo K et al. Caretaking, accomplishment and connection to nature: the gardening triad. People Nat. 2024;6:2014–2028.

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Could low stomach acid be affecting your digestion?

Could low stomach acid be affecting your digestion?

Walk into any pharmacy and you'll see an entire aisle dedicated to one idea: that you have too much stomach acid. Antacids. Acid blockers. Proton pump inhibitors (PPIs) sold over the counter and prescribed by the millions and for many people, they can bring much-needed relief. But there is a narrative that acid is the villain. Suppress it, and everything gets better. Except, like most things in health, the story is more complicated than that. Stomach acid is not the enemy. It is one of the most carefully regulated and biologically expensive secretions the body produces. We need it to digest protein, absorb nutrients, activate enzymes and defend against the microbes that arrive on every bite of food. And while reflux and acid-related irritation are real and most certainly worth treating, there is another side most people have never heard of: stomach acid that is too low. It is called hypochlorhydria when production is reduced, and achlorhydria when it is essentially absent. And the reason it is rarely discussed is not that it is rare. It is because the symptoms look almost identical to the ones we have been taught to blame on the opposite problem. What stomach acid actually does Before talking about what happens when it is low, we should discuss what it does when it is working properly. The stomach maintains a remarkably acidic environment, with a pH between roughly 1.5 and 3.5. That's more acidic than vinegar, on par with lemon juice and a hundred thousand times more acidic than the blood that surrounds it. This acidity does five essential jobs: It unfolds dietary proteins so that digestive enzymes can begin breaking them down into amino acids. It activates pepsin, the main protein-digesting enzyme. Pepsin is released in an inactive form called pepsinogen, and it only becomes active in the presence of acid. It releases nutrients from food. Vitamin B12 must be cleaved from animal protein before the body can use it, and that cleavage depends on acid. Iron, calcium, magnesium and zinc absorption are also influenced by an adequately acidic stomach. It provides a defensive barrier against the bacteria, viruses and parasites that arrive in food and drink, reducing the chance of gastrointestinal infection and bacterial overgrowth further down the digestive tract. It signals the next stage of digestion. When acidic stomach contents move into the small intestine, that acidity triggers the release of bile from the gallbladder and digestive enzymes from the pancreas. Suppress acid for long enough and any of these processes can falter. Why low stomach acid is more common than we think A long-held assumption that gastric acid declines steadily with age has been re-examined in recent years. In healthy adults without underlying disease, acid production actually holds up fairly well into older age. The reason it becomes more common in older people is not age itself, but the accumulated conditions and medications that come with it. The most common contributors to low stomach acid include: Long-term use of acid-suppressing medication, particularly PPIs (omeprazole, lansoprazole and others). These were designed for short-term use, but are frequently taken for years without review. Helicobacter pylori is a bacterium that colonises the stomach lining and can suppress acid secretion over time. It is one of the most common chronic infections in the world. Autoimmune gastritis (also called autoimmune atrophic gastritis), a condition where the immune system mistakenly attacks the cells that make stomach acid (called parietal cells). Because these same cells also produce something called intrinsic factor, a small molecule the body needs to absorb vitamin B12 from food, this condition is closely tied to B12 deficiency and pernicious anaemia (a type of anaemia caused by not being able to absorb B12 properly). Previous gastric surgery, including procedures for weight loss or ulcers. The symptoms (and why they are confusing) The symptoms of low stomach acid overlap almost entirely with the symptoms of too much. Both can cause: Bloating after meals Excessive burping Feeling full quickly Nausea Poor tolerance of protein-rich meals A heaviness or sluggishness after eating Undigested food in the stool Recurrent low iron or B12 on blood tests This is why self-diagnosis is unreliable, and why the standard response "I have indigestion, I'll take an antacid" can sometimes work against you. If reduced acid is part of the picture, suppressing it further may worsen digestion, even if it offers short-term symptomatic relief. How do you actually know if you have low stomach acid? This is one of the harder questions in this whole topic, because there is no single easy test that gives a definitive answer outside of a hospital setting. The baking soda burp test (the traditional at-home version) This is the test that circulates widely online and has been around for decades. The idea is simple chemistry. Mix a quarter teaspoon of baking soda (sodium bicarbonate) into 100–150 ml of cold water and drink it first thing in the morning, on an empty stomach. When sodium bicarbonate meets hydrochloric acid in the stomach, the two react to produce carbon dioxide gas, which causes you to burp. The theory is that if you burp within roughly three minutes you have adequate stomach acid, and if you do not burp at all (or only burp after five or more minutes) your stomach acid may be low. The baking soda test has never been formally validated against a gold-standard medical test and the results are easily influenced by things that have nothing to do with stomach acid such as swallowed air, what you ate the night before, gastric motility, body position and natural fluctuations in stomach pH throughout the day. That said, it is harmless to try and may offer a rough, suggestive clue, particularly if repeated over three to five consecutive mornings and the pattern is consistent. Treat it as a curiosity, not a diagnosis. The Heidelberg pH test Is considered the gold standard for measuring gastric acid. It involves swallowing a small capsule that transmits pH readings from inside the stomach. It is not widely available, and is expensive when accessed privately. Normal Abnormal (low acid) Heidelberg pH test results. In a healthy stomach (left), pH drops sharply after a meal as acid is released. With low stomach acid (right), the pH stays at around 6, indicating little to no acid is being secreted.Source: The Functional Gut Clinic Endoscopy with biopsy Is the definitive test for atrophic gastritis and autoimmune gastritis. A gastroenterologist passes a thin camera into the stomach and takes small tissue samples for analysis. Blood tests Can support the diagnosis and a useful one is serum gastrin (which rises when stomach acid is low, as the body tries to stimulate more production), pepsinogen I and II and the pepsinogen I to II ratio. For suspected autoimmune gastritis, the relevant blood markers are anti-parietal cell antibodies and anti-intrinsic factor antibodies. Indirect markers Indirect markers in routine bloodwork can also raise suspicion: persistently low ferritin, low vitamin B12, low magnesium, or unexplained iron deficiency anaemia. Helicobacter pylori testing Is straightforward and important. It can be done with a non-invasive breath test, stool antigen test, blood test or via biopsy during endoscopy. If positive, it is treatable with a short course of combination antibiotic therapy. A note on reflux Reflux happens when stomach contents move upward into the oesophagus. The oesophagus is not built for acid exposure, so even a normal amount of stomach acid in the wrong place can burn. The crucial point is that reflux is not always a problem of how much acid is being produced. It is often a problem of where the acid is going. The lower oesophageal sphincter, the valve between the stomach and oesophagus, can become weak or relax inappropriately due to hiatus hernia, abdominal pressure, pregnancy, certain foods, smoking, alcohol, obesity or delayed gastric emptying. The acid escapes upward not because there is too much of it, but because the door is not closing properly. This matters because aggressive long-term acid suppression treats the symptom while leaving the underlying mechanical problem untouched, and may introduce new problems of its own. Habits that support healthy digestion Whatever the underlying picture, certain habits support healthy digestion regardless of whether your acid is high, low or perfectly normal: Eat slowly and chew thoroughly. Digestion begins in the mouth. The mechanical breakdown of food and the signalling that prepares the stomach both depend on this first step. Eat in a calm state where possible. The digestive system runs on the parasympathetic nervous system, the "rest and digest" branch. Eating in a rushed, stressed state genuinely impairs digestive function. Include adequate protein. Protein stimulates gastric acid secretion. Eating protein at most meals supports the digestive cascade. Avoid large, heavy meals close to bedtime. Particularly important if you are reflux-prone, since lying flat with a full stomach makes reflux far more likely. Notice your triggers. Alcohol, peppermint, chocolate, deep-fried foods, very spicy foods, coffee and carbonated drinks are common reflux triggers. Triggers are personal. Get the right tests if symptoms persist. If you have ongoing fatigue, hair loss, mouth ulcers, weakness, numbness or tingling, ask your doctor to check iron, ferritin, vitamin B12 and other relevant markers. These can reveal a digestive problem hiding upstream. Be cautious with DIY acid supplements. Supplements designed to replace stomach acid typically contain Betaine Hydrochloride paired with pepsin, taken at the beginning of each meal. Clinically, people often report improvements in bloating, reflux and stool consistency within a few days of starting it. However, this is not a supplement to use casually, particularly if you have reflux, gastritis, ulcers, Barrett's oesophagus or are on anti-inflammatory medication, steroids or blood thinners. It is best used only under the guidance of a qualified practitioner. Try traditional acid-stimulating foods. Cabbage, both fresh and fermented, can be a stimulant of stomach acid production. A small helping of fresh cabbage salad, cabbage juice, or sauerkraut at the start of a meal can be a food-first way to prepare the stomach for what's about to arrive. Bitter greens like rocket and chicory work similarly, as does a small glass of warm lemon water or apple cider vinegar diluted in water before meals. Stomach acid is not the enemy. A healthy digestive system depends on it being present in the right amount, in the right place, at the right time. If your symptoms are persistent, recurring, or not improving with what you have tried, the most useful thing you can do is investigate properly rather than guess. Sometimes the answer is less acid. Sometimes it is more. And sometimes the answer has very little to do with acid at all. The body is not asking us to silence it. It is asking us to listen more carefully. References 1. Maideen NMP. Adverse Effects Associated with Long-Term Use of Proton Pump Inhibitors. Chonnam Medical Journal. 2023;59(2):115–127. pmc.ncbi.nlm.nih.gov/articles/PMC10248387 2. Bhatnagar MS, Choudhari S, Pawar D, Sharma A. Long-Term Use of Proton-Pump Inhibitors: Unravelling the Safety Puzzle. Cureus. 2024;16(1):e52773. pmc.ncbi.nlm.nih.gov/articles/PMC10882567 3. Shahid MS, Ahmed N, Kamal Z, et al. A Systematic Review of Long-Term Use of Proton Pump Inhibitors (PPIs) in Older Adults on Polypharmacy: Do PPIs Deplete Nutrients? Cureus. 2025;17(8):e90888. pmc.ncbi.nlm.nih.gov/articles/PMC12456669 4. Vavallo M, Cingolani S, Cozza G, Schiavone FP, Dottori L, Palumbo C, Lahner E. Autoimmune Gastritis and Hypochlorhydria: Known Concepts from a New Perspective. International Journal of Molecular Sciences. 2024;25(13):6818. pmc.ncbi.nlm.nih.gov/articles/PMC11241626 5. Li P, Zhu W, Ding J, Lei F. Study of Helicobacter pylori infection in patients with chronic atrophic gastritis and its relationship with lifestyle habits and dietary nutrient intake. Medicine (Baltimore). 2024;103(2):e36518. ncbi.nlm.nih.gov/pmc/articles/PMC10783413

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Am I in menopause?

Am I in menopause?

For many women, the years leading up to menopause can feel quite confusing. One month your cycle is normal, the next it is late. You may notice hot flushes, night sweats, poor sleep, mood changes, brain fog, itchy skin, lower libido or weight changes, and it can sometimes all feel as though it has come out of nowhere.  The truth is that menopause is not usually one sudden event. It is more often a transition, and that transition can start years before your periods stop completely.

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