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Search the Library Changes in Menstrual Cycles Changes in period or menstrual cycles are commonly associated with perimenopause. What to expect varies based on the stage of perimenopause you're in. Body December 1, 2025 Read Why does Menopause Happen? Theory as to why women go through menopause General October 8, 2025 Read IUDs There are two types of IUDs. Hormonal IUDs can have an impact on perimenopause. Copper IUDs have limited or no impact on symptoms and changes associated with perimenopause. Body March 9, 2026 Read Changes Associated with Perimenopause Listing of changes associated with perimenopause. This list is a starting point and we're constantly adding new changes. General October 1, 2025 Read Hot Flashes & Night Sweats Changes in hormones can impact the body's temperature comfort zone. Body December 1, 2025 Read Oral Birth Control Oral birth control can impact symptoms and changes experienced during perimenopause and menopause transition. Body March 9, 2026 Read Periodontal Disease Changes in hormones impact the dental health. With the right care team and plan disease progression can be managed. Due to lack of menopause certifications for dentists, building a care team in this area may take some extra time and consideration. Body March 2, 2026 Read UTIs Changes in hormones impact the urinary tract & how it functions. It may be time for a new routine to prevent UTIs. Body March 1, 2026 Read

Changes in Menstrual Cycle aka. Changing cycle times This can be one of the first signs of perimenopause. Give me some actionable research TLDR. Changes in period or menstrual cycles are commonly associated with perimenopause. What to expect varies based on the stage of perimenopause you're in. Towards the end of perimenopause, it is common for women to have menstrual cycles which last 60 days or more. Cycle irregularity has been linked to reproductive aging (we don’t love this wording either, but it’s how the medical field refers to this) and more importantly these irregularities can provide a window into how your hormone levels are shifting. The Stages of Reproductive Again Surrounding the Menopausal Transition have been studied and established well enough to create a framework called STRAW. STRAW: Stages of Reproductive Aging Surrounding the Menopausal Transition (Soules et al, 2001 ) *This update to FSH levels and likelihood of symptom presence was added in the 2012 update to the STRAW Framework (Harolow, et al, 2012 ) What causes periods to become irregular? FSH . As women age, we have less follicles. As we enter into early perimenopause, there is an increase in FSH (follicle stimulating hormone) which gets follicles to mature more rapidly and as a result, menstrual cycles are often shortened in the early phases of perimenopause (Santoro, 2016 ) LOOP Cycles (aka luteal-out-of-phase events). This happens when ovulations happen in really short succession, think multiple ovulations between periods. This can be associated with other hormone fluctuations which drive additional irregularities (Santoro, 2016 ) Over time, these short menstrual cycles will give way to longer and longer menstrual cycles You're not alone. Periods will eventually stop and a woman is in menopause one year after her last period. So, this is a phase which will eventually end. Not knowing when your period is coming and what it might look like can be particularly challenging if you've been fairly regular for decades. This can be a big change, and change can be hard. Know you're not alone. This is a natural transition, has a definitive end with menopause. Women all over the world are going through this change with you. The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. For additional information view our Medical Disclaimer .

Hot Flashes & Night Sweats aka. Vasomotor Symptoms Roughly 80% of women experience hot flashes, which llast an average of 10 years and average 4 - 20 per day (Avis et al, 2018 ) Give me some actionable research TLDR. Changes in hormones can impact the body's temperature comfort zone. Vasomotor Symptoms (aka Hot Flashes and Night Sweats ) are experienced by 80% of women and last approximately 10 years on average. Hot flashes are a sudden sensation of warmth that typically will last for about 15 minutes, and will vary in impact on activities. Some women experience them as a mild sensation of heat, but they can be severe enough to significantly disrupt activity. During a “severe” hot flash, it is difficult to continue normal activity. Hot flashes most often will peak in the late perimenopause and the few years of postmenopause, but it is highly variable. Most women eventually have improvement in hot flashes, but some are “superflashers” and have symptoms that start earlier in the transition and last longer. Night sweats are thought to be due to a similar phenomenon occurring during sleep and they can significantly disrupt sleep. What causes hot flashes & night sweats? As the ovary makes less estradiol, a group of neurons called the KNDy neurons (kisspeptin - neurokinin B - dynorphin) become overactive, which in turn causes the temperature regulation center of the hypothalamus to have a narrowed “comfort zone” of temperature. Small variations in temperature that would have previously been fine for the body now prompt large responses of flushing and sweating (Deecher and Dories, 2007 and Rapkin, 2006 ). Relationship to other symptoms Newer research also suggests that patients with vasomotor symptoms may also have a higher rate of other complications such as cardiovascular disease (Thurston et al, 2021 ), low bone density (Anagnostis et al, 2024 ), high blood pressure (Lee et al, 2024 ), and cognitive decline (Thurston et al, 2023 ). It is unclear at this time if severe vasomotor symptoms cause the health issues, or if they are associated with the health issues. Ongoing research is needed. The data are complex around the question of: “will treatment of the vasomotor symptoms reduce my risk?”. There are specifics of age, timing of menopause, personal medical history and goals that need to be discussed with your physician that will impact how this question is answered for you. The primary reason to treat vasomotor symptoms is the significant impact on sleep and daily function that it can have on many people. The lack of sleep can make mood regulation and brain fog symptoms worse. There are treatments that are effective, both hormonal and non-hormonal. You're not alone. Not knowing when hot flashes might be coming and knowing those around you can see what's happening can be incredibly difficult and may feel isolating. Know you're not alone in dealing with these changes, and that these changes typically end in post menopause. Leverage your support network to make adjustments, seek additional options if what you try initially doesn't work, and emotional support as you navigate this new phase of life. The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. For additional information view our Medical Disclaimer .

UTIs aka. Urinary Tract Infections 10 % of women have had a UTI in the last 12 months Give me some actionable research TLDR. Changes in hormones impact the urinary tract & how it functions. It may be time for a new routine to prevent UTIs. Women who are in perimenopause and post menopause are diagnosed with more urinary tract infections (UTIs). The primary cause of increased bladder infections is thought to be caused by decreases in the estradiol level causing changes in the microbiome (the bacterial population that lives on the skin) of the bladder and urogenital region. The decreased estrogen environment reduces prevalence of healthy lactobacilli species and allows more disease-causing bacteria to grow more easily. (Sovran,et al, 2016 ) Recurrent urinary tract infections are part of the genitourinary syncrome of menopause, which affects almost half of women during menopause transition. Other symptoms of genitourinary syndrome can be pain with intercourse, urinary frequency without infection, worsening urinary incontinence, vaginal pain and dryness. It is important to make sure that symptoms experienced are actually due to a bacterial infection and not a manifestation of the genitourinary syndrome of menopause. What is a UTI? UTIs (Urinary tract infections) are caused by bacterial infection of the urinary system, in which bacteria from the skin travels up into the bladder through the urethra, causing frequent and painful urination, occasional bloody or cloudy urine, lower abdominal pain, and sometimes sensation of incomplete emptying. There are many bacteria that can cause infection, and most often infections will respond well to antibiotic therapy. Your doctor likely will do a urine dipstick and may or may not run a urine culture. Symptoms should respond within 5 days of treatment, and further testing or change in antibiotic therapy is needed if you’re not feeling better. Untreated, bladder infections can occasionally travel higher into the body, affecting the kidneys (a condition called pyelonephritis), causing flank pain, vomiting and fever. Any symptoms of this severity need to be evaluated and treated promptly. Ok... so how frequent is frequent...? 2 or more UTIs in 6 months or 3 or more UTIs in 12 months. Recurrent UTIs are most often reinfection rather than relapse of a prior infection. The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. For additional information view our Medical Disclaimer .

IUDs aka. Intrauterine Devices 15% of women using contraception are estimated to be using IUDs as their contraception method of choice impacting a significant portion of the population in perimenopause Give me some actionable research TLDR. There are two types of IUDs. Hormonal IUDs can have an impact on perimenopause. Copper IUDs have limited or no impact on symptoms and changes associated with perimenopause. Why are we talking about this? It is estimated that more than 15% of the women using contraception in the US are using IUDs, making this a meaningful topic for many women entering into perimenopause. Understanding how these contraception methods function and their potential impacts on perimenopause and menopause can inform how women approach these milestones. Types of IUDs. There are two primary categories of interuterine devices (IUDs): Hormonal and non-hormonal (copper). In the United States, five FDA-approved brands are currently available (Lanzola & Ketvertis, 2023 ). How do IUDs work? Hormonal IUDs , which all use a synthetic progestin called levonogestrel (LNG), work locally within the uterus. The progestin thickens cervical mucus, keeps the lining of the endometrium thin, and in higher dose devices may partially suppress ovulation. This form of contraception acts predominantly within the uterine cavity, systemic absorption is less than that of oral progestin (Pinkerton et al, 2022 ), which is a meaningful distinction in perimenopause symptom management. Copper IUDs operate differently from the hormonal IUDs. The copper ions from this type of IUD create a spermicidal environment without any hormonal action. Potential Impact of IUD on Perimenopause Symptoms & Changes Hormonal IUDs Help to prevent heavy bleeding which is sometimes associated with perimenopause. With Hormonal IUDs, the endometrium is where the impact of IUDs and perimenopause overlap is the heaviest. As estrogen levels fluctuate, the uterine lining can thicken unpredictably and contribute to heavy menstrual bleeding. LNG IUDs contract this by promoting a thin inactive lining as a result these IUDs have been used off-label to has the progestin component of Hormone Replacement Therapy, which helps manage heavy menstrual bleeding and risk of endometrial cancer (Clark & Westberg, 2021 ). Masking menstrual irregularities as these IUDs often consistently decrease period frequency and duration. These IUDs are also often associated with a decrease in period frequency or an increase in menstrual cycles. These IUDs can obscure menstrual irregularity associated with perimenopause as well as the onset of menopause. Up to 40% of Mirena users experience amenorrhea within 3 years of insertion (Bayer HealthCare Pharmaceuticals, 2024 ). Clinical guidance suggests many women can continue hormonal IUDs until approximately age 55, at which point most women have likely gone through menopause. Mixed Research on mood changes . Research on whether IUDs impact symptoms of depression is mixed ((Elsayed et al, 2022 ), and most studies focus generally on women of reproductive age. Additional research or reviews are needed here specifically on the intersection of IUDs and mood changes in women experiencing perimenopause. Little or no impact on symptoms across other systems. Given that these devices and the progestin they release act predominantly in the uterine cavity, they don't address the symptoms of perimenopause across the rest of the body like vasomotor symptoms (hot flashes), GSM symptoms, and cognitive changes. (Pinkerton et al, 2022 ) Copper IUDS Little or no impact on symptoms and changes associated with perimenopause. There are often reports of heavier bleeding and cramping in the first few months after insertion, this form of contraception doesn't alter the frequency of a woman's menstrual cycle so any shifts in period frequency which are often a first sign of perimenopause won't be masked. Bone Mineral Density (BMD) . Neither type of IUD on its own has a material impact on bone mineral density for women who are near menopause. Since the IUDs act locally, it makes sense that an impact across other body systems hasn't been found (Yang et al, 2012 ). However, IUDs have been used as a part of Hormone Replacement Therapy to provide endometrial protection while estrogen can provide protection against fractures (Mukherjee & Davis, 2025 ). How will I know if I've entered into menopause? The Menopause Society states 90% of women will reach menopause by age 55 and recommends the continued use of contraception until then or menopause is confirmed. There are two main types of test for whether or not menopause has occurred. 1) Stop use of hormonal birth control and watch for a year to see if a period returns. 2) Testing FSH levels. The process here will vary by birth control type. The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. For additional information view our Medical Disclaimer .

Flourishing Through will be running a three month test for Founding Members which will enable your voice to shape the future of our platform. Before we kick off, we'll start with some brief phone calls to understand what you'd find valuable. Time commitment for feedback is estimated to be less than 90 minutes a month. We're still working through the details and will share more with those who are interested! I am excited about participating in Flourishing Through's Founding Test Member Group! * I am 18+ years old Email* User Name * Submit

Periodontal Disease aka. Gum Disease 1 in 3 women is estimated to experience periodontal disease in her lifetime (Medline) Give me some actionable research TLDR. Changes in hormones impact the dental health. With the right care team and plan disease progression can be managed. Due to lack of menopause certifications for dentists, building a care team in this area may take some extra time and consideration. What is Periodontal Disease? An inflammatory condition affecting gums, the ligament holding teeth in place (periodontal ligament), and jawbone (Mehrotra & Singh, 2023 ). The impacts of periodontal disease aren't limited to the mouth; there is also research linking this to other chronic conditions like cardiovascular disease (Beck et al, 2000 ). This takes hold when there is a shift in the bacterial population and is sustained by the body's own immune response as bacteria feed off of the cells who have come to fight the infection causing a vicious cycle of chronic inflammation (Hajishengallis et al, 2000 ). The link between shifts in estrogen and it's impact on the microbiomes of the body is well documented. This includes the biome in the mouth. As estrogen levels shift potentially impacting the mouth microbiome, there's an increased likelihood of developing periodontal disease in perimenopause and post menopause (Nieto, M. et al, 2025 , Thomas et al, 2025 ). Once it has moved past gingivitis, Periodontal Disease is called Periodontitis and is ranked in terms of severity based on how far the gums are pulling away from the teeth, the amount of bone loss on the teeth, and any tooth loss. The disease is also graded based on how quickly it is progressing. There is no set progression path or timeline (Gasner & Schure, 2025 ). This is important to note, because if you have a mild form of periodontitis you may be at risk for the disease to progress more quickly as you enter into perimenopause and menopause. Symptoms & Diagnosis from the Mayo Clinic Swollen or puffy gums bright red, dark red, or dark purple gums, gums which feel tender when touched gums that bleed easily spitting out blood when brushing or flossing bad breath that won't go away pus between teeth and gums loose teeth painful chewing receding gums a shift in the teeth A dentist or periodontist can provide a diagnosis if you're concerned about periodontal disease. Those who are also experiencing dry mouth may be at increased risk for periodontal disease (Mayo Clinic ) This is a disease which typically progresses slowly over time, so regular cleanings with your dentist can help catch this early and provide you with mitigation strategies. Additional research addressing the oral health concerns of women in perimenopause and post menopause is needed to inform women and to guide health care providers as they practice (Thomas et al, 2025 ) The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. For additional information view our Medical Disclaimer .

Oral Birth Control 25% of women ages 15 - 44 are estimated to be using oral birth control, which is the most common form of contraception in the US. Give me some actionable research TLDR. Oral birth control can impact symptoms and changes experienced during perimenopause and menopause transition. Why are we talking about this? With an estimated 25% of women ages 15 - 44 using it, the oral birth control pill is the most common form of contraception in the US (Cooper & Patel, 2024 ). Understanding their prevalence and their use of hormones to function, it is important for women to understand how their contraceptives may or may not potentially be impacting how they experience perimenopause and menopause. Types of Oral Birth Control. Combined Oral Contraceptives (COCs). These are the most commonly prescribed pills. They contain both progesterone (prevents pregnancy) & estrogen (controls bleeding) (Baird & Glasier, 1993 ) and typically contain 21 days of hormone pills and 7 days of placebo pills which allows for monthly bleeding. The pill is also prescribed for other issues related to menstruation including pain, irregularity (Bishop et al, 1960 ), migraines without aura, and acne (Redmond et al, 1997 ) to name a few (Maguire & Westhoff, 2011 ). Progestin-Only Pills aka POPs or Minipills. These pills contain progestin only. Opill (norgestrel) is the first daily oral contraceptive approved by the FDA for over the counter use without a prescription and fits within this category. Extended Cycle / Continuous Use Pills . These are COCs which provide a much longer time period between hormone free pills and bleeding. These may be packaged as 84 hormone or active pills and 7 placebo inactive pills. Your health care provider may also instruct you on how to use one of the typical COCs in an extended use fashion. Potential Impact of Oral Birth Control on Perimenopause Symptoms & Changes Regular bleeding . Both the COC and Extended Cycle pills described above provide for more regular bleeding and create a sense of predictability around bleeding. For many women, this removes the bothersome element of unpredictable menstrual bleeding which accompanies perimenopause. The regular bleeding via the contraceptive pill removes the period as a physical indicator for entry into perimenopause transition. Age and symptoms are more likely to help your physician figure out where you MAY be. Physical symptom management . For many women, the peaks and valleys of the variable hormone levels of perimenopause are the most bothersome. These hormone fluctuations can contribute to many of the physical, cognitive, mood and sleep symptoms that disrupt daily function. These peaks and valleys are caused by cycles without ovulation, or cycles with multiple ovulations (LOOP cycles). Often physicians will advise to use hormonal contraception to manage this ovulation variability rather than the postmenopause hormone therapy regimens that will not address ovulation. The birth control pills’s mechanism of suppression of ovulation will “clamp” down this hormone variability and thus help a lot with management of symptoms in perimenopause. (It is important to note that some progesterone only pills do not act by blocking ovulation) Bone mineral density . Both the COC and Extended Cycle pills have been linked to an increase in bone mineral density for those women who are in perimenopause or immediately post menopause roughly age 46 - 53 while those who are not on the pill experience a decrease. The bone mineral density for women who are taking birth control pills prior to perimenopause did not seem to be impacted by COCs. (Isley & Kaunitz, 2011 ) Low bone mineral density can lead to a higher risk of fractures late in life. How will I know if I've entered into menopause? The Menopause Society states 90% of women will reach menopause by age 55 and recommends the continued use of contraception until then or menopause is confirmed. It is a complex question to determine if you are in menopause if you’re on an oral birth control pill. If you are NOT at risk for pregnancy, your physician may advise that you stop taking the pill and monitor natural period patterns as they return. If you don’t have a period for 1 year, then you’re in menopause. Some popular websites and medical providers will advocate for hormone testing to determine where in the process you are. This is not likely to be helpful or predictive. Hormone testing has very limited use and can be very expensive. One month to the next, and one day to the next, is highly variable with regards to hormone levels in perimenopause and tell us nothing about what will happen the next month. Birth control pills will impact the hormone levels that are tested. Working with a knowledgeable health provider certified by The Menopause Society will be helpful in guiding you through this transition. Note : If you're on birth control or considering starting birth control, it is VERY important to collaborate with your healthcare team to find the best form of birth control for you. For women in their 40's the type of birth control is more person-dependent than age-dependent. Health risks change as we get older, and this will influence your choice of safe and effective contraceptive management. Your primary care team will be able to help find the right solution for you. (Primary Care Notebook, 2026) The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. For additional information view our Medical Disclaimer .

Changes Associated with Perimenopause Physical Changes Vasomotor Symptoms aka Hot Flashes & Night Sweats Sudden intense heat in face, neck, and chest which may come with perspiration, quickened heart rate, anxiety, and may be followed by a period of feeling chilled. Night sweats are hot flashes that happen at night. Along with shifts in period frequency, this is one of the signature hallmarks of perimenopause. Hot flashes and night sweats often peak in post menopause. These are believed to be caused by the decreases in estrogen and increases in FSH which are hallmarks of perimenopause and menopause. However, since experiences vary widely it is believed there are other factors also impacting the prevalence of hot flashes & night sweats. Average hot flashes per day range from 4 to 20. (Avis et al, 2018 ) Actions, Prevalence, & Duration Physical Changes Changes in Menstrual Cycle Menstruation might be more or less frequent or there may be significant changes in flow. All of these could be signs of perimenopause. Actions, Prevalence, & Duration Physical Changes Changes in Sleep. Continuity & Duration Trouble falling asleep or waking after falling asleep. Sex hormones play a role in sleep regulation so the fluctuations of these hormones during perimenopause may introduce new challenges with sleep. (Coborn et. al, 2022 and Pengo, et. al, 2018 ) While there is a link between night sweats and decreased ability to sleep through the night, night sweats are estimated to account for less than 30% of the sleep disturbances in perimenopausal women. (Coborn et. al, 2022 and Summer, 2024 ) Restless Legs Syndrome (RLS) and Obstructive Sleep Apnea (OSA) are two conditions found in roughly 50% of women with trouble sleeping during perimenopause. (Summer, 2024 ) Anxiety and frustration with a lack of trust in one's own ability to sleep can create a viscous cycle of sleep disturbances. (Summer, 2024 ) There is evidence to suggest these disruptions continue through post menopause (Pengo, et. al, 2018 ). Actions, Prevalence, & Duration Physical Changes Changes in body composition Proportions of fat and lean mass shifting as women head into menopause. So while the scale might read the same, there might be more fat and less muscle. At the start of perimenopause, fat gain rates double and lean mass declines. These changes stabilize within 2 years of experiencing menopause. (Greendale et al, 2019 ) Estrogen and FSH are both linked to changes in fat mass, and both of these hormones fluctuate significantly as women prepare for and move through menopause. (Fenton, A., 2021 ) These changes highlight reductions in metabolism, changes in liver function, insulin resistance, and lower satiation rates which can lead to increased weight gain and low grade inflammation. These changes and the risk factors associated with them can be alleviated through lifestyle. Nutrients including Vitamin D, Calcium, Vitamin C, B Vitamins and protein are all thought to play a large role in alleviating some of the risk factors mentioned above. (Erdelyi, et al, 2019 ) The links between the gut microbiome, Estrogen, and FSH aren't well understood. Some preliminary research in animals has shown the gut microbiome may impact estrogen metabolism. (Fenton, A., 2021 ) Actions, Prevalence, & Duration Physical Changes Changes in composition of hair, nails, or skin Skin . As estrogen levels decline, skin loses thickness, collogen, and elasticity. (Thorton, MJ, 2013 ) Skin may also take longer to heal from wounds. (Thorton, MJ, 2013 ) There may also be more dark spots and irregularities in pigmentation. (Bravo et al, 2024 ) Hair. Decreases in estrogen may lead to thinning hair and or the increase of hair growth on the face. (Zouboulis et al., 2022 ) Nails . May become brittle or have increased ridges. (Zouboulis et al., 2022 ) Actions, Prevalence, & Duration Physical Changes Genitourinary Syndrome of Menopause (GSM) aka Vulval, vaginal, and urinary changes All of these changes were grouped together in 2014 to be called Genitourinary Syndrome of Menopause. The name here can be confusing since it's called of Menopause. It's called of menopause because if left untreated, the symptoms will persist or worsen. So unlike hot flashes, these don't typically go away on their own once hormone levels even out. If someone is going to experience symptoms here, they often begin in perimenopause and continue until they're treated. These changes are driven by decreases in estrogen levels. Decreases in estrogen levels can change structures, pH, and microbiomes of these systems. Some more specific examples of what these changes can entail include: vaginal dryness, irritation, burning, pain during sex, pelvic pain, UTIs, increased urinary frequency, and urinary incontinence. These changes can significantly impact quality of life and are treatable. (Carlson & Nyugen, 2024 , and Park et al., 2023) Lactobacilius are the predominant microbiota in the biome of the vagina before the overall decline in estrogen which begins in perimenopause. Once estrogen declines so do the number of lactobacillus throwing the balance of the biome out of whack, which is when women sometimes experience physical changes and discomfort. (Mercier et al, 2023 ) Women who suffer from urinary changes including symptoms in their urinary tract are 7x more likely to experience painful intercourse and are 4x more likely to have issues becoming sexually aroused. The two systems are linked, and treating urinary issues can have significant impacts on sexual health and quality of life. (Wasserman & Rubin, 2023 ) Since the name changed recently (2014), here are some other names these changes have gone by: vulvovaginal atrophy Actions, Prevalence, & Duration Mental Changes Changes in Cognition Typically reported and researched as changes in verbal skills, attention, processing speed, and short term memory. Actions, Prevalence, & Duration Mental Changes Changes in Mood Changes in hormone levels can lead to feelings similar to those experienced in PMS. Specific symptoms include irritability, depression, anxiety, low energy, and difficulty concentrating. (Mallory, AB, 2022 ) These changes are driven by fluctuations in hormones ahead of menopause. They may no longer be linked with menstrual cycles. There is a link between prior history of depression or bipolar disorder and relapse during perimenopause. (Musial, et al, 2021 ) Many of the hormones which fluctuate significantly during perimenopause (Estrogen, Progesterone, and FS) have an impact on production of and reception of serotonin. Serotonin helps your body with cognitive function, happiness, temperature, sleep, sex drive, and hunger. (Cleveland Clinic, 2025 ) Actions, Prevalence, & Duration Social Changes Changes in feelings of connectedness Coming soon.. Actions, Prevalence, & Duration Social Changes Changes in Sex Drive Declining levels of estrogen impact arousal and can also impact vaginal dryness, vaginal tissue density, and urinary issues. Changes driven by hormonal shifts during this time may also be impacting sex drive. So, resolving other changes, may help with changes in sex drive. Lack of sleep, depression, and anxiety have been linked to a decrease in sex drive (Woods et al, 2010 ) Actions, Prevalence, & Duration Social Changes Changes in Confidence Experiencing any of the changes described above can be unsettling. They may also be keeping you from engaging in activities you used to enjoy or engaging with friends in the same way you did before. (Menopause Center 2025 ) Many women report feeling more confident once they're post menopause. Actions, Prevalence, & Duration Physical Symptoms

Flourishing Through Perimenopause Perimenopause is the time before menopause starting with periods becoming irregular until entering menopause. During perimenopause, hormones are often fluctuating a great deal and these fluctuations impact our body, mind, and community. Menopause is said to have occurred once a woman goes 12 months without her period; this typically happens around age 50 (Soules et al, 2001 ). This is a transition for women and our loved ones into some of the best years of our lives. We may not get to chose when or how this journey starts or ends. We can choose what we learn, how we respond, and the support system we build for ourselves . Research has shown how we move through perimenopause impacts the rest of our lives, and we've got a lot of amazing years ahead of us (SWAN ). Our goal is to get to a spot where we're Flourishing Through this phase and into the best years of our lives . Many women report a greater level of confidence and freedom post menopause, and proactive, well-supported navigation of perimenopause makes that outcome more likely ( Avis & McKinlay, 1991 ). Changes linked to Perimenopause. More than 80% of women experience symptoms of menopause which impact their wellbeing and for some symptoms can last through their 70s (Menopause Society ). If you're experiencing these changes, you're not alone, and there are actions which can be taken to help alleviate symptoms. Body . Period irregularity (Irregular cycles), hot flashes, night sweats, sleep disturbances, changes in body composition (weight gain in new places), changes in composition of hair (hair thinning), changes in composition of nails, changes in composition of skin, urinary tract pain, UTIs, vaginal dryness, and painful sex Mind. Mood, Cognition Community. Sex drive, Confidence, Feelings of closeness with friends and loved ones Every journey through menopause is unique so the combination of and intensity of changes will vary from person to person. These changes can continue to impact women for years after menopause has occurred. Evidence suggests how this phase of life is managed can have lasting impacts on a woman's quality of life. Flourishing through provides research based summaries to help women and their loved ones understand perimenopause and its impacts on the well being of your body, mind, and community. All three of these areas of well-being are undoubtedly connected. We've found sometimes looking at a change from a few different angles helps us frame a more complete picture. Actions. Research based summaries and a call to action. These should provide insights on underlying drivers and potential paths forward to make you more informed as you move through this journey and collaborate with your healthcare providers. Self education and advocacy is particularly important in perimenopause since many healthcare providers aren't formally trained in perimenopause and it's impacts (Christmas, M. , 2023 ) Health tracker. We're working to launch health trackers so you can log your changes, track them over time, and have data based conversations with your healthcare professionals. Curated Community Sessions. In 2026, we're hoping to offer curated community sessions which will provide a safe environment for women and their loved ones to connect with individuals who are also going through this journey for shared learning, belonging, and growth. We can't wait to Flourish Through this journey with you and your loved ones.

Why does menopause happen? Summary. While preliminary research and hypothesis exist around drivers for menopause, there's certainly for more research. There are three primary theories around why humans experience menopause The Grandmother Theory, The Mother Hypothesis, and The Reproductive Conflict Hypothesis. The grandmother hypothesis appears to have the most data supporting it. Biologically women go through menses when their reserve of follicles is depleted. However, the decline in sex hormones and lived experiences of changes doesn't appear to be necessarily linear with the decline in follicles. It would be interesting to better understand parallel processes and complimentary drivers of menopause. Theory There are many theories as to why women go through menopause, but there does appear to be an evolutionary reason for women to go through menopause. From our earliest records and across the globe, women have been going through menopause around age 50 and for those women who reach menopause they often live a significant portion of their lives post menopause. Three of the leading theories are: The Grandmother Hypothesis seems to have originated in the 1950s, but who exactly started this theory is a bit unclear. More recently Kristen Hawkes' research on the Hadza people of Tanzania has continued to build on this hypothesis. The hypothesis suggests women's evolution is uniquely focused on altruism (Johnstone & Cant, 2019 ) and are best able to contribute to their communities by helping take care of grandkids as opposed to continuing to have and rear their own children. Data collected by Hawkes and her team found data supporting the theory that grandmothers help increase the wellbeing and survival of their grandchildren. Interestingly, humans and four types of whales are the only large mammals which not only experience menopause but also live a significant portion of their lives post menopause (Landau, 2021 ). The phenomena of post menopausal grandmothers helping the survival of their grandchildren has also been proven with resident killer whales (Nattrass et al, 2019 ) - Further discussion: How does families being spread out today with children going away to college and living further away from their original families as they have their own children impact the longevity and wellbeing of children today? How does this relate back to Ellen Langer's theory of kids living in old age the way they see their grandparents living? The Mother Hypothesis. This hypothesis proposed by George Williams in 1957 , suggests women experience menopause for two reasons. First, pregnancies become riskier as women get older, so it becomes advantageous for survival to stop being able to reproduce. Second, human children have a long period of dependency on their parents at some point it becomes more beneficial to focus on supporting the children which have already been born than to add more children to the family. suggest this tipping point occurs when the next generation begins to reproduce. Assuming passing down genes is the motive for survival, it is more beneficial for women to allow their children to help by passing down their genes. The Reproductive Conflict Hypothesis. In this hypothesis Johnstone & Cant build on the work of George Williams in 1957 by suggesting the tipping point between having kids and focusing on your existing children occurs when the next generation begins to reproduce. Assuming passing down genes is the motive for survival, it is more beneficial for women to allow their children to help them by passing down their genes. Further discussion: This is a particularly prominent example of framing. Who is helping who? Are the grandmothers helping their own children or are their children helping them? How does biology align with how individuals consciously consider the impact their lives will have? Biological Process Menses are driven in large part by the number of follicles carrying oocytes (immature eggs) which women are born with. The number of oocytes a woman has and the number of follicles she has should be approximately synonymous as each oocyte is held by a follicle. Follicles provide a protective environment for the oocyte before and during maturation. Once an oocyte matures, it breaks free of from the follicle and heads to the uterus where it might meet a sperm (Lumen Learning ). Throughout a normal menses FSH (follicle stimulating hormone) and LH (luteinizing hormone) stimulate the growth of follicles and their oocytes. This process also impacts the levels of estrogen, progesterone, and testosterone present for women and these hormones fluctuate regularly with the menstrual cycle. Women are born with roughly 2 million follicles. This number is believed to peak in-utero and decline throughout the rest of a woman's life. As we approach age 50 it is believed very low follicle reserves signal the lack of a need for FSH and LH to continue to develop follicles. This lack of LH and FSH to develop follicles also means the levels of estrogen, progesterone, and testosterone eventually decline (Cox & Takov, 2025 ). As this process winds down, hormone levels may spike unexpectedly. Further discussion: Why are there seemingly random spikes in hormone levels if menopause is driven entirely by the decline in follicle reserves? Why does progesterone decline at a different rate than estrogen? If the two are both linked to follicle reserves, wouldn't they both decline at the same rate? Further discussion or research: What in particular sparks a woman's first period? How might this help us understand why and when periods stop?

Flourishing Through is a research based platform for education, support, and community for perimenopause Perimenopause deserves better. Too many women spend years confused by symptoms their doctors don't connect to the menopausal transition. Flourishing Through was built to change that — with research-based content, symptom tracking, and a community that understands what you're going through. Why Flourishing Through? Most health content about perimenopause is either too vague to be useful or too clinical to be accessible. Flourishing Through was built in the gap. We translate the latest perimenopause research into clear, honest guidance — written with physician input, transparent about what the evidence does and doesn't yet tell us, and designed for women who want real answers, not oversimplified reassurances. Because you deserve information you can actually trust. Everything you need to navigate perimenopause with confidence 🔬 Research You Can Trust Evidence-based articles covering the full range of perimenopause changes — written with physician input and fully cited, so you know exactly where the information comes from. 📊 Track Your Symptoms Log your symptoms over time and start seeing patterns — so you can have more informed, productive conversations with your care team. 🤝 You're Not Alone Access a community of women navigating the same transition, plus ongoing content that grows with you as new research emerges. Free Content Become a Member Start learning today - go deeper as a member Free Access Introductory perimenopause articles Overview of stages and symptoms Access to selected research summaries Member Access Full research library - all topics fully cited In-depth action based guides rooted in reserach Symptom Tracking New content added regularly Community Support (Coming Soon) Become a Member Not ready to join yet? Stay in the loop. Perimenopause can start earlier than most women expect - and the more you know, the better prepared you'll be. Sign up for our newsletter and get our free Perimenopause Starter Guide delivered to your inbox. What's inside: The most common early signs of perimenopause What to track before your next doctor's appointment How to talk to your care team about the menopausal transition Join our mailing list Email* Subscribe I want to subscribe to your mailing list.

Through and Through A Flourishing Through App Through and Through puts symptom tracking and evidence-based education in the palm of your hand. Understand what your body is telling you — and finally feel seen in a transition that too many women navigate alone. What Is Through and Through? Perimenopause brings changes that can feel unpredictable and isolating — from hot flashes and sleep disruption to brain fog, mood shifts, and relationship strain. Flourishing Through is a dedicated platform that helps you make sense of it all. Our app gives you daily symptom tracking across physical, mental, and social dimensions so you can uncover patterns, identify triggers, and walk into your next doctor's appointment with real data in hand. Alongside tracking, you'll find a growing library of research-based articles that explain the science behind what you're experiencing — no guesswork, no trends, just evidence. This isn't a general wellness app with a perimenopause add-on. Every feature was built specifically for this stage of life. What You'll Get **Symptom Tracking That Sees the Full Picture** Log what you're feeling across three dimensions — physical changes like hot flashes and joint pain, mental shifts like anxiety and brain fog, and social impacts like withdrawal and changes in intimacy. Over time, your tracking reveals patterns that help you understand and advocate for yourself. Also Available **Education Grounded in Research via Flourishing Through** Our content library connects your symptoms to current medical research. Learn why these changes are happening, what the science says, and what other women in perimenopause are experiencing too. **A Platform Built for You** Flourishing Through was created because women in perimenopause deserve more than being told "it's just stress." You deserve tools, knowledge, and validation — and that's exactly what we're here to provide. Access Through and Through App or Flourishing Through Website Through and Through is available on the App Store and on the web, giving you flexibility in how you engage with the platform. **On your iPhone:** Download the app from the App Store for on-the-go symptom tracking and access to our full content library. **On the web:** Access Flourishing Through right here at flourishingthrough.com for the full education platform experience from your browser. Each access point comes with its own subscription so you can choose the option that works best for you. Your Privacy Is Protected Your data is personal. We comply with Washington's My Health My Data Act and maintain strict privacy practices for all consumer health data. You can review our full Privacy Policy for details. Start Your Journey You don't have to figure perimenopause out alone. Start tracking, start learning, and start flourishing.

Consumer Health Data Privacy Policy Flourishing Through, LLC Effective Date: 12.09.2025 This Consumer Health Data Privacy Policy ("Policy") is provided pursuant to the Washington My Health My Data Act ("MHMDA") and applies to Washington residents and any consumer whose consumer health data is collected in Washington State ("you" or "your"). This Policy describes how Flourishing Through, LLC ("Flourishing Through," "we," "us," or "our") collects, uses, shares, and protects your consumer health data. 1. What is Consumer Health Data? Consumer health data is personal information that is linked or reasonably linkable to you and that identifies your past, present, or future physical or mental health status. Under the MHMDA, this includes: Individual health conditions, treatments, diseases, or diagnoses Social, psychological, behavioral, and medical interventions Health-related surgeries or procedures Use or purchase of prescribed medication Bodily functions, vital signs, symptoms, or measurements Diagnoses or diagnostic testing, treatment, or medication Reproductive or sexual health information Biometric data Genetic data Precise location information that could reasonably indicate an attempt to acquire or receive health services or supplies Data that identifies an individual seeking health care services Any information that is used to associate you with health status information that is derived or inferred from non-health data 2. Categories of Consumer Health Data We Collect We collect the following categories of consumer health data: Perimenopause and Menopause related changes: Information about symptoms you experience, including hot flashes, sleep disturbances, mood changes, cognitive changes, and other perimenopause-related symptoms Physical Health Tracking: Information you track regarding your physical health changes, menstrual cycle patterns, and bodily functions Mental Health Information: Information you provide about your mental and emotional well-being during perimenopause Social and Lifestyle Information: Information about social connections, relationships, and lifestyle factors that may impact your perimenopause experience Account and Profile Information: Name, email address, date of birth, and other information you provide when creating your account 3. Sources of Consumer Health Data We collect consumer health data from the following sources: Directly from you: When you create an account, use our mobile application, complete tracking entries, participate in community discussions, or otherwise interact with our services Automatically collected: Usage information from your interactions with our website and mobile application, such as pages visited and features used 4. How We Use Consumer Health Data We collect and use your consumer health data for the following purposes: To provide our services: To enable you to track your perimenopause symptoms, access educational articles and resources, and participate in our membership platform To personalize your experience: To tailor content and recommendations based on your tracked symptoms and interests To facilitate community support: To connect you with support groups and community features (planned for 2026) To improve our services: To analyze aggregate, de-identified data to improve our platform and develop new features To communicate with you: To send service-related communications, respond to your inquiries, and provide customer support To process payments: To manage your subscription and process payments through authorized payment processors To comply with legal obligations: To comply with applicable laws, regulations, and legal processes 5. How We Share Consumer Health Data We share your consumer health data with the following categories of third parties: Service Providers and Processors We share consumer health data with third-party service providers who perform services on our behalf, including: Technology and hosting providers (including Wix and Adalo, Inc.) Affiliates We do not currently share consumer health data with any affiliates. If this changes, we will update this Policy and obtain your consent as required. Specific affiliates that receive consumer health data: None at this time. Other Disclosures We may also disclose your consumer health data: To comply with legal obligations, court orders, or governmental requests To protect our rights, privacy, safety, or property, or that of our users or the public In connection with a merger, acquisition, or sale of assets (with your consent as required by law) 6. Sale of Consumer Health Data We do not sell your consumer health data. If we ever intend to sell consumer health data, we will obtain your separate written and signed authorization before doing so. 7. Your Rights Under the MHMDA Under the Washington My Health My Data Act, you have the following rights regarding your consumer health data: Right to Confirm and Access You have the right to confirm whether we collect your consumer health data and to access such data. You also have the right to receive a list of all third parties and affiliates (with contact information) that have received your consumer health data from us. Right to Delete You have the right to request deletion of your consumer health data that we have collected. Upon verification of your request, we will delete your consumer health data from our systems, including archives and backups, and direct our service providers and any third parties who received your data to do the same. Right to Withdraw Consent You have the right to withdraw your consent to our collection, use, or sharing of your consumer health data at any time. Withdrawing consent will not affect the lawfulness of processing based on consent before its withdrawal. 8. How to Exercise Your Rights To exercise any of your rights under this Policy, you may: Log into your account and access your privacy settings Email us at: admin@flourishingthrough.com We will verify your identity before processing your request. We will respond to verified requests within 45 days of receipt. If we need additional time, we will notify you of the reason and extension period. 9. Consent for Collection and Sharing We will obtain your informed, affirmative consent before collecting your consumer health data. We will obtain separate consent before sharing your consumer health data with third parties (other than service providers performing services on our behalf). You may withdraw your consent at any time through the methods described in Section 8 above. 10. Data Security We implement reasonable administrative, technical, and physical security measures designed to protect your consumer health data from unauthorized access, disclosure, alteration, or destruction. These measures include: Encryption of data in transit and at rest Access controls limiting employee and contractor access to consumer health data to only those who require it to perform their job functions Regular security assessments and updates to our systems Contractual requirements for service providers to maintain appropriate security measures While we strive to protect your consumer health data, no security system is impenetrable, and we cannot guarantee the absolute security of your information. 11. Data Retention We retain your consumer health data for as long as necessary to provide you with our services, comply with our legal obligations, resolve disputes, and enforce our agreements. When you request deletion of your data, we will delete it from our active systems and direct our service providers to do the same. Backup copies may persist in our systems for a limited period but will not be used for any purpose other than disaster recovery. 12. Children's Privacy Our services are not directed to individuals under the age of 18. We do not knowingly collect consumer health data from children under 18. If we learn that we have collected consumer health data from a child under 18, we will delete such information promptly. 13. Changes to This Policy We may update this Consumer Health Data Privacy Policy from time to time. If we make material changes, we will notify you by email or through a notice on our website prior to the changes taking effect. We will also obtain your consent for any material changes to how we collect, use, or share your consumer health data as required by law. The date at the top of this Policy indicates when it was last updated. 14. Contact Information If you have questions about this Consumer Health Data Privacy Policy or wish to exercise your rights, please contact us at: Flourishing Through, LLC Email: admin@flourishingthrough.com 15. Limitation of Liability This Consumer Health Data Privacy Policy describes our practices regarding consumer health data under the Washington My Health My Data Act. For additional information about how we collect, use, and protect other types of personal information, please refer to our General Privacy Policy available on our website. * * * This Consumer Health Data Privacy Policy is effective as of 12.09.2025 and supersedes any prior Consumer Health Data Privacy Policy.

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Terms & Conditions Terms & Conditions - the basics These Terms of Service ("Terms") govern your access to and use of Flourishing Through, LLC ("Flourishing Through," "we," "us," or "our"), including our website, mobile application, and membership services. By accessing or using our services, you agree to be bound by these Terms, our Privacy Policy, and any additional terms that may apply to specific features. PLEASE READ THESE TERMS CAREFULLY. IF YOU DO NOT AGREE TO THESE TERMS, YOU MAY NOT USE OUR SERVICES. 1. ACCEPTANCE OF TERMS By creating an account, subscribing to our membership services, or otherwise accessing or using Flourishing Through, you acknowledge that you have read, understood, and agree to be bound by these Terms and our Privacy Policy. If you are using our services on behalf of an organization, you represent that you have authority to bind that organization to these Terms. 2. DESCRIPTION OF SERVICES 2.1 Educational Platform Flourishing Through is a subscription-based membership platform that provides educational content, resources, and tools focused on perimenopause. Our services include: Research-based educational articles about perimenopause Mobile application for tracking physical, mental, and social changes Educational resources and content library Future access to community support features (planned for 2026) 2.2 Educational Purpose Only IMPORTANT NOTICE: FLOURISHING THROUGH PROVIDES EDUCATIONAL INFORMATION ONLY AND DOES NOT PROVIDE MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. THE INFORMATION PROVIDED THROUGH OUR PLATFORM IS FOR EDUCATIONAL PURPOSES AND SHOULD NOT BE RELIED UPON AS A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER WITH ANY QUESTIONS YOU MAY HAVE REGARDING A MEDICAL CONDITION. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY IN SEEKING IT BECAUSE OF INFORMATION YOU HAVE READ ON FLOURISHING THROUGH. 3. ELIGIBILITY AND ACCOUNT REQUIREMENTS 3.1 Age Requirement You must be at least 18 years old to access or use Flourishing Through. By using our services, you represent and warrant that you meet this age requirement. 3.2 Account Security When you create an account, you are responsible for: Maintaining the confidentiality of your account credentials All activities that occur under your account Notifying us immediately at [support email] if you suspect any unauthorized use of your account Providing accurate, current, and complete information during registration and updating it as necessary 3.3 Personal Use Your account and membership are for your personal, non-commercial use only. You may not share your account credentials, allow others to use your account, or transfer your account to another person without our prior written consent. 4. MEMBERSHIP SUBSCRIPTION 4.1 Subscription Plans Flourishing Through membership is offered on a monthly subscription basis. Current pricing will be displayed at the time of subscription on our website and in the mobile application. We reserve the right to modify our subscription plans and pricing with thirty (30) days' notice to active members. 4.2 Payment and Billing By subscribing to our membership services: Payment is processed through the Apple App Store or Google Play Store, depending on your device You authorize us to charge your payment method on a recurring monthly basis All fees are stated in U.S. dollars and are non-refundable except as required by law or as expressly stated in these Terms Your subscription will automatically renew each month unless you cancel before the renewal date 4.3 Failed Payments If a payment fails or is declined, we may suspend your access to membership services until payment is successfully processed. Your membership may be automatically canceled if payment issues are not resolved within fourteen (14) days of the failed payment. You are responsible for any charges, fees, or costs associated with failed payments. 4.4 Price Changes We reserve the right to change our subscription fees. We will provide you with at least thirty (30) days' advance notice of any fee increase via email to your registered email address or through a notice in the mobile application. If you do not agree to a price change, you may cancel your subscription before the new price takes effect. 5. CANCELLATION AND REFUNDS 5.1 Your Right to Cancel You may cancel your membership at any time through: Your account settings in the mobile application Your Apple App Store or Google Play Store subscription management settings Contacting our support team at [support email] 5.2 Effect of Cancellation When you cancel your membership: Cancellation takes effect at the end of your current billing period You will retain access to membership services until the end of the paid period No refunds will be provided for partial months or unused time, except as required by applicable law Your account and associated data may be retained as described in our Privacy Policy 5.3 Our Right to Suspend or Terminate We reserve the right to suspend or terminate your membership and access to our services immediately, without notice or refund, if you: Violate these Terms or our Privacy Policy Engage in fraudulent, illegal, or harmful activities Use the services in a manner that harms us, other members, or third parties Fail to pay membership fees Attempt to circumvent security measures or access unauthorized areas of our services 6. ACCEPTABLE USE 6.1 Permitted Use You may use Flourishing Through solely for lawful, personal, non-commercial purposes in accordance with these Terms. You agree to use our services in a respectful manner that does not interfere with other users' ability to enjoy the platform. 6.2 Prohibited Conduct You agree not to: Use our services for any illegal purpose or in violation of any applicable laws Attempt to gain unauthorized access to our systems, other user accounts, or computer systems or networks Interfere with or disrupt the integrity or performance of our services Transmit any viruses, malware, or other malicious code Harvest or collect information about other users without their consent Use automated systems (bots, scrapers) to access our services without our written permission Reverse engineer, decompile, or disassemble any aspect of our services Remove, obscure, or alter any copyright, trademark, or other proprietary rights notices Engage in any conduct that harasses, threatens, or harms other users 7. DATA PRIVACY AND PROTECTION 7.1 Health Data Collection When you use our tracking features, you may provide health-related information. Our collection, use, storage, and protection of your personal data, including health information, is governed by our Privacy Policy and applicable privacy laws, including the Washington My Health My Data Act (MHMDA). 7.2 Your Privacy Rights You have the right to: Access your personal data Request correction of inaccurate data Request deletion of your data Opt out of certain data uses Receive a copy of your data in a portable format Withdraw consent for data processing where consent is the legal basis For complete details on how we collect, use, and protect your data, and how to exercise your privacy rights, please review our Privacy Policy. 8. INTELLECTUAL PROPERTY RIGHTS 8.1 Our Content and Ownership All content provided through Flourishing Through, including but not limited to text, articles, graphics, videos, logos, images, software, and the mobile application itself (collectively, "Content"), is owned by Flourishing Through or our licensors and is protected by United States and international copyright, trademark, patent, trade secret, and other intellectual property laws. 8.2 Limited License to You We grant you a limited, non-exclusive, non-transferable, non-sublicensable, revocable license to access and use our Content solely for your personal, non-commercial use as a member. This license does not permit you to: Copy, reproduce, distribute, or publicly display our Content Create derivative works from our Content Use our Content for any commercial purpose Modify, translate, or create adaptations of our Content Remove, obscure, or alter copyright, trademark, or other proprietary rights notices from our Content 8.3 Your Content and Data Any information you input into our tracking features or community areas (when launched) remains your property. However, by using our services, you grant us: A worldwide, non-exclusive, royalty-free license to use, store, and process your data as necessary to provide and improve our services The right to create aggregated, anonymized data from user inputs for research, analytics, and service improvement purposes This license terminates when you delete your data or close your account, except for data that has been anonymized and aggregated, which may be retained indefinitely. 9. DISCLAIMERS AND LIMITATIONS OF LIABILITY 9.1 No Medical Advice Disclaimer FLOURISHING THROUGH IS AN EDUCATIONAL PLATFORM ONLY. WE ARE NOT HEALTHCARE PROVIDERS AND DO NOT PROVIDE MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. THE INFORMATION PROVIDED IS FOR EDUCATIONAL AND INFORMATIONAL PURPOSES ONLY AND SHOULD NOT BE RELIED UPON AS A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. YOU ACKNOWLEDGE AND AGREE THAT WE ARE NOT LIABLE FOR ANY HEALTH OUTCOMES, DECISIONS, OR ACTIONS TAKEN BASED ON INFORMATION FROM OUR PLATFORM. ALWAYS CONSULT WITH A QUALIFIED HEALTHCARE PROVIDER BEFORE MAKING ANY HEALTHCARE DECISIONS OR TAKING ANY ACTION BASED ON INFORMATION PROVIDED THROUGH OUR SERVICES. 9.2 Service Availability and Accuracy FLOURISHING THROUGH IS PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS. WE MAKE NO WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, OR NON-INFRINGEMENT. WE DO NOT GUARANTEE THAT: (A) OUR SERVICES WILL BE AVAILABLE AT ALL TIMES OR WILL BE UNINTERRUPTED, SECURE, OR ERROR-FREE; (B) ANY DEFECTS OR ERRORS WILL BE CORRECTED; (C) OUR SERVICES ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS; OR (D) THE INFORMATION PROVIDED THROUGH OUR SERVICES IS ACCURATE, COMPLETE, OR CURRENT. 9.3 Limitation of Liability TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, FLOURISHING THROUGH, ITS OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, AND AFFILIATES SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, OR ANY LOSS OF PROFITS, REVENUE, DATA, OR USE, WHETHER IN AN ACTION IN CONTRACT, TORT (INCLUDING NEGLIGENCE), OR OTHERWISE, ARISING OUT OF OR IN ANY WAY CONNECTED WITH YOUR USE OF OUR SERVICES, EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. OUR TOTAL LIABILITY TO YOU FOR ANY CLAIMS ARISING OUT OF OR RELATED TO THESE TERMS OR YOUR USE OF OUR SERVICES SHALL NOT EXCEED THE AMOUNT YOU PAID FOR MEMBERSHIP IN THE TWELVE (12) MONTHS PRIOR TO THE EVENT GIVING RISE TO LIABILITY, OR ONE HUNDRED DOLLARS ($100), WHICHEVER IS GREATER. 9.4 State Law Limitations Some jurisdictions do not allow the exclusion or limitation of certain warranties or damages, so some of the above limitations and exclusions may not apply to you. In such jurisdictions, our liability will be limited to the greatest extent permitted by law. 10. INDEMNIFICATION You agree to indemnify, defend, and hold harmless Flourishing Through, its officers, directors, employees, agents, affiliates, and licensors from and against any and all claims, damages, obligations, losses, liabilities, costs, and expenses (including reasonable attorneys' fees) arising from: (a) your use of our services; (b) your violation of these Terms; (c) your violation of any third-party rights, including intellectual property rights; or (d) any harm caused to any third party through your use of our services. 11. MODIFICATIONS TO SERVICES AND TERMS 11.1 Service Changes We reserve the right to modify, suspend, or discontinue any aspect of our services at any time, including but not limited to features, content, functionality, or availability. We will provide reasonable notice of material changes when practicable, but are not obligated to do so. We are not liable to you or any third party for any modification, suspension, or discontinuation of our services. 11.2 Terms Updates We may update these Terms from time to time. When we make material changes to these Terms, we will notify you by: Sending an email to your registered email address Displaying a prominent notice within the mobile application Updating the "Last Updated" date at the top of these Terms Your continued use of our services after the effective date of the updated Terms constitutes your acceptance of the changes. If you do not agree to the updated Terms, you must stop using our services and cancel your membership. 12. DISPUTE RESOLUTION 12.1 Governing Law These Terms and your use of Flourishing Through are governed by and construed in accordance with the laws of the State of Washington, without regard to its conflict of law principles. 12.2 Informal Resolution Before pursuing formal legal action, you agree to first contact us at admin@flourishing through.com to attempt to resolve any dispute informally. We will work in good faith to resolve the matter. Most disputes can be resolved this way. 12.4 Venue and Jurisdiction If informal resolution and arbitration (if applicable) do not resolve the dispute, you agree that any legal action arising from or related to these Terms or your use of our services shall be brought exclusively in the state or federal courts located in King County, Washington. You consent to the personal jurisdiction of these courts and waive any objection to venue in these courts. 12.5 Class Action Waiver TO THE EXTENT PERMITTED BY LAW, YOU AND FLOURISHING THROUGH AGREE THAT EACH PARTY MAY BRING CLAIMS AGAINST THE OTHER ONLY IN AN INDIVIDUAL CAPACITY AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS, CONSOLIDATED, OR REPRESENTATIVE PROCEEDING. 13. GENERAL PROVISIONS 13.1 Entire Agreement These Terms, together with our Privacy Policy and any additional terms that apply to specific features, constitute the entire agreement between you and Flourishing Through regarding your use of our services and supersede all prior agreements and understandings. 13.2 Severability If any provision of these Terms is found to be invalid, illegal, or unenforceable by a court of competent jurisdiction, the remaining provisions will remain in full force and effect. The invalid provision will be modified to the minimum extent necessary to make it valid and enforceable. 13.3 Waiver Our failure to enforce any provision of these Terms or to exercise any right under these Terms does not constitute a waiver of that provision or right. Any waiver must be in writing and signed by an authorized representative of Flourishing Through. 13.4 Assignment You may not assign, transfer, or delegate these Terms or your rights and obligations under these Terms without our prior written consent. We may assign, transfer, or delegate these Terms and our rights and obligations without restriction, including in connection with a merger, acquisition, reorganization, or sale of assets. 13.5 Force Majeure We are not liable for any failure or delay in performance due to circumstances beyond our reasonable control, including but not limited to acts of God, natural disasters, war, terrorism, riots, embargoes, acts of civil or military authorities, fire, floods, accidents, pandemics, strikes, or shortages of transportation facilities, fuel, energy, labor, or materials. 13.6 Survival The provisions of these Terms that by their nature should survive termination shall survive, including but not limited to: Intellectual Property Rights, Disclaimers and Limitations of Liability, Indemnification, Dispute Resolution, and General Provisions. 13.7 Electronic Communications By using Flourishing Through, you consent to receive electronic communications from us, including emails, notifications through the mobile application, and postings on our website. These electronic communications may include notices about your account, transactional information, and promotional messages. You agree that all agreements, notices, disclosures, and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing. 13.8 No Agency Relationship No joint venture, partnership, employment, or agency relationship exists between you and Flourishing Through as a result of these Terms or your use of our services. 14. CONTACT INFORMATION If you have any questions, concerns, or complaints about these Terms or our services, please contact us at: Email: admin@flourishingthrough.com ACKNOWLEDGMENT AND ACCEPTANCE By creating an account, subscribing to Flourishing Through membership services, or otherwise using our platform, you acknowledge that: You have read and understood these Terms of Service in their entirety You agree to be bound by all terms and conditions contained herein You understand that Flourishing Through provides educational information only and not medical advice You are at least 18 years old You will comply with all applicable laws and these Terms when using our services You have reviewed our Privacy Policy and understand how we collect, use, and protect your data You acknowledge that membership fees are non-refundable except as expressly provided in these Terms or required by law IMPORTANT: THIS IS A LEGALLY BINDING AGREEMENT. PLEASE READ IT CAREFULLY AND SAVE A COPY FOR YOUR RECORDS. IF YOU DO NOT AGREE TO THESE TERMS, DO NOT USE FLOURISHING THROUGH. * * *

Refund Policy A legal disclaimer The explanations and information provided on this page are only general and high-level explanations and information on how to write your own document of a Refund Policy. You should not rely on this article as legal advice or as recommendations regarding what you should actually do, because we cannot know in advance what are the specific refund policies that you wish to establish between your business and your customers. We recommend that you seek legal advice to help you understand and to assist you in the creation of your own Refund Policy. Refund Policy - the basics Having said that, a Refund Policy is a legally binding document that is meant to establish the legal relations between you and your customers regarding how and if you will provide them with a refund. Online businesses selling products are sometimes required (depending on local laws and regulations) to present their product return policy and refund policy. In some jurisdictions, this is needed in order to comply with consumer protection laws. It may also help you avoid legal claims from customers that are not satisfied with the products they purchased. What to include in the Refund Policy Generally speaking, a Refund Policy often addresses these types of issues: the timeframe for asking for a refund; will the refund be full or partial; under which conditions will the customer receive a refund; and much, much more.

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Privacy Policy Privacy Policy - the basics Flourishing Through LLC Effective Date: 10.01.2025 Last Updated: 12.09.2025 1. INTRODUCTION Welcome to Flourishing Through ("we," "our," or "us"). We are committed to protecting your privacy and being transparent about how we collect, use, and share your information. This Privacy Policy explains how we handle your personal information when you: Visit our website at [website URL] Use our mobile application ("App") Subscribe to our membership services Interact with our content and community features By using our services, you agree to the collection and use of information in accordance with this Privacy Policy. If you do not agree with this policy, please do not use our services. 2. INFORMATION WE COLLECT 2.1 Information You Provide Directly Account Information: Name and email address Username and password Payment information (processed by third-party payment processors) Subscription preferences Profile Information: Age or date of birth General health interests and goals Communication preferences Health and Wellness Tracking Data: Physical changes you choose to track Mental health observations you choose to record Social well-being notes you choose to document Personal journal entries and notes Community Participation: Posts, comments, and messages in community features Feedback and survey responses 2.2 Information Collected Automatically Usage Information: Pages viewed and features accessed Time spent on different sections Articles read and content interactions Search queries within the platform Device Information: Device type and operating system Mobile device identifiers IP address Browser type and version Analytics Data: App performance data Error reports and crash logs General usage patterns and statistics 2.3 Information from Third Parties Payment confirmation from Apple App Store or Google Play Store Authentication information if you use social login (future feature) 3. HOW WE USE YOUR INFORMATION We use your information for the following purposes: Service Delivery: Provide access to membership content and features Process and manage your subscription Enable tracking and journaling features in the App Deliver personalized content recommendations Communication: Send account-related notifications Provide customer support Send newsletters and updates about our services (with your consent) Notify you about changes to our services or policies Improvement and Development: Analyze usage patterns to improve our services Develop new features and content Conduct research on perimenopause and women's health (in aggregate, de-identified form) Troubleshoot technical issues Legal and Safety: Comply with legal obligations Enforce our Terms of Service Protect against fraud and abuse Defend our legal rights 4. WASHINGTON STATE HEALTH DATA PROTECTIONS 4.1 My Health My Data Act (MHMDA) Compliance As a Washington State-based company collecting health data from Washington consumers, we comply with the Washington My Health My Data Act (RCW 19.373). Consumer Health Data includes information that: Identifies or is reasonably capable of being associated with you, AND Relates to your past, present, or future physical health, mental health, disability, diagnosis, or healthcare Your Rights Under MHMDA: Right to Access: You can request access to your consumer health data Right to Delete: You can request deletion of your consumer health data Right to Withdraw Consent: You can withdraw consent for processing at any time Right to Data Portability: You can receive your data in a portable format Our Commitments: We will not sell your consumer health data We will not share your health data without your explicit consent, except as required by law We implement reasonable security measures to protect your health data We conduct regular security assessments We limit access to health data to authorized personnel only 4.2 Geofencing Restrictions We do not: Use geofencing technology around healthcare facilities Collect location data to identify individuals seeking health services Track your visits to health-related locations 5. HOW WE SHARE YOUR INFORMATION We do not sell your personal information or consumer health data. We may share your information in the following limited circumstances: Service Providers: Payment processors (Apple, Google) to process subscriptions Cloud hosting providers for data storage Analytics providers to understand usage patterns (using de-identified data when possible) Email service providers for communications All service providers are contractually obligated to protect your information and use it only for the purposes we specify. Legal Requirements: When required by law, regulation, or legal process To protect our rights, property, or safety To prevent fraud or security threats In connection with legal proceedings Business Transfers: In the event of a merger, acquisition, or sale of assets, your information may be transferred (you will be notified of any such change) With Your Consent: When you explicitly authorize us to share information For community features, as described in Section 11 Aggregated Data: We may share de-identified, aggregated data for research or informational purposes 6. DATA SECURITY We implement reasonable administrative, technical, and physical security measures to protect your information, including: Encryption of data in transit and at rest Secure authentication protocols Regular security assessments and updates Limited access to personal data on a need-to-know basis Employee training on data protection However, no method of transmission over the internet or electronic storage is 100% secure. While we strive to protect your information, we cannot guarantee absolute security. 7. DATA RETENTION We retain your information for as long as necessary to: Provide our services to you Comply with legal obligations Resolve disputes Enforce our agreements Account Data: Retained while your account is active and for a reasonable period after closure (typically 90 days, unless legally required to retain longer) Health Tracking Data: Retained according to your preferences; you can delete this data at any time through the App Financial Records: Retained as required by law (typically 7 years for tax purposes) Anonymous Usage Data: May be retained indefinitely in aggregated form 8. YOUR PRIVACY RIGHTS 8.1 General Rights Access: Request access to the personal information we hold about you Correction: Request correction of inaccurate information Deletion: Request deletion of your information (subject to legal retention requirements) Opt-Out: Unsubscribe from marketing communications Data Portability: Receive your data in a portable format 8.2 Washington State Residents If you are a Washington resident, you have additional rights under MHMDA (see Section 4.1) and the Washington Privacy Act (if enacted). 8.3 How to Exercise Your Rights To exercise any of these rights, contact us at: Email: privacy@flourishingthrough.com In-App: Settings > Privacy > Submit Request Mail: [Physical Address] We will respond to your request within 45 days (or as required by applicable law). 9. CHILDREN'S PRIVACY Our services are intended for adults aged 18 and over. We do not knowingly collect information from children under 18. If we discover we have collected information from a child under 18, we will delete it promptly. 10. THIRD-PARTY SERVICES 10.1 Payment Processing Subscription payments are processed through: Apple In-App Purchase (for iOS users) Google Play Billing (for Android users) Wix Payments (powered by Stripe) for website-based memberships and services These services are governed by Apple's, Google's, and Wix's respective privacy policies. We receive only confirmation of payment, not your payment card details. 10.2 Third-Party Links Our services may contain links to third-party websites or resources. We are not responsible for the privacy practices of these third parties. We encourage you to review their privacy policies. 11. COMMUNITY FEATURES 11.1 Current Features Currently, community features are limited. Any future community features will include: Clear privacy controls Options to participate with a username 11.2 Future Community Groups (Planned 2026) When we launch community support groups: You will be able to control what information you share Group interactions may be visible to other group members We will provide detailed privacy settings before launch Moderators may have access to group content for safety purposes 11.3 User-Generated Content Any information you choose to share in community features may be visible to other members. Do not share: Sensitive personal health details you wish to keep private Information that identifies you if you prefer anonymity Protected health information covered by HIPAA 12. INTERNATIONAL DATA TRANSFERS Our services are based in the United States. If you access our services from outside the U.S., your information will be transferred to and processed in the United States, which may have different data protection laws than your jurisdiction. 13. CALIFORNIA RESIDENTS If you are a California resident, you may have additional rights under the California Consumer Privacy Act (CCPA). Please contact us for information about exercising these rights. 14. COOKIES AND TRACKING TECHNOLOGIES 14.1 What We Use Essential Cookies: Required for the App and website to function Analytics Cookies: Help us understand how users interact with our services Preference Cookies: Remember your settings and preferences 14.2 Your Choices You can manage cookie preferences through: Your device settings Browser settings (for website) App settings > Privacy Note that disabling certain cookies may limit functionality. 15. DO NOT TRACK SIGNALS Our services do not currently respond to "Do Not Track" browser signals, as there is no universally accepted standard for how to respond to such signals. 16. CHANGES TO THIS PRIVACY POLICY We may update this Privacy Policy periodically to reflect: Changes in our practices New legal requirements Additional features or services We will notify you of material changes by: Posting the updated policy with a new "Last Updated" date Sending an email notification to registered users Displaying a prominent notice in the App Your continued use of our services after changes take effect constitutes acceptance of the updated policy. 17. CONTACT US If you have questions, concerns, or requests regarding this Privacy Policy or our privacy practices: Email: admin@flourishingthrough.co Response Time: We will respond to privacy inquiries within 10 business days. 18. DISPUTE RESOLUTION Any disputes regarding privacy or personal information will be subject to the dispute resolution provisions in our Terms of Service, including: Initial good-faith negotiation Arbitration (if required) Governing law: Washington State CONSENT ACKNOWLEDGMENT By using Flourishing Through's services, you acknowledge that you have read, understood, and agree to this Privacy Policy. For Washington residents: You acknowledge your rights under the My Health My Data Act and consent to our collection and processing of consumer health data as described in this policy. Flourishing Through

Shipping Policy A legal disclaimer The explanations and information provided on this page are only general and high-level explanations and information on how to write your own document of a Shipping Policy. You should not rely on this article as legal advice or as recommendations regarding what you should actually do, because we cannot know in advance what are the specific shipping policies that you wish to establish between your business and your customers. We recommend that you seek legal advice to help you understand and to assist you in the creation of your own Shipping Policy. Shipping Policy - the basics Having said that, a Shipping Policy is a legally binding document that is meant to establish the legal relations between you and your customers. It is the legal framework for presenting your obligations to your customers, but also to address different possible scenarios that may occur, and what happens in each and every case. A Shipping Policy is a good practice and it helps both sides - you and your customers. Your customers may benefit from being informed about what they can expect from your service. You may benefit because people may be likely to shop with you if you have a clear Shipping Policy in place since there won't be any questions about your shipping timeframes or processes. What to include in the Shipping Policy Generally speaking, a Shipping Policy often addresses these types of issues: the timeframe for processing orders; the shipping costs; different domestic and international shipping solutions; potential service interruptions; and much, much more.

Medical Disclaimer Last Updated: 12.09.2025 The information provided on the Flourishing Through website and mobile application is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Not a Substitute for Professional Medical Care The content available through Flourishing Through, including articles, resources, tracking tools, and community discussions, should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition, symptoms, or health concerns. No Doctor-Patient Relationship Use of this website and app does not create a doctor-patient relationship between you and Flourishing Through LLC, its owners, or contributors. We are not healthcare providers and do not provide medical services. Individual Health Varies Perimenopause and menopause affect each person differently. Information shared through our platform represents general educational content and may not apply to your specific situation. Your healthcare provider is the best source for personalized medical guidance based on your individual health history and needs. Emergency Situations If you are experiencing a medical emergency, call 911 or your local emergency number immediately. Do not rely on information from this platform for emergency medical situations. Do Not Disregard or Delay Medical Advice Never disregard professional medical advice or delay seeking it because of something you have read on Flourishing Through. If you think you may have a medical condition or concern, contact your healthcare provider promptly. User-Generated Content Community discussions and user-shared experiences on our platform represent personal perspectives and should not be considered medical advice. Other users are not healthcare professionals unless explicitly identified as such, and even then, they are not providing medical care through this platform. Accuracy and Updates While we strive to provide accurate, evidence-based information, medical knowledge evolves continuously. We make reasonable efforts to keep content current but cannot guarantee that all information is complete, accurate, or up-to-date at all times. Consult Before Making Health Decisions Before making any decisions regarding your health, medications, supplements, or treatment approaches based on information from this platform, consult with your qualified healthcare provider.

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