Treatments primer
A plain-English overview of the conventional treatments worth knowing about. We don't prescribe and we don't dose, the aim is to walk into your next appointment with the right questions.
Six treatment areas below, each with what the guidelines say, what the trade-offs look like, and the questions worth bringing in. Skim, then jump.
Free for everyone, before your next appointment
Most appointments are short. These three habits get you taken seriously and walking out with an actual plan.
'I feel awful' is hard to act on. Three numbers on a Post-it ('sleep 4/10, mood 3/10, hot flashes ×6') tells your GP exactly where to start.
Try this week: Sticky note on the bathroom mirror. Sleep, mood, flashes. One number out of ten for each, plus the count. Two weeks. Bring it to the appointment.
This page is education, not advice.
Nila isn't a medical service. Nothing here is a recommendation to start, stop or change a medication. Use it to know what exists and to bring better questions to your doctor or specialist.
Before the prescribing conversation
Estrogen, progesterone, testosterone, FSH and LH — one focused page for each, plus the synthetic family and the newer non-hormonal options. Most of the appointment goes better when the words are already in place.
Read the hormones primerMultiple solid human trials and guideline support. The kind of thing your doctor or specialist will recognize straight away.
Good early human data, in routine use, but the evidence base is still maturing. Worth raising; worth a real conversation.
Long use and modest modern data, or newer options still earning their place. Useful to know exists.
A menu, not a prescription.
Start here
Tap the area you most want to talk to your doctor or specialist about. We'll jump you to what's on the menu for it, full primer is right underneath if you want to read end-to-end.
The myths
Eight things you'll still hear in 2026, and what the evidence actually says, including the Women’s Health Initiative (WHI) in real numbers.
Read the mythsThe vocabulary
What "body-identical", "bioidentical", "compounded" and "synthetic" actually mean, and which distinction really moves the needle on risk.
Read the explainerBefore your appointment
When bloods help, when they don't, and the timing rules that change the result — from NICE, BMS and the Menopause Society.
Read the guideCanada · cost
BC and Manitoba cover it publicly. Everywhere else is a patchwork. The honest province-by-province map.
See the province mapStill cycling
What still works (and what doesn't) when you're 40+, when you can stop, and the STI conversation that rarely comes up in a midlife appointment.
Read the guideWhen the framing doesn't fit
The "loss of femininity" script lands hard for a lot of people. Anatomy-not-identity language, what the recent research says, and how to keep the appointment about your body.
Read the framingIf appointments feel hard
If old experiences in exam rooms show up in your body the next time you book one, what trauma-informed care actually looks like, how to ask for it, and scripts for when language disappears.
Read the guideThe talking-therapy menu
Three protocols worth knowing by name — CBT-Meno for hot flash bother, CBT-I for insomnia, CT-MS for menopausal mood — and how to find a therapist actually trained in them.
Read the guideThe non-prescription lane
What the evidence does and doesn't support for sleep, pain, anxiety and hot flashes, plus the HRT, SSRI, tamoxifen and blood-thinner interactions almost nobody flags at the dispensary.
Read the guideFind a practitioner
A primer on menopause-literate doctors and specialists.
Browse the directoryNon-prescription side
Curated, evidence-tiered. Companions to, not replacements for, medical care.
Open the libraryWhere they fit
An honest map of what's evidence-backed, what's marketing, and the interactions worth flagging before you DIY a stack.
Read the landscapeGo deeper
Studies and guideline summaries behind the recommendations.
Browse the studiesA note on second opinions
From members
A question you asked your doctor or specialist, a study that cleared the fog, the comparison that helped you choose, share what made the path clearer.
