For some women, perimenopause is the first time a lifetime of autistic traits becomes harder to compensate for. The noise feels louder, social interactions take more energy, routines matter more, and the strategies that worked for decades suddenly aren't enough. Perimenopause doesn't cause autism, but it may make the mask much harder to hold.

Most physicians treating recurrent UTIs in women are missing half the picture. Estrogen gets some attention. Testosterone almost never does. And yet the female urethra is rich in androgen receptors, depends on testosterone for its resilience and thickness, and becomes significantly more vulnerable to bacterial colonization when those levels decline. This is not experimental medicine. This is physiology that has simply never made it into the standard of care.