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.
Eight areas, each closed until you open it. Pick the one you want to raise at your next appointment.
Start here
Tap an area and it opens below. Nothing else on this page needs reading first.
Not after a prescription? The relief finder filters non-drug options by symptom, sleep, movement, pelvic floor, CBT, cooling, food.
By area of the body
Where the treatment only works alongside a practice, we give the area its own hub.
Pelvic health
Leaking, urgency, heaviness and a floor that won’t switch off: how breath and the pelvic floor work together, four voice-guided practices, the 12-week program, and when to bring in a physio.
Open the pelvic health hubThis 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 primerFree 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.
Start loggingAll eleven, side by side
Patches, gels, pills, micronized progesterone, the IUD, vaginal estrogen and DHEA, testosterone, and the non-hormonal prescriptions — each with its evidence grade and sources.
See the optionsThe numbers on the box
The estradiol dose ladder, roughly how a patch compares to gel pumps or spray, which brand name is which molecule in the UK, Canada, the US and Australia, and what the first six months usually feel like.
Decode the prescriptionThe 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 literacy
Six red flags that separate real menopause evidence from wellness marketing, and the questions to ask before you buy or believe.
Read the guideThe 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 landscapeNon-hormonal, non-surgical
Silicone support for prolapse and stress leaking. What the fitting is like, how you care for it, and the sentence that gets you a trial.
Read the guideNon-hormonal, non-surgical
The HIFEM chair is advertised hard for bladder leaks. What the trials found, who paid for them, and how it compares with pelvic floor physio.
Read the honest versionBleeding & cycles
The bleed on the pill is a withdrawal bleed, not a period. What continuous dosing does, who it suits in perimenopause, and the trade-offs nobody mentions.
Read the guideGo deeper
Studies and guideline summaries behind the recommendations.
Browse the studiesA note on second opinions
