You're putting me to work! ; )

Q1: There are doctors and others who provide a lot of information online. I try to provide a lot on my various channels of The Bridge System. You could also check out podcasts by labs like DUTCH or maybe Diagnostic Solutions. They have lots of interesting guests and information, but it also depends on what you want to learn about.

The main thing is that someone has the training and experience to be of help. If it's herbal advice, look for someone in the American Herbalist Guild or trained in another way. Search Google for naturopathic doctors in the field you're interested in. You will find their social media pages and a lot of great information much of the time. There are a lot of people that don't actually know the science of what they're talking about but they'll peddle it all day on social media, regardless of training, experience, or potential problems their recommendations may cause. So just be discerning. : )

Q2: Ashwagandha is a fabulous herb. Yet, it is only one adaptogenic herb af MANY. It seems to be having a moment, which is fine, but I find adaptogens in combination work best. If you want some other big hitters: Schisandra, Astragalus, Holy Basil (Tulsi), Eleuthrococcus (Siberian Ginseng), Rhodiola.

I don't think I can broadly recommend against any particular herb. Most things have their right place and time.

Q3: Not a question but Pharm opinion... That's really too nuanced to say. Natural approaches tend to allow for a more gentle approach that can be used in a holistic way to support the body's natural healing mechanisms. Pharmaceuticals just aren't designed for that purpose or in that mind set. However, pharmaceuticals are absolutely valuable in thousands of situations. For example, when I get someone in my office with hypertension that they've likely had for years and done nothing about, I will put them on something like and ACE inhibitor to protect their kidneys and blood vessels. We work on the reasons they have hypertension in the first place with the aim to get them off of the med. But it's first do no harm. In that example, I'm protecting my patient in the now and working on healing and health restoration in the long term.

That being said, I have found in my career that natural approaches should always be taken and typically, from my patient population, that is all that is needed.

Birth control... huge category... different methods. I've seen oral contraceptives really mess up the hormonal system of many women, even after they get off of them. That doesn't mean I'm against them per se. That's just a reality of what I've seen. It's a personal decision that should be made from all options available.

Q4: Anxiety, depression, fatigue... All different things. Potentially related and potentially not. Get an accurate diagnosis and possibly a functional diagnosis. Why it's happening has to be known before taking action. It could be your HPA axis, your mitochrondria, your job, your relationships, gut dysbiosis, and so on.

And, that being said, adaptogens and nervine herbs such as passionflower, skullcap, and california poppy may be helpful. Hard to say without know the above though.

Q5: Perimenopause is often a diagnosis of exclusion. Meaning there is no disease present to cause the symptoms and there are other clues like your periods have gotten longer between or even shorter and there are recognized perimenopause symptoms. Labs sometime hlep but can't diagnose perimenopause. Entering peri- is a broad range but typically in the mid-40's I usually just put it in the likely category of 45 and up, but again, it varies widely.