Dr. Linda Nykin ND, CFMP

Dr. Linda Nykin ND, CFMP Naturopathic Doctor & Functional Medicine Practitioner

PMOS/PCOS supplement advice can get crowded pretty quickly. When I’m evaluating supplements for effectiveness, I look at...
09/09/2026

PMOS/PCOS supplement advice can get crowded pretty quickly. When I’m evaluating supplements for effectiveness, I look at the strength and quality of the evidence, how consistently the research shows a benefit, which outcomes have been studied, the dose and formulation used, and most importantly, whether the findings are relevant to the person in front of me!

I also consider labs, symptoms, medications and pregnancy plans to decide what may be useful, then identify how we will measure whether it is meeting the goal we chose it for.

The strength of the evidence varies depending on the supplement and the outcome being studied, which is why recommendations can look different from one person to the next.

If you’d like support sorting through which options may fit your needs, I’d be happy to connect and talk about an individualized PMOS/PCOS plan. You can schedule a discovery call through the link in my bio!

For PMOS Awareness Month, I want to make space for a part of PMOS that does not get nearly enough attention: what happen...
09/06/2026

For PMOS Awareness Month, I want to make space for a part of PMOS that does not get nearly enough attention: what happens at midlife!

PMOS, formerly called PCOS, is so often discussed through the lens of periods, ovulation and fertility. Those conversations are important, but they are only one chapter. For many women, the PMOS conversation fades once pregnancy is no longer the goal.

Perimenopause is an important time to revisit it!

The transition may be harder to recognize if your periods were already irregular or if you have used hormonal contraception to manage symptoms for years. That does not mean the transition is not happening or that new symptoms should be dismissed.

PMOS-related metabolic health also remains relevant at midlife. At the same time, perimenopause may bring changes in sleep, muscle mass, body composition and insulin sensitivity that shift what your body needs.

The goal is not to perfectly separate PMOS from perimenopause on your own. It is to notice what has changed, consider whether your routine health monitoring is current and recognize when you could use more support.

Has your PMOS care changed as you have?

Save this for later, or share it with someone who has wondered whether PMOS still matters beyond fertility!

Which midlife change has been hardest to connect to your hormones?
09/03/2026

Which midlife change has been hardest to connect to your hormones?

IBS can be deeply frustrating because symptoms may be significant even when structural testing looks normal.In my clinic...
09/01/2026

IBS can be deeply frustrating because symptoms may be significant even when structural testing looks normal.

In my clinical work, I find it incredibly useful to ask how the gut is moving, sensing, signaling, and responding. Understanding those patterns can help us identify what may be driving your symptoms and choose treatments that are more likely to bring meaningful relief!

Disorders of gut-brain interaction, and the emerging research in that field, are helping us to understand these patterns without dismissing the symptoms or inventing damage that has not been demonstrated.

This early research offers another glimpse into the physiology behind that connection, and it is an area worth watching!

08/27/2026

We’re wrapping up my Get to Know Your Hormones series with estrogen!

Estrogen is one of the hormones people hear about the most, but it does a lot more than regulate your period.

It is actually a family of hormones, including estradiol, estrone, and estriol, and it plays a role in bone health, brain function, vaginal and urinary tissue, temperature regulation, skin, and cardiovascular health.

During perimenopause, estradiol can also become much more variable. It may be relatively high at one point and then drop significantly later, which is one reason symptoms can feel so different from month to month.

In this final video, I’m breaking down what estrogen does, the different forms it takes, and why the pattern can matter just as much as the number itself.

And since we’ve now made it through the full series, I wanted to give you somewhere to keep all of this information together.

I created a free Hormone Reference Guide that walks through the hormones and hormone markers we covered, how they connect, what testing can and cannot tell you, and some of the questions that may be worth bringing to your provider.

Grab the free guide at the link in my bio. 🔗

Save this post if you want to come back to it.

Brain fog is one of the most common things I hear about from women in their late 30s and 40s.Maybe you’re forgetting wor...
08/21/2026

Brain fog is one of the most common things I hear about from women in their late 30s and 40s.

Maybe you’re forgetting words mid-sentence, rereading the same paragraph three times, losing your train of thought, or noticing that work suddenly takes more mental effort than it used to.

Perimenopause can absolutely be part of that picture.

Estrogen has effects throughout the brain, including pathways involved in glucose metabolism, memory, attention, and neurotransmitter signaling. During perimenopause, estrogen levels can become much more variable from one cycle to the next, and research has found small but measurable changes in cognitive performance during this transition.¹⁻³

The pattern can be useful too. Does the brain fog come and go? Is it worse during certain parts of your cycle? Did it start around the same time as night waking, hot flashes, heavier periods, mood changes, or fatigue?

When someone tells me she doesn’t feel as sharp as she used to, I want to look at the whole picture!

That may include:

• sleep quality and possible sleep apnea
• thyroid function
• CBC, ferritin and B12
• glucose and metabolic health
• cycle and symptom patterns
• mood and ADHD symptoms
• medications and alcohol use

A single hormone level usually isn’t going to explain why you feel foggy. The history, the timing, your other symptoms, and a thoughtful workup give us much more useful information.

The goal is figuring out what fits the whole picture.

Brain fog is common during perimenopause, and it still deserves to be taken seriously, especially when it’s new, worsening, or interfering with your daily life.

Save this for your next appointment. 💛

Sources

1. Maki PM, Jaff NG. Menopause and brain fog: how to counsel and treat midlife women. Menopause. 2024;31(7):647-649.
2. Rettberg JR, Yao J, Brinton RD. Estrogen: a master regulator of bioenergetic systems in the brain and body. Front Neuroendocrinol. 2014;35(1):8-30.
3. Greendale GA, et al. Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology. 2009;72(21):1850-1857.

If you have ever felt like your mood shifts are tied to your cycle but could never quite pin down the pattern… there may...
07/01/2026

If you have ever felt like your mood shifts are tied to your cycle but could never quite pin down the pattern… there may be a reason it feels different from what you read about online. Swipe through ➡️

In 2025, Peters and colleagues proposed the DASH-MC framework (Dimensional Affective Sensitivity to Hormones across the Menstrual Cycle ) outlining three distinct patterns of hormonally influenced mood changes, each driven by a different hormonal event and presenting with different symptoms. What makes this framework clinically meaningful is that it moves away from the idea of a single hormone level as the problem, and toward understanding individual sensitivity to specific hormonal shifts. Full citation: Peters JR et al. Molecular Psychiatry 30, 251–262 (2025). DOI: 10.1038/s41380-024-02693-4

What often gets missed is that estrogen is an active modulator of serotonin, dopamine, and norepinephrine signaling. When it drops quickly in the perimenstrual window, that shift has real downstream effects on neurotransmitter availability. It is not just “your hormones.” There is a specific biological mechanism behind it. If your lowest days consistently land right around your period, this is worth discussing with your provider!

This pattern tends to be the most surprising to people because mid-cycle is often thought of as the “good” part of the cycle when estrogen is high. What this research suggests is that for some women, it is the surge itself, not the level, that creates difficulty. The research on this pattern is early and more study is needed. But if mid-cycle consistently feels destabilising for you, it is worth tracking and worth bringing up.

One of the most important things to understand about this pattern is that two people with identical progesterone levels can have completely different experiences. What appears to vary is the individual nervous system response to allopregnanolone, the neurosteroid progesterone converts to, rather than the amount of progesterone itself. This is why “your progesterone is normal” does not always close the conversation.

These patterns are a framework, not a diagnosis, and some people will recognise themselves in more than one.

06/25/2026

Get to know your hormones! Your ovaries don’t work alone. They wait for a signal from your brain every single cycle.

FSH and LH are that signal. They come from the pituitary, not the ovaries, and they tell your body when to grow a follicle and when to ovulate. Most women have had these numbers checked without anyone explaining what the brain-to-ovary conversation actually looks like.

It’s not so much that these numbers in isolation matter. It’s the trend, the timing, and what else is going on clinically. A single normal FSH in early perimenopause doesn’t tell the whole story!

06/10/2026

Part 4 of Get to Know Your Hormones.

Spotting before your period, shorter cycles, worsening PMS symptoms. These can all trace back to low progesterone.

But here is the part most people are never told. The standard day 21 progesterone test is timed wrong for so many women!

Day 21 only makes sense if you ovulate on day 14. If your cycle is longer, shorter, or irregular, that test can come back low simply because it was taken at the wrong time, not because your body is not making progesterone.

The better window is about 7 days after you ovulate, or roughly a week before your period.

Save this for the next time you’re wondering if your symptoms could be hormone related!

06/08/2026

Part 3 of Get to Know Your Hormones.

DHEA is one of the most abundant steroid hormones in the body. It is produced primarily in the adrenal glands and sits upstream from testosterone and estrogen, meaning your body uses it as raw material to make other hormones.

What makes it unique is that it does not fluctuate with your cycle. Instead it follows a much longer arc. It peaks in your mid twenties and then declines steadily and predictably from there. By the time most people are in their forties levels can be significantly lower than they were at peak, often without a single obvious symptom pointing directly to it.

Fatigue that sleep does not fix. A quiet shift in motivation and drive. Difficulty maintaining muscle. Low libido that came on gradually with no obvious explanation. These are the kinds of symptoms that get attributed to stress, aging, or just being busy. But sometimes there is a hormonal layer underneath that nobody has looked at.

In this video: what DHEA actually does, what declining levels can feel like, whether it is worth testing, and why I would be cautious before supplementing it.
✅Save this series for the next time you’re wondering if your symptoms could be hormone related!

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