Alise Greenfield

Alise Greenfield I’m an NP helping women with mystery symptoms find and treat the root cause to feel better than fine

09/04/2026

You’ve been told progesterone declines first in perimenopause.

That’s only part of the story. 🫣

The ovaries produce BOTH progesterone and estrogen. They don’t selectively stop producing one over the other.

Estrogen begins to fluctuate in perimenopause. Estrogen is REQUIRED for ovulation and progesterone production.

She has a two-part job:

1. She tells the body it’s time to ovulate when she peaks (around day 12)

2. She primes the progesterone receptors so they can actually use the progesterone that’s produced

Estrogen doesn’t measurably decline the way progesterone does, so the party lines becomes “progesterone declines first.”

Except this means women are still left behind when taking progesterone doesn’t work. It leaves them feeling like they’ve done something wrong when, in fact, the problem is that medicine continues to misunderstand women’s physiology. 👊🏽

To silo perimenopause into only the loss of fertility and s*x hormones is short sighted. And simply - wrong. 😑 S*x hormo...
09/03/2026

To silo perimenopause into only the loss of fertility and s*x hormones is short sighted.

And simply - wrong. 😑

S*x hormones have impacts well beyond reproduction. Which means perimenopause goes far beyond fertility and hot flashes.

If that’s all that’s being evaluated, a lot is bound to be missed. 🫣

These are four labs I run in every midlife woman. Because she deserves a full evaluation. 💜

09/01/2026

She used to make it look easy. Then one day she realized she couldn’t hold it all anymore — and she thought something was wrong with her.

Nothing is wrong with her. Her estrogen is changing.

This is a major symptom that gets missed in perimenopause: stress resilience goes down. And it’s not simply that life gets busier around perimenopause (though it does). Because plenty of women have lives just as busy before they hit perimenopause.

But then one day they realize they can’t juggle it all anymore. They’re struggling, dropping the ball, and they think they’re not trying hard enough. So they exercise harder, eat cleaner, meditate, take the supplements, get outside. And it helps a little.

But what nearly everyone is missing is that estrogen is changing. It is no longer as dynamic with its peaks and valleys. It’s more variable and flatter. And estrogen is directly tied to our stress resilience, our ability to cope and manage multiple things at once. So when she’s checked out, everything gets harder.

This isn’t a personal failing. This isn’t because you’re not trying hard enough. It’s because your hormones are changing and everyone is missing the big picture.

This is where I see HRT help phenomenally. Especially given in a dosing pattern that most closely matches our natural physiology and rhythm. It helps restore (not balance, ugh) our hormonal pattern, improve our stress resilience and gives us breathing room.

If this sounds like you and you’re ready to get some answers, comment CLARITY to schedule labs and your initial consult together.

Birth control is not a diagnosis.It’s a tool. Sometimes the right one. Sometimes the easiest or most convenient one. It’...
08/29/2026

Birth control is not a diagnosis.

It’s a tool. Sometimes the right one. Sometimes the easiest or most convenient one.

It’s become the default answer to every hormonal complaint: painful periods, mood changes, acne, perimenopause.

It starts to represent what the medical establishment is already saying to women: stop complaining, stop being loud, your symptoms don’t matter. Take this pill and be on your way.

It stops being medicine and starts being a detour.

You came in with a question, with real symptoms your body is trying to communicate to you. You deserved an actual investigation.

I don’t talk about the behind-the-scenes of building this practice very often. 👀But I get asked about it. So I am starti...
08/26/2026

I don’t talk about the behind-the-scenes of building this practice very often. 👀

But I get asked about it. So I am starting to share bits and pieces.

The first year I made less than $20k total. 😬 I’ve cried in business coaching sessions. I’ve put groceries on credit cards. I’ve had moments where I seriously considered going back into conventional medicine just to make it stop. 🫣

And I’ve also had moments where the universe winked at me and reminded me exactly why I’m doing this.✨

I wrote about it — the grit, the grief, the spirituality that has kept me going, and why I needed the magic to lean into the medicine.

It’s one of the most personal things I’ve published. Comment MAGIC and I’ll send you the link. 💫

08/23/2026

Antidepressant use increases dramatically in women during perimenopause. That’s not a coincidence. 🫣

Estrogen has a direct relationship with serotonin and dopamine, neurotransmitters that help regulate your mood. When estrogen starts its perimenopausal chaos, your neurochemistry comes along for the ride.

So when a woman in her 40s shows up feeling anxious, flat, or not like herself — and gets prescribed an antidepressant instead of a hormone workup — that’s not care. That’s a significant care gap.

This isn’t about demonizing antidepressants. They have real utility. But a hormonal problem deserves a hormonal investigation first.

Your body isn’t failing you. The system is failing to look in the right place.

Manon came to me at 42 feeling mostly fine.Not falling apart or in a crisis. Just noticing things. She was having troubl...
08/22/2026

Manon came to me at 42 feeling mostly fine.

Not falling apart or in a crisis. Just noticing things. She was having trouble finding words mid-sentence. Plus a little fatigue that wasn’t there before. Add to that low libido and mood shifts she couldn’t quite explain.

She was questioning perimenopause and didn’t feel like she was getting clarity with her P*P.

She also wanted to be proactive. She didn’t want to wait until her body was loud about it.

We looked closely at her labs, her foundations and her hormonal picture. We addressed what we found.

We Supported the foundations. And added HRT.

She recently told me she feels great. “The best she’s felt.”

Not because something was dramatically wrong. Because something was subtly shifting and we caught it early enough to actually do something about it.

This is what proactive hormone care looks like. You don’t have to be suffering to deserve care. You just have to be ready to commit.

The month of August has been filled with so much joy. There has been lots of travel, food, family, friends & fun. It’s l...
08/19/2026

The month of August has been filled with so much joy.

There has been lots of travel, food, family, friends & fun.

It’s looked exactly like August should look.

I saw this quote from Julia Child and it summed up how I’ve been feeling the last couple years:

“Life itself is the proper binge.”

So this summer, I decided to add more joy, binge on life more. And it was amazing 😍

08/05/2026

📣No hot flashes doesn’t mean no perimenopause.

It means you might be one of the 30-50% of women whose perimenopause are never the “classic” and “textbook” symptoms. It means symptoms somewhere we don’t expect — in your brain, your sleep, your mood, your ability to find the word that was just there a second ago.

These women get left behind. Told their labs are normal. Told it’s stress. Told to come back when things get worse.

If this is you, you’re not imagining it. And you’re not too young.

Does this sound like you or someone you know?

We spend so much time worrying we’re not enough. And then sometimes, out of nowhere, we get proof that we are.My 5 year ...
07/22/2026

We spend so much time worrying we’re not enough. And then sometimes, out of nowhere, we get proof that we are.

My 5 year old daughter came home from school with a drawing and a writing prompt.

The prompt was about what she wants to be when she grows up.

She wrote: “When I grow up I want to be a mom because my mom is so grat.”

I cried. Because I don’t always think I’m doing a good job. The mental load, the long days, the moments I’m distracted or depleted — I carry all of it.

But she doesn’t see any of that. She just sees her mom.

Our kids don’t need extravagant things. They need someone who loves them, sees them, validates them, and shows them the world safely.

I think about that in my practice too. That’s all any of us really need — someone who sees us, believes us, and helps us feel safe in our own body. 💜

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