The Sirona Health Podcast: Women’s Hormones & Mental Health

Brain Fog in Menopause: What's Actually Happening in Your Head

Mon, 31 Aug 2026 09:00:00 +0100

Walking into a room and forgetting why. Losing a word mid-sentence. Reading the same paragraph three times. In this episode, Dr Georgina Standen properly unpacks brain fog — what it actually is, what's driving it, and answers the question sitting underneath almost every conversation about it: does this mean something worse is coming?

In this episode:

What brain fog actually clusters around — and why part of it looks more like an attention problem than a memory problem
The honest answer to "is this dementia" — and the reasoning behind it, not just reassurance
The evidence for a real, causal hormonal mechanism, from studies where memory dipped and recovered as oestrogen was removed and restored
The three "amplifiers" that actually drive brain fog day to day — hot flushes, sleep, and mood — and why treating those is often where real improvement comes from
Where HRT does and doesn't fit, and why the evidence on dementia prevention specifically is still genuinely unresolved

Sirona Health Podcast is hosted by Dr Georgina Standen, GP and founder of Sirona Health (sironahealth.co.uk), a specialist women's health practice covering menopause, PMS/PMDD and teen health. Book a consultation at sironahealth.co.uk.

This podcast is for general information only and doesn't replace individual medical advice — please speak to your GP or a specialist about your own symptoms. If you're struggling, please reach out for support.

Menopause and Your Mental Health

Mon, 24 Aug 2026 09:00:00 +0100

Why do so many women feel like their mental health suddenly changes in their forties and fifties, often without any obvious trigger? In this episode, Dr Georgina Standen applies everything this series has built so far — hormone sensitivity, DASH-MC, reproductive depression — to perimenopause specifically, and explains why this transition is so often missed, dismissed, or misdiagnosed.

In this episode:

The clinical pattern that shows up again and again: a history of PMS, PMDD, postnatal depression or a rocky relationship with the pill, now resurfacing in a new form
Why perimenopause isn't simply hormonal decline, but volatility — and why that's what actually destabilises a sensitive brain
The real numbers: a 30% rise in major depressive disorder, a doubling of bipolar incidence, and higher anxiety rates during perimenopause specifically
"Diagnostic overshadowing" — why menopausal symptoms so often get treated as a purely psychological problem
Why sleep is so often the hidden driver behind anxiety at this life stage
Why standard HRT isn't a universal fix, and what a properly personalised approach actually looks like

Why Do Some Women Get PMDD and Others Don't? The Genetics Behind It

Mon, 17 Aug 2026 09:00:00 +0100

If two women have identical hormone levels but completely different experiences of their cycle, what's actually different between them? In this episode, Dr Georgina Standen goes back a step further than hormones themselves, into the genetics and cell biology behind why some brains are wired to be more hormone-sensitive than others.

In this episode:

The classic hormone-suppression study that proved PMDD isn't about hormone levels at all
What twin studies tell us about how much of PMDD is inherited
The specific genes researchers keep finding — ESR1, a serotonin receptor gene, and GABRB2
The cellular research showing PMDD cells respond differently to hormones at a genetic level, right down to a mismatch between gene instructions and the protein actually produced
Why understanding the mechanism explains why treatment isn't one-size-fits-all

What Brain Scans Actually Show: From PMDD to Menopause

Mon, 10 Aug 2026 09:00:00 +0100

What does a brain scan actually show us about PMDD — and does the same evidence tell us anything about what happens after menopause? In this episode, Dr Georgina Standen walks through the neuroimaging research, from how PMDD brains respond differently to hormones, to what a major new study reveals about the postmenopausal brain.

In this episode:

Why gonadal hormones appear necessary for the prefrontal cortex to function normally — and what that means for mood and concentration
How the emotional brain, particularly the amygdala, responds differently across the menstrual cycle
What's measurably different in the brains of women with PMDD compared to women without it — and why it correlates with symptom severity
A landmark study of almost 125,000 women (11,000 with brain scans) on menopause, grey matter volume, and dementia risk
Why HRT didn't reduce these grey matter changes — and why the evidence on HRT and dementia risk is genuinely conflicting, not just unclear

What Is Reproductive Depression?

Mon, 03 Aug 2026 09:00:00 +0100

Had PMDD in your twenties, postnatal depression after having children, and now feel unlike yourself in perimenopause? These aren't separate problems. In this episode, Dr Georgina Standen explains reproductive depression — the idea that one underlying trait can show up again and again at every major hormonal transition in a woman's life.

In this episode:

Why PMDD, postnatal depression, contraceptive-related mood changes, and perimenopausal depression are so often treated as unrelated — and why that's a mistake
The biological reason this pattern recurs: what puberty, pregnancy, contraception and perimenopause actually have in common
Why this reframe matters for prediction — how a PMDD history can flag risk for postnatal depression, and why that's worth knowing before pregnancy, not after
Why treatments that worked for you at one life stage are often a sensible starting point at another
What this concept isn't — and why it doesn't erase the other real factors at play at each life stage

Why Doesn't My PMDD Look Like Everyone Else's?

Mon, 27 Jul 2026 09:00:00 +0100

Tried to identify with PMDD, but your worst week doesn't line up with the "classic" post-ovulation pattern? You're not alone — and you're not imagining it. In this episode, Dr Georgina Standen introduces DASH-MC, emerging research showing there isn't just one pattern of hormone sensitivity, but at least three.

In this episode:

Why PMDD has traditionally been described as one condition — and why so many women don't recognise themselves in that description
Type 1: the classic post-ovulation progesterone and allopregnanolone pattern
Type 2: the lesser-known pattern driven by falling oestrogen around your period — often showing up as low mood, brain fog and fatigue rather than irritability
Type 3: the surprising pattern linked to the oestrogen surge around ovulation — impulsivity, risk-taking and difficulty controlling urges
Why this matters for ADHD specifically, and for choosing the right treatment

It's Not Your Hormone Levels, It's Your Brain

Mon, 20 Jul 2026 09:00:00 +0100

If your hormone tests keep coming back "normal" but you still feel awful — this episode explains why. Dr Georgina Standen breaks down the real science behind PMS and PMDD: it's not about how much oestrogen or progesterone you have, it's about how your brain responds to it.

In this episode:

Why women with PMS and PMDD usually have completely normal hormone levels — and why that's not a dead end
The lab research showing PMDD cells respond differently to the same hormone exposure, right down to gene expression
Why SSRIs can work within days for PMDD, when standard depression treatment takes weeks
The traditional progesterone-and-GABA explanation — how allopregnanolone should calm the brain, and why it doesn't always
Why hormonal contraception can be so unpredictable for PMDD specifically, and why more isn't always better
How stress, sleep, and alcohol can amplify an already-sensitive system

Diagnosis - Why It Takes So Long, and Who Can Actually Help

Sun, 12 Jul 2026 19:00:00 +0100

Why does it so often take years to get a PMDD diagnosis — and once you suspect it, who should you actually go and see? In this episode, Dr Georgina Standen explains why this condition falls through the gaps in the healthcare system, and how to find a clinician who can actually help.

In this episode:

Why PMDD diagnosis is genuinely complex — hormone tests are usually normal, and treatment has to be individualised
Why so many women aren't believed the first time they raise their symptoms
How PMDD sits between gynaecology, psychiatry and general practice — and why that gap slows diagnosis down
What GPs, gynaecologists and psychiatrists are each trained to spot, and where the gaps are
What actually matters most when choosing who to see — and why it's rarely about job title

A full transcript of this episode is available above.

Diagnosing PMS vs PMDD and Getting a Diagnosis: How PMS and PMDD Are Actually Diagnosed, and What Cycle Mapping Adds

Sun, 12 Jul 2026 18:00:00 +0100

There's no blood test for PMS or PMDD — so how do you actually get diagnosed? In this episode, Dr Georgina Standen walks through the real diagnostic process, and introduces cycle mapping, a tool that goes far beyond simply tracking your period.

In this episode:

Why diagnosis relies on daily tracking rather than a single test — and why two full cycles matters
The screening tools and diagnostic criteria doctors actually use (PSST, DRSP, DSM-5)
What gets ruled out along the way, and why
What cycle mapping is, and how it goes beyond period-tracking to reveal how your hormones and symptoms move together
Why regular periods don't always mean regular ovulation
Who cycle mapping is especially useful for — including women without regular periods to track against

Mentioned in this episode:

Belle app: https://bellehealth.co/
Flo app: https://app.flo.health/
DRSP via ROCG (appendix III): https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/premenstrual-syndrome-management-green-top-guideline-no-48/
Mira hormone monitor (up to 30% off with SIRONAHEALTH): https://shop.miracare.com/products/fertility-max-starter-kit?variant=45163642224933
Sirona Health PMS/PMDD page: sironahealth.co.uk/pms

A full transcript of this episode is available above.

The Numbers and the Picture: How Common Are PMS and PMDD, and What Do They Actually Look Like

Sun, 12 Jul 2026 18:00:00 +0100

How common are PMS and PMDD, really — and why does the research seem so contradictory? In this episode, Dr Georgina Standen unpacks the numbers behind these conditions, and the full picture of symptoms that goes far beyond bloating and a bit of tearfulness.

In this episode:

Why estimates of PMS prevalence range so wildly across studies — from 12% to 98%
What the actual research says about how many women meet criteria for PMS and PMDD
The 200+ documented symptoms of PMS, and which specific cluster defines PMDD
Why symptoms can look completely different from one woman to the next
Why perimenopause so often brings a resurgence of PMS/PMDD-type symptoms — and what that pattern actually means

Mentioned in this episode:

Belle app: https://bellehealth.co/
Flo app: https://app.flo.health/
Sirona Health PMS/PMDD page: sironahealth.co.uk/pms

A full transcript of this episode is available above.

Sirona Health specialises in menopause, PMS/PMDD and teen health. Find out more at sironahealth.co.uk.

PMS vs PMDD: Understanding the Key Differences

Sun, 12 Jul 2026 18:00:00 +0100

What's actually the difference between PMS and PMDD — and how do you know which one you're dealing with? In this episode, Dr Georgina Standen breaks down the two conditions clearly, without the mystique.

In this episode:

What defines PMS, and why it's so common
What makes PMDD a distinct, more severe condition — not just "worse PMS"
Why there's no blood test for either, and what tracking actually shows
How diagnosis leads to different treatment paths

Mentioned in this episode:

Belle app: https://bellehealth.co/
Sirona Health PMS/PMDD page: https://www.sironahealth.co.uk/pms