case study

From Dismissed to Thriving: Sandra's 90-Day Perimenopause Reset

How a tailored HRT + CBT-I protocol helped a 48-year-old marketing director reclaim her sleep, energy, and focus.

Patient

Sandra K., age 48

Condition

Perimenopause

Duration

90 days

Protocol

HRT + CBT-I + Lifestyle

Outcome

Significant improvement

Outcomes at 90 Days

78%

Reduction in night sweats

5.2hrs

Avg sleep → 7.1 hrs uninterrupted

9/10

Would recommend RoarMD

The Challenge

Two Years of "Just Stress"

Sandra had seen three different physicians over two years. Night sweats, brain fog, irritability, and waking at 3am were explained away as anxiety and work stress. Her labs were "normal." She was told to reduce her coffee intake and consider therapy.

By the time she reached RoarMD, she hadn't slept more than 5 hours continuously in 14 months. Her performance reviews at work were slipping. She was considering stepping back from her career.

Our Approach

Connecting the Dots

At Sandra's first RoarMD visit, her hormone panel revealed she was in late perimenopause — a fact her previous physicians had not tested for. Our clinical team developed a three-part protocol:

1. Low-dose estradiol patch — started at 0.025mg, titrated based on symptom response over 6 weeks.

2. CBT-I via the RoarMD app — 6-session program targeting sleep restriction and stimulus control.

3. Temperature regulation strategies — cooling mattress pad, modified evening routine, timed light exposure.

"For the first time in years, someone actually listened to what I was describing. Not just the symptoms, but what it was doing to my life."

–– Sandra K., RoarMD member since 2025

Results

90 Days Later

By week 6, Sandra's night sweats had reduced by over 60%. By week 12, she was averaging 7.1 hours of continuous sleep — up from 5.2. Her self-reported energy, focus, and mood scores improved across the board. She returned to leading her team with what she called "my old self, but better."