Episode 7: Comfort Is Not Evidence - SSRIs and Hot Flushes

In this episode Kate Thomas, an AHPRA-registered pharmacist with 25 years of clinical experience, covers:

• Why warmth and charisma can be persuasive but dangerous in unregulated healthcare
• The lack of regulation around naturopathy and the real-world harm it can cause
• How wellness culture specifically targets women during hormonal vulnerability
• How SSRIs actually work in the brain and what they do not do
• Why SSRIs are sometimes prescribed for perimenopause hot flushes
• How perimenopausal anxiety is frequently treated with antidepressants when estrogen deficiency may be the real driver
• Adrenal fatigue: why it is not a real diagnosis and why it feels so convincing

One of the most important ideas in Episode 7 is also one of the simplest: feeling cared for and being clinically helped are not the same thing. Kate opens the episode with a comment thread about naturopathy that raises an uncomfortable truth about how women in midlife are often sold reassurance instead of rigour. Warmth, charisma and simplification can feel like good medicine, but in an unregulated space they can cause genuine harm. Kate covers real Australian regulatory cases involving banned health practitioners as a reminder that my clients love me is not a clinical defence. 

Women navigating perimenopause are particularly vulnerable to wellness culture for understandable reasons. Hormonal changes are confusing, appointments are rushed, and practitioners who offer time, warmth and simple explanations are deeply appealing. Kate examines how this vulnerability is exploited, why the lack of naturopathy regulation in Australia matters, and how feeling validated has quietly become a substitute for clinical outcomes in many women's health spaces. Understanding this dynamic is an important part of making informed decisions about your care. 

SSRIs are one of the most commonly prescribed medications for women in their 40s and 50s presenting with anxiety, and they are also sometimes used off-label for hot flushes during perimenopause. In Episode 7, Kate explains how SSRIs actually work in the brain, what they genuinely help with, and where their limitations lie. Critically, she makes the case that perimenopausal anxiety is frequently treated with antidepressants when estrogen deficiency may be the real underlying driver. Getting the right diagnosis matters enormously, and a telehealth pharmacist consultation can help you ask the right questions before accepting a prescription. 

Anxiety that emerges or worsens in perimenopause is often attributed to life stress, personality or a new mental health condition. But estrogen plays a significant role in regulating the brain systems involved in stress response and emotional processing. When estrogen fluctuates and declines during perimenopause, anxiety can emerge as a direct physiological response rather than a psychological one. Kate makes a clear and evidence-based case for why this distinction matters and why defaulting to antidepressants without considering hormonal drivers is a lazy clinical response that many women in midlife deserve better than. 

Adrenal fatigue is one of the most persistent and widely believed diagnoses in the wellness space, and it is not a real medical diagnosis. In Episode 7's Wellness Woo of the Week, Kate explains what adrenal fatigue actually claims to be, why the concept feels so convincing and relatable, and how it turns genuinely complex physiology into something oversimplified and commercially convenient. For women who have been told their exhaustion, brain fog and low mood are caused by adrenal fatigue, this segment offers important clarity. 

If this episode has raised questions about your anxiety, your medications, SSRIs or your perimenopause symptoms, a telehealth pharmacist consultation with Kate is a great next step. In a dedicated one-on-one session you can go through your symptoms, your current medications and your treatment options in plain language, without rushing. 

Kate Thomas offers a range of in-depth telehealth medication consultation and medication review services to help you understand your body and your medications.

You can view the transcript for this episode below