Clinical Assessment

Ober’s test is framed as a hip mobility test rather than a test of iliotibial band length. A straight leg raise between 70 and 90 degrees is treated as the desired range. A very limited straight leg raise may indicate that the hamstrings are already held long because of anterior pelvic tilt. An excessive straight leg raise may reflect laxity involving the sacrotuberous ligament or other hip ligaments. Midlife symptoms such as weight gain, poor sleep, fatigue, temperature problems, or hair changes should prompt both menopausal hormone assessment and screening for other endocrine issues. Checking hormone levels can help determine where someone is in the perimenopausal or menopausal transition. Management plans should depend on hormone levels, thyroid status, symptoms, goals, and overall health context. Microbial assessment includes comprehensive stool analysis with beta-glucuronidase and may include whole genome shotgun sequencing. Metabolic assessment includes fasting insulin, fasting glucose, HbA1c, lipid particle analysis, body composition, and CGM when indicated.