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In Part 1, More Than Just Feeling Hot: Understanding Hot Flashes, we talked about what a hot flash actually is, why it happens, and what is going on with your body's internal thermostat during perimenopause and menopause. Yet, not every episode of feeling hot, flushed, sweaty, or waking up drenched at night is necessarily menopause. If you're in your 40s or 50s, it's pretty easy to blame hormones and very often hormones are the reason. However, what if you're years past menop

We have all heard about hot flashes and have always associated them with menopause. They’re one of those symptoms we’ve joked about, laughed about and almost come to expect as just part of going through menopause. If you've had a hot flash yourself, you don't need anyone to describe one to you. Up to 80% of women have hot flashes at some point during perimenopause or menopause. For some, they're just slightly annoying. For others, they show up throughout the day and night and

Fatigue is one of the most common symptoms women experience during perimenopause. It can affect your quality of life, your memory, your ability to concentrate and be productive, or sometimes just your motivation to get dressed and do something. Fatigue also isn't usually coming from just one thing. Hormone changes, poor sleep, night sweats, heavier periods, low iron, stress, mood, nutrition, hydration, and metabolism can all play a part. When several of these are happening at

In my last post, I discussed what Genitourinary Syndrome of Menopause, or GSM, actually is, the vaginal, vulvar, and bladder changes that come with declining estrogen, why it's so common, and why it doesn't get better on its own. If you missed it, I suggest going back and reading that first. Here I want to go over what we can actually do about it. GSM responds well to treatment. There's more than one path depending on your symptoms and what you're comfortable with, and it is

Long before I started focusing on perimenopause and menopause, I spent many years caring for older women in the hospital who were admitted with acute illnesses on top of their chronic medical conditions. One thing I saw over and over again was recurrent UTIs. So many times, a UTI would become part of an already complicated hospital stay, and I would hear from the patient or her family, “Oh, she gets UTIs all the time,” or, “It seems like she’s on antibiotics for them througho

Some women that come to see me will tell me, "For a week or two every month, I just... I don't feel like myself." She'll describe getting angry over nothing, crying for no clear reason, feeling so heavy she can barely get out of bed. Then almost overnight, it eases up and she's fine again. Until next month, when it starts all over. She's often frustrated and exhausted by all of this, usually without the support or understanding she actually needs. Many of these women have PMD

If you read part one, you know why perimenopause can make you feel anxious, foggy, or like you're one bad night of sleep away from losing it. Maybe that shows up as anxiety, maybe it shows up as rage you don't recognize in yourself, snapping at your kids or your partner over something tiny and then feeling awful about it an hour later. You also learned the science behind it and why it's not a personal failure. I want to talk now about what actually helps. The question I hear

Why Perimenopause Can Make You Feel Like a Different Person Part 1: What Is Actually Happening and Why Have you ever found yourself thinking,"What is wrong with me?" Maybe you've noticed you're more anxious than you've ever been. You're snapping at your partner over something that normally wouldn't bother you. You feel overwhelmed by things you've handled for years. Maybe you just don't feel like yourself anymore, and you can't quite explain why. I want to tell you that if th

Has your digestion suddenly started doing things it never used to? Have you been bloated more often after meals? Have you noticed more constipation one week then running to the bathroom the next? Maybe you've just felt "off" for months, and no matter what you eat, your gut doesn't seem happy. If this is you, you are not alone. I hear this from women in midlife all of the time. Many of us think of menopause as hot flashes, night sweats, or sleep changes. However, one thing we

So many women I talk to have spent most of their lives trying to be smaller. For some of us it started young. The first diet in high school, counting calories in college, always feeling like our bodies were somehow not quite right. For others, it did not really kick in until midlife, when the body started changing in ways that felt completely out of our control and the response was to restrict even more. Either way, by the time most women walk into my office, they have some v

What Nobody Told You About Cholesterol and Menopause Let's start with some statistics that still don't get said enough. 1 in 3 women will die from cardiovascular disease. It kills more women than all cancers combined, and approximately 1 woman dies from it every 80 seconds in this country. Nearly 45% of women over 20 already have some form of it. I don’t mean to scare everyone, but this is so important to know. One of the biggest changes during menopause is often one you can'

If you're reading this, there is likely a midlife woman in your life who seems a little different lately. You might have noticed that she is more tired than usual, maybe she's not sleeping, maybe she's more emotional, more forgetful, or just doesn't seem like herself. Maybe she even has been giving you some dirty looks. You could be wondering what happened. However, the truth is, she's probably wondering the exact same thing. Men, this one is for you. Perimenopause and menop

Have you ever walked into a room and completely forgotten why you went there? Have you been in the middle of a conversation and suddenly lost your train of thought? Maybe you just can’t find the word you have been searching for and then it pops into your head an hour later?Women describe it differently, but I hear the same symptoms over and over in my office. "I feel like I'm in a fog.” "My brain doesn't work the way it used to." It's hard not to wonder if you're stressed,

One of the most common concerns I hear from women in my practice is, "I'm exhausted, but I can't sleep." Sleep changes start during perimenopause. Some women have trouble falling asleep. Others fall asleep without much difficulty but find themselves staring at the ceiling at 2 or 3 in the morning, unable to get back to sleep. Some wake up multiple times throughout the night, while others spend eight hours in bed and still wake feeling exhausted. Sleep disturbances are one of

Skin changes are often one of the first things women notice during perimenopause and menopause. The skin may feel drier. Fine lines may seem more noticeable. The jawline may change. Makeup may not sit the same way it once did. Some women notice increased sensitivity, thinning skin, or a loss of elasticity. While some of these changes are part of normal aging, menopause accelerates many of them because estrogen plays an important role in maintaining healthy skin. Understanding

Understanding Menopause and Its Hidden Challenges When most women think about menopause, they often focus on hot flashes, night sweats, sleep disruption, weight gain, or mood changes. Very few consider their bone health. However, bone loss may be one of the most crucial health changes occurring beneath the surface during midlife. The challenge is that bone loss is silent. You don’t feel your bone density declining. You don’t wake up one morning and notice weaker bones. For ma

A lot of women reach their 40s or 50s and suddenly feel like their body changed overnight. Joints ache. Recovery feels slower. Sleep becomes lighter. Workouts that used to feel easy suddenly feel harder. You may feel stiffer getting out of bed, more sore after exercise, or like your body is just not tolerating stress the same way it used to. And while many women are told this is “just aging,” there is often something much bigger happening underneath the surface. More experts

Most women are taught to watch for breast cancer, and that matters. What we don’t talk about enough is that heart disease is actually the leading cause of death in women. Heart disease accounts for about 1 in 5 deaths, and each year it takes more lives than all cancers combined. Menopause impacts the heart health is more important than you think. Unfortunately, this isn’t something that comes up often in conversations around midlife. Many women, and honestly many providers do

For years, we've been told a pretty simple story: estrogen is the "female hormone" and testosterone (HRT) is the "male hormone." But hormones don’t belong to one sex. Women make testosterone too, from both the ovaries and the adrenal glands, and it plays a real role in how the body functions across multiple systems. It also sits earlier in the hormone pathway as a precursor to estrogen, meaning your body actually uses it as part of the process of making other hormones. Here's

The 20+ Year Ripple Effect: Understanding Hormone Therapy For more than 20 years, women’s health has been shaped by a ripple effect that started in 2002 with the Women’s Health Initiative. The headlines that followed were alarming and spread quickly. Many women stopped hormone therapy almost overnight. Clinicians became more cautious too. Over time, menopause care quietly took a step back. What followed was a ripple effect of less education, less comfort in having these conve