Perimenopause is the transition period leading into menopause, while menopause itself occurs once you’ve no longer had a menstrual cycle for 12 months. Typically, perimenopause happens 2 to 10 years before menopause is in full effect and lasts, on average, four years. Symptoms vary greatly, and some even have no symptoms! The perimenopause years are when the most hormonal fluctuations occur, and on average, occur over age 40. If a person goes through menopause earlier, perimenopause symptoms can also occur in your 30s. Postmenopause is considered the remainder of your life after your final menstrual period, which is, on average, around ages 51 to 52.

Menopause itself is actually just one day. We define it as the day when 12 months of no menstrual period has passed. When people refer to how long their menopause lasts, they are typically referring to the menopause transition or perimenopause. Those are the transitional years leading up to your period stopping, which can last an average of 2 to 10 years before the final menstrual period. Irregular menstrual periods, hot flashes, night sweats, and mood changes are some of the more common symptoms seen in this period. Some people have no symptoms, but that is not the norm. That’s why women need to understand the symptoms of perimenopause and how to minimize them as soon as hormone changes begin.

Yes! You should not have to suffer through the negative effects of menopause. There are plenty of ways to minimize symptoms significantly, including non-hormonal therapies, nutrition, exercise, and menopausal hormone therapy (MHT), sometimes referred to as hormone replacement therapy (HRT). MHT treats the root cause of menopause (hormone deficiency), is the most effective treatment option, and reduces symptoms up to 80-90% after just a few weeks of use. In my signature course, Mastering Midlife & Menopause, you will learn my detailed recommendations for nutrition and exercise, specifically for midlife, to support your body’s changes naturally. To learn more about symptom management, click here to sign up for my email list and receive health and wellness tips specifically for midlife women. You will also learn when my course becomes available in 2024.

For many women, hormonal changes during menopause can influence mood and mental well-being. The most difficult years in menopause are the two years before and two years after your last menstrual cycle. Some will experience brain fog, mood swings, anxiety, and even depression. Sudden shifts in their hormones, thoughts, and physical well-being, coupled with the frustration of not being heard, leave many women with a sense of anxiety and depression.

Menopausal hormone therapy (MHT) is very safe overall. For the average perimenopausal or postmenopausal patient, risks are low. Mainstream media has overstated these risks in the past due to misrepresentation and misinterpretation of the data from the 2002 Women’s Health Initiative study. This led to a lot of apprehension, and the after-effects of this publicity have been LONG. With the most commonly prescribed modern menopausal hormone therapy, there is no absolute increased risk of breast cancer over your baseline risk and no increase in venous blood clots, heart attack, or stroke. This is also based on your medical history and the formulation and type selected. Overall, it is the MOST effective solution and is a low-risk solution and option for menopausal symptoms in over 90%+ of the population that goes through menopause. However, a shockingly low 4% of menopausal patients are using MHT.

Menopausal hormone therapy (MHT) is not birth control. The doses and formulations do not impact or stop ovulation, nor do they prevent pregnancy. MHT is most commonly recommended and prescribed as body identical estradiol and natural micronized progesterone in low doses, which can help the symptoms of menopause but minimize side effects. I think of it like giving your body back the ovarian hormones that are naturally declining. Hormonal birth control is more potent and considered synthetic forms of estrogen and progestin, many of which stop ovulation, prevent pregnancy, and can affect menstrual bleeding. People who have had various side effects on hormonal birth control pills, for example, do very well with physiologic natural menopausal hormone therapy formulations.

Absolutely, yes! We should not discount birth control as a viable option. Hormonal oral contraceptive pills, rings, implants, or progestin containing IUD (intrauterine devices) can be solid treatment options in the perimenopause years. Many people benefit from oral contraceptives or progestin IUDs for perimenopausal symptom relief, especially when they also need to treat abnormally heavy or irregular periods. In the case of an IUD, we can combine hormone therapy with your progestin IUD as needed. Birth control is still needed in the perimenopause years to prevent pregnancy.

Testosterone is a hormone produced by the ovaries. It should not be thought of as an exclusive male hormone. It declines by 50% by the time you reach menopause. Replacement of testosterone can help a variety of symptoms, including mental cognition, energy levels, muscle and bone mass, and sexual desire. Its most well-established evidence-based guidelines are within the realm of treatment for hypoactive sexual desire disorder (HSDD), or low libido, in the postmenopausal patient. It can be used off-label for other reasons, as well. You should closely monitor your blood levels to avoid long-term adverse effects.