This is your Women's Health Podcast podcast.
You are listening to the Women’s Health Podcast. I’m your host, and today we are diving straight into a season of life so many of you have asked about: perimenopause. If your periods are getting unpredictable, your sleep has gone off a cliff, and you sometimes look at a hot flash and think, “Is this my new personality?” this episode is for you.
Perimenopause is the transition time leading up to menopause, when estrogen and progesterone start to fluctuate. The Mayo Clinic explains that this can bring irregular periods, hot flashes, night sweats, mood shifts, brain fog, vaginal dryness, and changes in sex drive. The Menopause Society adds that this phase can last several years and is a completely normal, biological transition, not a malfunction. You are not “falling apart”; your body is moving into a powerful new stage.
In today’s episode, imagine we’re joined by an expert like Dr. Mary Jane Minkin, a gynecologist known for her work on menopause education, to answer the questions so many of you send in. I might start by asking her: What exactly is happening with our hormones in perimenopause, in simple, everyday language? How can a listener tell the difference between perimenopause and just “a stressful year” or a thyroid issue? And what are the most important signs that say, “It’s time to talk to a clinician”?
Next, I’d want to ask about treatment options. According to Mayo Clinic and the NHS in the United Kingdom, hormone replacement therapy, or HRT, is the most effective treatment for hot flashes and night sweats and can also help with mood changes, brain fog, joint pain, and vaginal dryness. The Menopause Society notes that, for many women under 60 and within about 10 years of their final period, the benefits of estrogen-based therapy often outweigh the risks, as long as they do not have specific contraindications like certain cancers, clotting disorders, or uncontrolled blood pressure. I would ask our expert to walk through when HRT might be appropriate, when it might not be, and what questions every woman should ask her clinician before starting.
For those who cannot or choose not to use hormones, places like Mayo Clinic describe effective nonhormonal options: certain antidepressants called SSRIs, a newer nonhormonal medication called fezolinetant for hot flashes, gabapentin for night sweats and sleep, and lifestyle approaches like weight management, limiting alcohol, and practicing stress reduction techniques such as yoga, mindfulness, or cognitive behavioral therapy. I’d ask: Which of these options have the best evidence, and how long should a woman try something before deciding it is or is not helping?
We would also talk about sexual health. Lower estrogen can cause vaginal dryness, discomfort with sex, and more frequent urinary symptoms. The NHS and Mayo Clinic both highlight local vaginal estrogen, as well as over-the-counter lubricants and moisturizers, as safe and effective ways to restore comfort for many women, even when systemic hormones are not used. I’d ask our expert how listeners can start that conversation without embarrassment, and how to advocate for themselves if their symptoms are dismissed.
Before we wrap, here are some key takeaways. First, if your body feels different in your forties or early fifties, you are not imagining it; perimenopause is real, common, and valid. Second, there are many treatment options, hormonal and nonhormonal, and you deserve a personalized plan, not a shrug. Third, your mental health and sexual health are part of this conversation; mood shifts, anxiety, low desire, and pain with sex are all worth bringing to your clinician. And finally, being informed is an act of women’s empowerment. When you know what is happening in your body, you can make decisions based on knowledge, not fear.
Thank you for tuning in to the Women’s Health Podcast. If this episode on perimenopause was helpful, please subscribe so you do not miss what is coming next, and share it with a friend who might need to hear that she is not alone in this transition.
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