All About Perimenopause: Signs, Symptoms & Treatment | Empowering Midlife Wellness

I’ve been talking a lot lately about menopause, but the years immediately before menopause are probably the most difficult ones to manage for both patient and provider, since they are characterized by highly fluctuating hormone levels, and frequently associated with lots of nasty side effects. Today I’ll be focusing on those years before menopause that we call “peri-menopause” - when we are still producing ovarian hormones, but in levels that are fluctuating and unpredictable, and sometimes make us feel like we are on a roller coaster of highs and lows that feel impossible to control.
The good news is that once you understand what’s happening, we can create a treatment plan with effective options to alleviate these symptoms and put life back into balance, getting you through those really difficult years.
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[@JenJenANDChrissy]

I was 45 y.o. and went to my OBGYN for mood swings that were so bizarre I thought I was going crazy. I would have days where I would be so fearful and my brain would feel like I was experiencing the worst dreadful event, yet everything in my life was perfectly stable (no financial problems, or marital issues, job was stable, physical health was fine). Then a couple of days out of the month I would feel so unsafe to leave my home for no reasonable explanation...almost agoraphobia. I've always been a go-getter and never let any fear stop me from doing anything adventurous, EVER. My OBGYN listened to me rant and she said I wasn't perimenopausal and suggested I see a psychiatrist. Seriously? I would expect this from a male doctor, but mine was female and slightly younger than I was. I fired her and found someone who treated me with compassion and understanding. She is a Nurse Practitioner and she checked my hormone levels at different times of the month. The results showed exactly what you are explaining with the fluctuation cycles. It's been 7 years and I'm really getting tired of all this rollercoaster riding. I have no idea what my mood will be when I wake up in the morning (anxious, depressed, angry, flat, energetic, fearful, rage, stoic) and I just have to deal with it. What I tell myself is "just go with the feelings, because they're not staying here forever. They will change in a few hours". I try to treat myself kindly and compassionately without shame. Nearly every day I feel like a toddler is at the wheel of my emotions, spinning the dial over and over again in evil bliss. This chapter sucks so bad. My periods are as painful as when I was 14 and muscle relaxers are my best friends on those days. I don't even want to start with the bloating rant....how the hell can I gain 9 lbs in 6 days because of fluid???

[@tisaheard9350]

Same here. I'm 46 and just this past May started having anxiety. Periods have been irregular and my cycle is at 22 days from 28. Most days I don't feel like myself and the mood swings can be on another level. When I told my doctor I believe I was in perimenopause. me said "yeah u might be" and that was it. I left that appt thinking I need to find another ob. Hang in there lady. I'm praying it gets easier for u.

[@footballeditz78968]

Thank you. So we'll explained. One of the best perimenopause videos I've watched.❤

[@Zyriana522]

This is me now and I am 45 years old too

[@annbaker8217]

Iv started hrt tablets was scared to take them but suffering with heart palpitations fear and panic and joint but I think the hrt tablets are drying my skin

[@njerinjogu1228]

Am 47 yr.but these is more than murdness .

[@ktbrown7643]

I am 48...i have been suffering since 2020 i had my very first hot flash..here are the ever growing list : hot flashes, night sweats, day sweats, body odor changes, dry skin, thining skin, hair falling out, nails brittle, grey hair, nausea, loss of appetite, food cravings, hightened smell, mood swings, depression, anxiety, dizziness, fatigue, insomnia, nightmares, heavy bleeding, heavy cramps, numbness in hands, vision problems, low libido, upset stomach,brain fog , swollen joints, knee pain, joint pain, lol that is all i can remember right now..the list is growing;) ..if you have any to add and give us a heads up!!

[@janicemarcellin6353]

@ktbrown7643 we are twinning. Lol

[@myrnamanlapaz8235]

I'm.also😢

[@shengtvadventours2901]

Same here😢

[@olgapreciado8705]

Same + a lot of itching 😢

[@trishasdomingo]

The itching is the worst 😔especially at night.

[@Wendy-t1v]

I’m 52 and been having menopause symptoms for the last couple of years. I’m sharing this information in hopes that it can help other women not to have to suffer anymore. Not sleeping, hot flashes, anxiety, dread, guilty feelings, sense of fear driving, brain fog, tired, chronic joint pain loss of drive in life, feeling like barely making it through the day, anger for no big reason. Started progesterone first did help with sleep, only helped a little with hot flashes , added vitamin E which helped with hot flashes and my chronic hip/low back pain. Added testosterone cream, helped with my brain fog and gave me some energy and helped with sleep and helped me feel confident in driving again. Then added estrogen cream and it stopped the anxiety, guilt and dread feelings. My estrogen levels didn’t improve and my testosterone levels didn’t increase above 19. I switched to the estrogen patch and started testosterone injections .03 twice a week and what Huge improvement!!! I have a zest for life again, more energy and I feel I can take on the world again!!! I sincerely hope this helps someone. Wishing every woman to feel like themselves again. We shouldn’t have to suffer!!!

[@akaMcSassy]

I'm 43 and im convinced that I've been dealing with this since 41. Started with palpitations and fatigue. Doctors blamed my weight and anxiety about this sudden changes and other health markers going south. Fixed those with nutrition and exercise but still dealing with anxiety for no reason. Cycling every 21-25 days for the past year And apparently testosterone is leaving me (per bloodwork). Feels so good to know there's a reason, I've been helping myself with diet and lifestyle changes and there's hope.

[@EllaGreenn]

We don't get any medals for suffering. 🙏 Thank you so much!! This is one of the most helpful and important videos I've ever seen. I'm 43yo, 2 years ago after 15 years of mirena birth control and no periods I thought it would be a good/healthy idea to remove my IUD to have my last years/cycles of bleeding the natural way. I knew nothing about this, it was just on a whim, natural is always better, right? My obgyn just shrugged and did what I asked without any warning or explanation. I have gone through hell. An hour or so later, I started violently vomited, which continued for 3 days. I thought it was a coincidental flu. A bit later horrible panic attacks started hitting me, out of the blue I couldn't breath and my resting heart rate went through the roof, sometimes it lasted all night long. I even went to the ER once, convinced I would not survive. On top of all that came the relentless insomnia, brain fog, mood swings, forgetfulness, sweating, pain, water retention, ... Not one doctor made a link with the removed IUD (even when I told them it started right after that), perimenopause or ANY possible hormonal cause at all. I saw a video about perimenopause a few weeks ago but was still unsure what to do. I simply can not think anything through, I feel like a beheaded chicken. My gp doesn't believe a word of this silly perimenopause 'hypothesis', but some pushing he was willing to prescribe me an oral contraceptive pill (Annais). Today (my first cycle day) I'm gonna start the pill. I'm very nervous about it, since I had such severe reactions to progesterone changes. So 🤞 A new IUD (maybe with testosterone, because no libido, hair loss,... ) would probably be better, but I can't see my obgyn until early June and I can't stand this for even one more day. I'm also afraid that I'll react heavily to the IUD, which I wouldn't be able to remove quickly if I do. Hopefully this pill will alleviate my brain fog enough to get organized to talk to a (new) doctor in a coherent way to plan my next HRT moves carefully. I hope this might help someone else going through hell, thinking they're dying, going crazy, experiencing early dementia,... Although long term (very happy) mirena users probably won't have it suddenly removed if they have a doctor who cares to explain to them what the risks are. Maybe I had a worse reaction than normal, but since the HRT use of the IUD, having it removed at my aged is the worst possible move anyway. Sorry for the rambling rant.

[@mycustompaintedlife502]

I don’t have any physical symptoms but I am so sad all the time and I thought I was losing my mind. I can’t recall simple things. Yes! Shame and guilt are two emotions that I am quite familiar with. My kids look at me like a “poor thing” I literally can’t get out of bed most days.

[@sylviarivera1999]

I think I’ve watched more than 30 perimenopause videos and talked to my gyno, and this was the most thorough and informative source yet. Thank you.

[@EMILYHERRERA]

Check out the menopause barbie.

[@ktbrown7643]

​@@EMILYHERRERA thanks! I just subbed her!! She is awesome ❤❤❤

[@suziew5447]

Thank you for the truth. For the past few years I have been existing NOT living. This time has need a living hell of emotion and change. Why does this not get explained? I can’t wait for this to be over. Worse than being a teenager with hormones. It has been horrific emotionally beyond words. Don’t ask me these days what is a woman? I know and experienced it all . Don’t even try… 🙃I am sad woman don’t get the respect after all we go through. I’m happy just frustrated by all this pain and suffering emotionally and physically. I promise you a man would not survive it… 🤪

[@EMILYHERRERA]

You should try HRT. It doesn't have to always be this dramatic.

[@TheNordicHunter]

Thank you so much for all of this information. You explained it very well. I’m doing as much research as I can on this subject for my girlfriend. She doesn’t have the time and quite frankly it’s overwhelming for her, especially when she’s already in a bad place hormonally. And I want to know as much as I can so that I can know what to expect and help her, and understand what she is going through. I wish more men would look into this as well and understand what their partner is going through vs just thinking they are “crabby” or “it’s all in their head” or “they’ve gone crazy and need meds”. Women have been dealt many bad hands and this is one of them. It’s sad and more awareness has to happen. Obviously without doctors like you, we wouldn’t be able to gain this kind of information, so thank you for actively helping those less fortunate to find some inner balance and peace. I will check out more of your videos when I get a chance. Have a great day!!!

[@MzCaliRozay]

I hope your girlfriend appreciates you for this ❤️❤️

[@void9837]

@void9837 1 minute ago (edited) I went through menopause for one year and it was done. There's other reasons for fluctuating hormones and symptoms. Our bodies need an exercise warmup every morning with stretching, may need fruits and veggies to prevent malnutrition symptoms, remove chemicals from the food supply and water supply to prevent of health symptoms, need proper diagnosis of symptoms from healthcare professionals, and some people just need to fast for 3-5 days to resolve certain health conditions as well. Matthew 6:16-18.

[@TheNordicHunter]

@@MzCaliRozay Thank you. :) She said she did. Took a break from the research, but need to start up again. She doesn’t follow the tips I shared with her; such as not eating sweets before bed, or reducing sugar over all. Habits she enjoys and is worth the negative outcomes to her. Not good. :(

[@EMILYHERRERA]

​@@TheNordicHunterdon't try to micromanage your girlfriend or her health; that sounds awfully oppressive, which is exactly why women's health hasn't been studied as it should be. Leave her be.

[@TheNordicHunter]

@@EMILYHERRERA I think you need to take a break from societal brainwashing. Take a step back and breathe, then read my post again. Maybe even twice. Nowhere in there am I alluding to micromanaging her. In fact, if you read it with an open mind and not with a defensive mindset based on brainwashing, you will pick up that she doesn’t have time and is overwhelmed, and appreciates that I am doing this for her. And the fact that I’m learning to help understand the horrible thing that all women have to deal with. I have EMPATHY for ALL of you. Even the ones that toss me in a negative light. Meaning you, just in case you didn’t catch it. I love my INDEPENDENT girlfriend and only help at a level that she is ok with. Understand?

[@chubstuf]

Listening to this at 4:00 a.m. knowing that I need to be at work in 4 hours. I've already sent a message to my primary care physician. Thank you so much, I really appreciate you informing us of all of the important nuances our primary care physicians neglected to pass a long during our appointments!

[@anniebauer2563]

As if a physician would ever entertain listening to a patient telling them about the research being done in the UK & the Netherlands. The way Doctors treat Perimenopausal women is criminal and we pay for the privilege. You are one of very few Doctors who are knowledgeable and willing to treat upstream problems. Everything I've learned has been on my own volition and any treatment was from private doctors and extremely expensive.

[@cathys.3611]

Birth control made my anxiety and depressive moods (brought on by perimenopause) WAY worse. I did, however, switch to taking oral micronized progesterone and those symptoms went away. Just sharing in case someone else is in the same boat.

[@denise3432]

Thank you for this info!

[@sziami09]

Do you take it every day or just in the 2nd half of the cycle?

[@cathys.3611]

​@@sziami09I take it every night before bed. I was told I only needed to stop taking it while I was actively bleeding and then I could start taking it again.

[@sziami09]

​@@cathys.3611Thank you! I ve tried BC too but I felt awful so I stopped taking them. Do you still have regular cycles? What changes have you noticed since taking progesterone?

[@cathys.3611]

​@@sziami09Yes, I'm 42 and have regular cycles. I had been experiencing depressive moods and anxiety the past two years and the progesterone has stopped that. I was also having some pelvic aches/pains and that has eased up quite a bit, too, and my sleep has improved greatly. I used to have a difficult time falling asleep and sometimes woke in the middle of the night and couldn't fall back to sleep, and that has changed for the better as well; when I am off during my period I struggle again. I'm still working on having my other hormones properly tested as I believe I believe I have other deficiencies, but the micronized progesterone has been a lifesaver!

[@m0L3ify]

Well I guess this explains the sudden onset of PMS depression I've been experiencing over the last year or so. Daily walking helps keep it at bay, tho. It's kind of crazy to me that I know SO much about ovarian cycles because I used to work in a laboratory that studied puberty onset, but know nothing about menopause lol. I feel like women everywhere need one of those film strips like we had to watch in Middle School about "the changes," but for middle age. "Second Puberty" 😄

[@Janevelyn]

Reverse puberty I call it Why would puberty onset need testing ? I shudder to think

[@danyellowlyn]

I’m 49. Heavy periods all my life. After 2 kids tried Mirena - didn’t help. Endometrial ablation also didn’t help. Now having murder scene like periods. Made appointment to talk to ob re hysterectomy. Will make a note to inquire about uterine fibroid embrolization.

[@charleedell92]

Birth control pills are fantastic for this, the only issue they don't improve is low libido but I still plan to take them until I can safely assume my periods have stopped. It makes me angry that so many women are denied the birth control pill because it's "dangerous" yet their doctors don't mind them ending up with anaemia and needing hysterectomies. Surgery carries a MUCH greater risk of blood clots than the pill!

[@sevenone32]

Im so happy to have found this. I'm finding it very hard to work honestly. I'm so up and down all the time

[@alyssamiller9329]

Same here.... 😢

[@EMILYHERRERA]

It's hard to live in a society that requires we always work coupled with not focusing on women, to include studying us- they just NOW started testing menstrual products with actual blood & not water! It's a constant struggle, the struggles just change as we age. Yay for the patriarchy!

[@capeviolet]

This is the best description of perimenopause I found. Thank you!

[@NotACat2237]

Thank you so much. This is what I needed when I went to my doctor a year ago, but since I didn't get that, I stopped going. I am motivated to find a new doctor who wants to help me. Now that I have some good base knowledge of my own, I think it will be a lot easier.

[@ReneeWilliams-v7t]

I'm so thankfull you have done this video I could have cried when you said you feel like a different person, it's been how iv been feeling for a while now and this is the first video that has been helpfull. Thank you

[@jennystyles7421]

This has helped tremendously from what ive listened to previously Im 50 with murder style periods also, having lived with Endometriosis, ive never experienced anything so terrible. Waiting on Ultrasound results for fibroids, taking a low dose pill now continuously from my own research to get my health back

[@uppercut147]

Thank you so much for this video! I'm only 37 but have never had kids and for the past year, my periods have just been WEIRD. My most recent one, my hormones definitely weren't what I'm used to. I will definitely be making an appointment with my gynecologist to talk about this!

[@uppercut147]

@@JL-527 Glad to know someone else is experiencing it at this age, too, but sorry that we're both having to deal with it!

[@m0L3ify]

That happened to me at 36 and then a few years later everything went back to normal. In fact things became more normal than they'd ever been. But in my case I did quit dairy, which seemed to help immensely, so I don't know if in my case it was the hormones in dairy making things worse or what. But I can definitely relate to things getting worse at this time!

[@SuperKenyasfinest]

@@m0L3ify A similar situation occurred in my life when I eliminated sugar and dairy from my diet while introducing omega-3 supplements. I also adopted intermittent fasting during days 1 to 10 of my menstrual cycle, taking a break on days 11 to 15 (ovulation days), and resuming fasting on day 16-20 then take a break on day 20-28. Life so much better now 😊

[@m0L3ify]

@@SuperKenyasfinest Glad you found something that works for you!

[@avrilpankratz782]

Im 36 years old i have never had any children and i too have hit early stages of menopause im also in a low dose of birth control wch has helpd but i do feel cz of a history of bad hormones in mu body that i still experience issues sometimes mild and sometimes im no where its tough but im sire through time itl become easyer i do feel my labido is effected to. Its life i supose. Ive been to the dr so im monitoring everything so im good. But u will have good days and bad days this i know..

[@void9837]

@void9837 1 minute ago (edited) I went through menopause for one year and it was done. There's other reasons for fluctuating hormones and symptoms. Our bodies need an exercise warmup every morning with stretching, may need fruits and veggies to prevent malnutrition symptoms, remove chemicals from the food supply and water supply to prevent of health symptoms, need proper diagnosis of symptoms from healthcare professionals, and some people just need to fast for 3-5 days to resolve certain health conditions as well. Matthew 6:16-18.

[@piki4862]

Is that what's happening? I knew I was in perimenopause, I have the brain fog and some other symptoms but was wondering why all of a sudden in the last year I seem to suffer from diarrhea of the mouth. I say some stuff that later I'm kicking myself for. Why did I say that?! UGH! I also have the uterine fibroids and cysts on the ovaries. This perimenopause is the gift that keeps on giving. 😩 Yup. My doctor took blood once and I was told my hormones were "normal"

[@freedombug11]

Thank you so much for doing this video, I've been learning a lot lately but this gave me even more information and understanding that I was still lacking. That absolutely made me want to cry with relief and joy to hear you say at the end that if it's carefully managed, hypothetically it's very possible to go through the whole thing without having to suffer. Thank you for giving me hope.

[@Bravelyrising2024]

Great video! Very thorough and helpful. I’ve been in treatment for 7 years but my body is constantly changing and needing different things. Right now I’m dealing with the drastic hormone crash that makes me cry all day!!!! I feel like I’m going crazy and I want my life back. Let me add that I would do therapies and then stop them because I got fed up with the cost and the constant blood draws. I think I’m close to the end of peri now, so I’m getting back on track before I lose my mind and my husband. Haha…. No, but really😬

[@whs1073]

I live in Virginia and its unbelievable the lack of gyn doctors that have some knowledge about perimenopause or hormonal balance. I'm on perimenopause, but every time that I explain to my gyn how I feel, she (35 years old) looked at me with a face of indignation and tells me: "those are normal symptoms on a woman of your age" or "we can't do anything for you until you are in total menopause"! Total frustration!

[@shikhabubnakathuria2803]

Go to North American Menopause Society and find NCMP (menopause certified providers)! Ask friends, family, older women in your workout classes. Talk to receptionists at OB/Gyn offices and ask for practitioners who are are more well versed in menopause!

[@sweetpeasandyarrowaranchdi8327]

I think just having someone explain what is happening helps. Otherwise these symptoms happen, then I get anxious about it.

[@taram9409]

Yes, I agree completely!

[@Chichilovee]

Yes indeed

[@StelleenBlack]

44 and have had no period for 2 months and having 3 to 4 hot flashes an hour. I have an appointment in a few weeks, but this is insane. No sleep is getting to me.

[@mariangeles5638]

Thanks God I found you! What a master class about perimenopause … it’s just what I needed to know. I’m 45 years old and getting into this period and was so confused about what to do, take, treatments , how and which. I didn’t know about the DIM… seems worth trying. You explained simply clear. I appreciate it. Greetings from Belgium.

[@eneydatoledo6470]

Running into your videos was the best thing ever happened to me. 😊 I have been doing HRT since 2014. 1st creams patch & gel for testosterone. In June 2020 I decided to go with Biote Pellet & bled for several months like a normal period & sometimes like 3x in a month. Finally I found Dr Riley in CA where I live now. She was an OBGYN & performing Biote HRT. She was awesome & never bled while under her care but she retired in August 2021 so I had to look for another Dr. I found one but not OBGYN but just MD doing Biote. I re-started Biote treatment with him but I don’t think he really knew what he was doing in all. He focused more in selling me all bunch of pills & prescribing pills that he didn’t even monitored. You kniow like wrong mg for Thyrod . I started to bleed more like brownish spotting everyday & it’s really annoying. I notified him but just said increase progesterone to 300 or 400 which was making me really sleepy the very next day. But never concerned about the non stop sporting. I recently switched to another Dr here in Los Gatos California & so far he seems to know what he’s doing. 😊 41:58 He explained to me what you explained in regards to the uterus lining & bleeding bc excess of estrogene but only gave me the testosterone pellet this time ( no estrogen) & reduced my progesterone intake to 200 mg & 1/2 dosage of thyroid pill. He ordered a pelvic ultrasound & biopsy. I was a mess before seeing Dr Castillo. Fatigue, lack of motivation & depression. It’s being a week plus since the testosterone pellet (max dosage bc he said my testosterone was almost in the zero range based on lab results & my estrogen was pretty high). I can say that his treatment is really working. I started to notice my depression is gone & no sleepy in AM. Gaining my motivation to move &exercise…slowly but surely. For now things are improving. I have my pelvic & biopsy next so I’m anxious to see what the test results say about my bleeding/spotting. Not blood per say but brownish like spotting nonstop. Oh! He also switched to sublingual progesterone from a compound pharmacy. I’ll keep you posted. Again, so glad I ran into your video. You have a new subscriber. Many blessings! Martha Eneyda (56 yrs old ) 😊🙏💕

[@stephaniesteed7653]

Your comment help me find some comfort. I haven’t been a whole year without a period so I started my hrt pellets during that early transition but I have only been on the estrogen progesterone for 5 months now. I am experiencing the same problem as you were. My doctor told me I was starting my menopause from one test I took but I still had not gone a whole year without a cycle.

[@erickadennis7609]

So helpful! Thank you. What about using progesterone cream while on low-dose birth control pills? I haven’t had a good nights sleep in months do to night cramping.

[@EMILYHERRERA]

Do you have an update?

[@mermaidcoveclothesandnails]

This was so incredibly helpful. Thank you!

[@SimpleCreationsByShanda]

I don't even KNOW what kind of doctor treats Perimenopause. OB/GYN's won't dare discuss my symptoms much less help. Family doctor barely knows anything other than antidepressants. Can you please advise the type of doctor to search for? Thanks!

[@breezyveezy1]

Look for an integrative functional medicine doctor or naturopath. That’s who knew all about hormones when I was looking

[@filthyimpetuoussoul6220]

Thank you for sharing. Im going throught that bleed-everywhere-any-random-day-forget-the-28-day-cycle cause I have fibroids so this video got to me.

[@mountainmama8932]

I just subscribed! I cant wait to watch all your videos, and thank you again for explaining our bodies, and our hormones and the harmony it needs to feel the best way possible ❤ I first started looking into Perimenopause about a week ago - briefly heard someone talking about it, and symptoms and it caught my attention immediately. I had never heard that term. Although I've brought up several times to other woman that i think i might be experiencing the beginning of menopause and they always say " your too young" I think this this video will help a lot of woman understand what is happening inside their bodies. Instead of other women looking at me like im crazy, and have quite literally laughed hed in my face, after asking about menopause and my symptoms 😢I wish we were all informed on the entire process of 40 to 60 years old and the uncomfortable, unsettling, and interrupting stages our bodies and minds go through. I feel like I have some answers here, not just only for myself but for loved ones. This isnt discussed enough. I'm greatfull, I'm not crazy - lol, well, maybe just a little (aren't we all ;) ) the broccoli extract had me really excited for some relief. Thank you for that information as well. ❤

[@jenniferenage9263]

Very informative and encouraging. Thank you so much!!

[@susanaledesma4144]

The merina IUD with hormones was horrific for me. It caused me panic attacks, anxiety, suicidal thoughts. Hallucinations etc I will never recommend it to any body. I had to deal with the side effects for over a year. The hormones might cause a chemical imbalance in the brain.

[@chelseaj2356]

Mirena has been positively brilliant for me! I first used it as contraception, but now appreciate it for minimizing (eliminating, in my case) blood loss.

[@cutiebirdie2216]

What was your reason for using IUD? I’m so scared coz my dr recommended it as I have heavy periods. I’m 46.

[@EMILYHERRERA]

I hated it too; got it taken out after 4 months. Worst bc I've ever tried.

[@EMILYHERRERA]

​@@cutiebirdie2216some women really like it, while some women really hate it. It's always been like this. It constantly scrapes the uterus, and it has progesterone so it may stop the bleeding after a certain time.

[@meredithknight-bx8gt]

Wow

[@minttea3973]

Thanks 🙏 no one has explained it more clearly than you so far that I have seen.

[@EMILYHERRERA]

Try the Menopause Barbie

[@SuperKenyasfinest]

Thank you sooooo much Dr Susan for your wealth of information. I can’t wait to come to Texas to see you in person

[@middlewoman247]

Thank you so much for taking the time to make this informative video. Much appreciated ❤

[@marissaolivarez854]

Thank you for the practical life information! I’m researching what to expect as I approach this next phase of womanhood.

[@cristinamfsatt]

What a blessing has been finding this video, Dr. Hardwick! ❤ I'm going to check all your videos. Gracias!

[@michellel102]

Thank you for posting this!

[@taram9409]

Thank you Dr. Susan, this is one of the best, most informative video about perimenopause and menopause!

[@SavannahDzelme]

You are such a blessing for making this video! Thank you so much for giving this information on this platform.

[@SonyaSunny]

Thank you for all the focused details here. So, so helpful in such a confusing time!! 🙌🏼🙌🏼🙌🏼🙌🏼

[@ashleymoses9359]

I had my tubes tired when I was about 30 and after surgery the doc showed me some endometriosis tissue. He told me later in life I would have issues with it. Well now I’m 40 and I’m experiencing irregular periods, just recently had a period and a week later started back up. I found this strange given it’s like clock work. I have heavy bloating, cramps, mental fog, heavy bleeding, tearful at times, sleepy but restless, inner groin pain, pelvic pain, legs feel weak, paranoia, angry which is not me at all, headaches, hot flashes, more hungry as usual, feeling like I need to relieve myself. I eat right, I teach aerobics/ exercise regularly, sleep 7 hours, I just feel beside myself. I don’t want HRT! Not sure what to do. 👀

[@Iambeautiful123]

I am 46 and I have everything you said… just missing my periods right around July for 3 months…

[@mckohtz]

Thank you for this information. I am 48yo and at 45 yo I started skipping periods and my hot flashed got so bad it would interrupt my sleep making my mood swings really bad. So, I started applying over the counter progesterone cream when I am not having my period. My symptoms are so much better! Many doctors don't get any education on this subject and have not idea about what to do for the laundry list of peri-menopausal symptoms.

[@the.katherine.jasmin]

Thank you for this. I really appreciate the in depth conversation and explanation of what OTHER options are available than birth control to navigate peri-menopause symptoms. Which is all my OBGYN would offer before I start having 'regular hot flashes' - dismissing other symptoms I shared. I have an apt next week and want to explore these topics/options you discussed.

[@sleephoria]

A big thank you for sharing us with such valuable insights!

[@staciebrown9058]

Turning 54 in March, and think I’m entering the end of peri and start of menopause. We’ll see! I suffer from brain fog, night sweats, vaginal dryness and no libido! My question is: if both of my my grandmothers passed before knowing if breast cancer was an issue in my family and my mother passed at age 63 (from lung cancer - heavy smoker), is there a way to know if I can safely take estrogen? I would love to feel better 🙏🏻

[@EMILYHERRERA]

The research on this is awful because they just haven't cared about women for practically ever. There is good evidence to show that HRT is beneficial for most. Look up the Menopause Barbie & she'll explain all the hysteria + lack of interest in the medical field.

[@hildevan4025]

Thank you and regards from Germany

[@mountainmama8932]

This information is everything! Thank you Dr. Susan Hardwick-Smith ❤

[@starbettypink]

thank you so much ❤it is very helpful to me to figure out how to manage my self with the up and down hormones that they driving me crazy 😢

[@deborah10ism]

I had endometrial surgery about 13 or 14 years ago that explains a lot

[@NatalyaGubanova]

I'm so happy i found you ❤ Why it should be so hard for women to find information about this transitioning period and get it treated?? I feel like I was trying to get it piece by piece and your videos is greatly appreciated 🙏🙏🙏 You're very pleasant person and i wish i could have doctor as you 🤗

[@NaturalHealingAlchemist]

I’m almost 42 and have been perio for a few years but this last year has been thee worst so far! Dizziness and hot flashes that fuel panic attacks that cause more hot flashes ⭕️. 😣 I already suffer from crippling anxiety so it’s been much worse! I feel dizzy a lot and the insomnia sev. nights in a row doesn’t help. I cannot stand feeling so debilitated, I’m an active and usually happy person. I can’t even drive down the road to go walking sometimes because I have such awful panic attacks. Fibro-fog mixed with meno-fog🧠& now actual long COVID brain fog 😶‍🌫️ is making me very forgetful.😢I’ve been celibate for 9 years 😳 lol so no need for BC but, I may ask for a low dose to try. I remember it did make me gain some weight when I was younger but, hey I already got meno -belly 🐽creepin up. Been using maca and Ashwaganda tinctures, ginseng, ginkgo, red clover and vitamin d with k2 alcohol free tinctures almost daily. Ginger 🫚 of all kinds helps with nausea and some anxiety.I appreciate 😇this video so much love!🙏🙏🙏

[@pgh412east]

Do you find anything helps w fatigue..or all of that combined.

[@Butterflylovely5]

Get bio identical progesterone!

[@taram9409]

Thank you for sharing, it really helps to know I'm not the only one!

[@Vote2024again]

Well hopefully you're not in it long. I am in it now and I'm 50. Lots of the same symptoms. The one thing it is doing is sometimes it will mess up my blood pressure and it already has affected my sugars. Hopefully it's not doing that to you. ✌🏻

[@Serve24]

Can perimenopause start at age 38? Also, can hair thinning be a sign of perimenopause?

[@show_me_your_kitties]

Yes and yes. Go see your Dr and get the blood work.

[@lols6650]

This is so 😢 depressing. Actually I am mad, sad, confused and my ob only cares about pregnancy and delivery. Could you please advice what kind of Dr. Can help and take you seriously? Is it an endocrinologist? Internist?

[@chubstuf]

That's a great question. I ended up going to my primary care physician but because they weren't patient-centered, they sent me to dermatology because my hair was thinning. Dermatology told them this was hormone related hair loss and sent me back to my primary care physician who then referred me to gynecology. I was terrified that the young resident would have concerns over the 2020 Cancer scare that was debunked and that she would refuse to give me HRT. Luckily, I walked in knowing what I wanted, explained why and that I was aware of the risks and benefits. She was impressed and incredibly helpful. I walked in feeling a bit agist but I have to remember the younger physicians are getting the most updated information while the "wiser" providers are can be less progressive and more stubborn.

[@chubstuf]

Also, I think a lot of the provider focus is on preventing death, at least it is where I get care because I am an employee in a major medical system and see providers at a hospital. Because there's the potential one could have very complex medical problems during labor and delivery, there is a lot of focus in that area. I think most providers look at women in perimenopause as if they are complaining about aging which is a completely normal, progressive process. However, with as far as we've come in health care I think it should be seen as something similar to physical therapy because the body we've had our entire lives is misbehaving, making our quality of life poor. With education and some minor tweaks, we could be feeling just as healthy and excited about our futures as the 30-year-old swimmer who's recovering from a shoulder injury. And we deserve that kind of respect.

[@AngieCee1]

Same here. I'm 45 with low sex drive and other issues like fatigue and depression.I went to my PCP and ended up getting a mammogram, 2 paps (they didn't get a good sample the first time) then they said I had high estrogen and was told that could be a sign of cancer. Then I was told it was fine.... That your hormones change😮 during the month. We referred to an Gyno. Had blood and had a bunch of other tests. After months of this I was told that it's normal for a woman my age. Well I know that!! I went for any kind of answer or help, guidance... In the end they told me I should see a therapist for my low sex drive and depression. I don't know what to do now but just sit back and let it happen lol. But it's affecting my quality of life. I am glad I got everything checked out though, it was nice to know what I don't have, I guess lol

[@TheNordicHunter]

@@chubstufAre you sure it’s debunked? Can you include links if possible please. I’m doing research for my girlfriend and I’m not going to recommend something that could potentially give her cancer. There are a lot of natural ways to balance out hormones from what I am seeing on KZbin. Anywhere from behavior (exercise, eating right, no sugar, etc.) to creams (Progesterone from wild yams), to supplements (Chased Berry, sage oil, adaptogenic herbs, etc.). I’m still researching when I get the time, but more awareness has to happen. Doctors are just pill sales people. What an awful thing (one of many) that women have to go through. I’m sorry you and the others get dealt this hand.

[@TheNordicHunter]

@@AngieCee1Sadly most doctors just wake up, push pills and go home. There needs to be more awareness for this, but until then, women and their partners need to do as much research as possible to help themselves, because the medical community at large aren’t there for women. It’s so sad. Hope you are able to find what it is your body needs and get some relief or balance in your system.

[@julianadesilva6449]

This is so informative, thanks so much

[@jojohn2950]

Thank you! Good information.

[@HRGURUCA]

Period changes, major insomnia, feeling unseasy, light weight gain, and clear discharge (no smell) & waterlike texture. 39 😅 #God bless us! 🙌

[@gabisteed930]

Aww brill watch I'm about to start low dose birth control early 40s been getting symptoms since end of 30s..I thought having mental breakdown all this makes so much sense..wish i could see you im from uk thou xx

[@natashatrichardt885]

That was so informative, thank you so much. Wish you practised in Cape Town

[@jennyforonda4987]

Thank you very much for this valuable information

[@tinajaneiro-ne4ew]

What low dose birth control pill do you most often recommend? There are various options.

[@TheProactivePatients]

Ummm.. with 9 years working as an MFM genetic counselor, fertility definitely drops due to both hormone levels as well as aneuploidies, but I have seen MANY women having natural pregnancies throuout perimenopause (the 7-10 yrs prior to menopause) including a colleague with her natural pregnancy at age 52 (no donor egg, no fertility treatment). Women definitely ARE fertile in this window. Just less fertile.

[@EMILYHERRERA]

Yes, lots of surprise! babies can happen if prevention isn't exercised. Lots of planned conception as well.

[@Authentistic-ism]

How do pharmacogenetic phenotypes affect our treatment options? My genetics make me an ultra-rapid metabolizer, with risk of liver toxicity, for many pills.

[@jessicatruax7630]

Can you take progesterone and take dim at the same time? Would that balance out the estrogen highs of early periomenapause?

[@ecpapa3]

Great video!!!!

[@jacqueline827]

I got that comment saying but your too young to be in perimenopause

[@hanni5862]

Me too...

[@char2304]

Me too

[@salserasaenz]

Same😩 it’s so frustrating

[@GoWithin4]

juSt got it last week! 😅

[@fabisouza78]

Me too

[@lauracastle6035]

Thank you for this incredibly valuable information. I'll be 46 soon & feel ive been in peri for at least three years. My GP is useless. My naturopath gave me some GABA and some other supplements which did nothing. My OBGYN believes me & tried to treat me with Mirena but this made my migraines worse. She referred me in to menopause specualists but there is a long wait (3-4 mos) to be seen at this clinic. My question: why aren't OBGYN's better equipped at addressing perimenopause & menopause? Why the referral?

[@angelapurcaro9068]

How do you navigate perimenopause as someone who also lives with PCOS? Much of the perimenopause symptoms are also symptoms of PCOS... how should someone navigate treatment when the root cause could be perimenopause or PCOS or both?

[@zeljkafreslmicovic4825]

Thank you dr. Hardwick-Smith!❤️

[@Erogevoli123]

Very informative!

[@silviatorres5105]

Thank you so much for the great explanation, I just started this journey and had so many questions that you just cleared, I was just given by my doctor progesterone and asked her why not estrogen, she said is most likely is very high at this stage which I was very doubtful since I have heard stories when estrogen is the only solution, now I understand a lot more and that is not my case yet, I’m only 44 l.

[@EMILYHERRERA]

The fact that they're not taking labs to SEE what's going on, and at different times, is very telling. I'd find a more skilled, educated provider if possible.

[@heidiho3089]

Shoot, my gyno has me on 0.25 mg estradiol patches, and I have the symptoms you mention that would be more aligned with progestin/testosterone supplementation. I am 54 and still having my cycle. I have asked about progestin several times and she says that would not be given until menopause. So confused!!! Now I am starting an SSRI because the pms is so dark… wish I was getting proper tx!!! Any advice would be greatly appreciated.

[@EMILYHERRERA]

I'm sorry you're struggling. I wish we were more valued and celebrated in our culture; our quality of life would be so much better from the start.

[@CiaranWilcox]

I so appreciate this video. What does it say about my hormonal state that it brought me to tears??

[@factbasedcat]

I'm 47 and just starting perimenopause. How do I know when I'm no longer fertile and don't need bc? My grandmother had her first baby at 49 and last baby 52.

[@karieviola]

Thank you for this video. I'm in peri and am on an estradiol patch. I've been bleeding like the shining and it's horrible. The progesterone makes my brain fog horrible.

[@sziami09]

I think you should stop the estradiol if you have heavy bleeding, it makes it worse.

[@onewomansjourney760]

I went through "Midi Health" & was prescribed 0.025 Estradiol patch along with 0.01% Estradiol vaginal cream & 100 mg. USP Micronized Progesterone pill. I'm 48 & have had very erratic perimenopausal symptoms for several years but the last 12 months have been really difficult to manage, especially mood swings, cognitive function, sleep, dry eyes, dry mouth, joint pains, weight gain along with SO MANY other symptoms just seemed to suddenly appear out of nowhere. My cycles are irregular then go back to regular. Most menopause providers do give a small dose of Estradiol along with Progesterone in late perimenopause. No testosterone was prescribed due to both Estradiol & Progesterone can stimulate testosterone increase levels. Mine are 0.9 so none there but most women have TOO HIGH testosterone while on testosterone hormone replacement, as high as a man's levels which is dangerous & NOT needed. This is especially seen with pellets where the dose can NOT be controlled once the pellets have been inserted.

[@just-me6023]

I see them on the 30th, I'm sadly excited.

[@meganpatterson1653]

I just had an appointment. I do still get a period every 28 days and was afraid to take estrogen because I’ve been told for years I’m estrogen dominant. I was given estradiol patch .025 the 100 mg progesterone. Wow I feel so much better. In the past was only prescribed progesterone but I would get so bloated. I’m actually going up the next dose on my estradiol patch because the week before my period I experienced all my awful pms symptoms, crazy bloating. I’m just so confused as to why in this video she says no estrogen for perimenopaus

[@denise3432]

Thank you ladies very much for sharing! I see Midi in two days!! Soo excited cause peri is about to take me out!! 😢

[@Butterflylovely5]

@@meganpatterson1653why are you confused she explained it very clearly that in perimenopause we have estrogen dominance that means a lot of estrogen and non progesterone! Does it make sense?

[@Sara-gl8ue]

I do not recommend an IUD. Worst experience of my life. Wild yam cream is better. There's a protocol on how to use it for menopause.

[@shampoonka]

Would you advise to take DIM only in the second half of the period, when estrogen is at its highest or every day?

[@oliviawilson9703]

I feel like I might go on the low dose contraceptive. Never been on the pill in my life, but my doctors knows nothing about perimenapause would rather I continue on over the counter pain killers and put me in anti depressants ( which hes says will have a knock on effect on sleeplessness, brain fog as well as low mood), i know that all these are related to my fluctuating hormones and know approximately when during my cycle i will get symptoms especially headaches. Anyway i cant afford to attend a specialist at a menapause clinic so I am seriously considering the pill ( even though my prefence would be the bioidenticals).

[@girlwithoutacountry644]

Have you started bcp yet? How is it going for you? I’m considering trying it

[@onewomansjourney760]

Endometrial ablation are not the best as blood still pools behind dead tissues after the ablation at time of when you'd normally menstrate.

[@stephaniesteed7653]

My doctor tested my levels and said I was going into menopause but I think she was wrong because I have not been a whole year without my cycle. I don’t think those tests are accurate when you are pre menopausal.

[@EMILYHERRERA]

this is why timing and taking multiple tests are indicated for a practitioner that doesn't really have a clue about what's going on. I wish we had much better healthcare.

[@Srmisterio27]

Thanks for the very informative video. Question: By estrogen you mean total estrogen or just estradiol?

[@erratum3068]

I’m 53 and my period is super regular, no signs of slowing down. My usual symptoms of pms, anxiety and migraines are getting worse. What would you suggest. I’m in Europe and I’ve been told HRT is not an option as long as I have a period. Thank you for all the information 😊

[@erratum3068]

Also I can’t be on the pill, or IUD because my uterus is too small.

[@danabelden4492]

Going through this now

[@michelleflood251]

This makes me sad, Im only 32. I got married at 28 and was planning on having 6 kids. Im experiencing what I believe is perimenopause. I had a regular cycle of 32 days but the passed eight months have been between 28 and 35 days long. Now im on cycle day 50 and still no period and about 20 negitive pregnancy tests.cant go to doctor cause i dont have insurrance right now. 😔💔

[@saudylarin6308]

It could be polycystic ovary syndrome.

[@3hotspuds]

So in perimenopause when you add estrogen, say in the lowest dose via patch, would that ever cause your levels to be too high during one of your up days but made you feel better on your lower days? Is cream better in that regard? Just add on days you are symptomatic? Patches seem much easier overall just curious about them during fluctuations. Thanks

[@laniesider2586]

Any one having thinning hair or losses a lot of hair every day?

[@beachfrost3367]

I can see my scalp. It is very depressing as my hair used to be so thick.

[@laniesider2586]

@@beachfrost3367 I agree very depressing, my hair used to be thick also, now everyday while taking a shower or brushing my hair a lot falls out. My hair is now thinner with no volume.

[@beachfrost3367]

@@laniesider2586, mine too, always picking hair out of my hair brush and my bangs are so thin, I'm finding myself changing my part to have more hair to comb over. Then there's the sprigs of hair that used to be thicker but broke off at some point.😔

[@beachfrost3367]

@laniesider2586 , I've tried vitamins and all kinds of hair products to thicken my hair and none of it works. I've now switched to just using shampoos and products that volumize. I believe it's all hormonal. Wish someone would have given me a handbook for this part of life.

[@laniesider2586]

@@beachfrost3367 I agree with you, it really sucks!

[@mycustompaintedlife502]

Two years ago I went through a very difficult time and I lost an incredible amount of weight. Of course, my period stopped but now I’m 49, so idk if I’m menopausal or just too thin or maybe they just ran into each other

[@ednabehrens3663]

Thank you doc

[@sheathompson2880]

Can you take DIM with a low dose BC? Especially when the BC doesn’t take care of the other perimenopause symptoms. The BC is Heather .35mg.

[@jackyalexander4810]

Most well explained video yes just been prescribed by a Male dr anti depressants gave up about menopause as wouldn't listen!!!

[@millytorres9777]

Love this doctor. We don't get any extra medals for suffering ❤❤❤😂😂😂😂😂

[@EMILYHERRERA]

We need a cash incentive for dealing with all of this for decades. 😊

[@Rhianna2023]

I am 43 it started last year I thought I was dying somethings wrong I went to so many doctors specialists and nothing just said anxiety and offered antidepressants which I couldn’t take due to side effects so I am suffering every day I get panic attacks anxiety mood swings brain fog Diziness bad headaches I feel disconnected I am scared of being alone that I would faint and it still hasn’t happened weird pressure one side head now Integrative Dr has given me P2 detox clean d liver has anyone tried this?

[@fiorellatiradobertuccelli5124]

Great video! Would you still recomend taking progesterone in this pase if you got miomatosis, endometriosis and adenomiosis? Thank you! I am 50 and no symptoms other than irregular cycles for the last year (very unpredictable) and pain that might be due to strogen dominance/ low progesterone

[@Maratrushka]

My cousin dies at 47 for leuchemia I believe it was bc shes been anemic for many years withouth knowing. Now the same its happening to me but Im just taking progesterone cream from wild yam bio identical. Im 49 I stopped my heavy period 8 month ago and now it returned!! Its been more than a week Bleeding is heavy but I feel a bloated on my down parts that when I walk it hurts. Im increasing my intake of the cream out of desperation (2 pumps a day) and now Im thknking I will do 3 pumps. Because I have to work tomorrow. My mind is only set in getting better. Bevause if I dont I feel I cant not go with mynlive no more. Its a nighjtmare. Doctors are full of their ego so they will recomend checking u down there instead of ypur hormones!! They still in prehistorical books!!! But for charging are so good $$$

[@EMILYHERRERA]

This isn't how leukemia works.

[@janetrodriguez5445]

How do you take DIM? Do you take it every day? If you take it in the days when your estrogen is low wouldn’t that make things worse?