Stepping into menopause empowered and supported
By Kristen West
IF YOU’RE A 40- or 50-something woman scrolling social media these days, your feed is likely swamped with meno-messages. But there is a lot of conflicting information out in the inter-world when it comes to perimenopause and menopause treatments. And let’s face it, when you are in the thick of symptoms you suspect are hormone-related, you do not want to be guessing. Here, we look at what to expect during this stage of life, where to turn for care (hint: it’s not the latest algorithm), and what options may help you feel informed, supported, and empowered.
First, let’s clear up the difference between perimenopause and menopause. Perimenopause is the transitional phase leading up to menopause, typically beginning in the late 30s to mid 40s. During this time, estrogen and progesterone levels fluctuate, which can spark a range of physical and emotional changes. This phase may last several months or stretch on for years. Menopause is defined as 12 consecutive months without a menstrual period, typically in the early 50s. After that milestone, a woman enters postmenopause, when estrogen levels remain consistently low.
For many women, perimenopause is when symptoms first show up, and they can feel unpredictable. Hot flashes, night sweats, sleep disruption, brain fog, low energy, weight gain, and changes in mood or libido are common. While no two experiences look the same, symptom relief is possible, and there are medical providers who will take your care seriously.
One of the most helpful steps is establishing that care early. Dr. Catrina Bubier, managing partner at Women’s Health Care Associates and presidentof OB/GYN Affiliates, encourages women to start conversations in their early to mid-40s, even before symptoms feel disruptive. “By having these conversations early, we can avoid anxiety and provide appropriate education about what is normal or abnormal,” she says.
Choosing the right provider matters. An OBGYN has extensive training in the female body and can explain, from a physiological perspective, what’s happening and guide treatment decisions. Many women also choose an integrative approach, combining conventional care with naturopathic or holistic providers who focus on lifestyle, prevention, and whole-body balance. Having your providers collaborate can improve your quality of care, so make sure you tell them about each other.
In addition to hormone levels, examining thyroid and adrenal function can provide helpful insight, says Kristina Schieferecke, ND, of Healing Roots Natural Medicine. “You should always test, not guess. When all these systems are supported and functioning well, we see women experience fewer symptoms.”
Hormone replacement therapy, or HRT, is one common option for managing symptoms related to low or fluctuating hormone levels. By replacing estrogen and progesterone, HRT can support sleep, bone health, heart health, brain function, and muscle strength. “Hormones will not fix all of these problems, but it is a key component that we use to help,” Bubier says.
Hormone therapy carries a small increased risk of blood clots and, depending on personal history, hormone-sensitive cancers. However, newer formulations carry lower risks, and vaginal estrogen, which is minimally absorbed, may be an option even for women who can’t use systemic hormones.
Nonhormonal options are also available, including prescription medications for hot flashes and over-the-counter products such as Estroven or black cohosh. Talk with a provider before starting supplements to make sure they won’t interact with other medications.
Schieferecke says addressing deeper contributors is important, even if the patient is using HRT or medications to ease severe symptoms. Naturopathic care adds another layer of support, using nutrition guidance, herbal medicine, homeopathy, and lifestyle changes. “This flexibility allows us to support the whole person and address root causes,” Schieferecke says. Sleep support, stress management, and strength training also play important roles. “We lose about ten percent of our muscle mass each decade after 50, so we need to maintain exercise and weight training,” Bubier says.
Ultimately, menopause is deeply personal. Each woman brings her own health history, genetics, and goals into this transition. Bubier encourages women to advocate for themselves. “If you don’t feel heard, find another provider that will listen to you.”
With the right care team and information, this chapter does not have to feel overwhelming. It can be an opportunity to better understand your body and move forward feeling supported and informed.
