If you were born with a uterus, menopause is inevitable - but confusion and suffering don’t have to be. The years leading up to menopause, known as perimenopause, can begin earlier than many women realize (sometimes as early as your mid-30s). During this transition, hormone fluctuations can create symptoms that leave you wondering: Is this stress? Postpartum? Aging? Burn out? Or something else entirely?

The truth is, perimenopause is still widely misunderstood - even though awareness is growing. That’s why it’s so important to know how to advocate for yourself and your health.

Why Perimenopause Gets Missed

Like many women, I spent years thinking my mood swings, fatigue, and lack of libido were just leftover postpartum hormones coupled with job burn out. It wasn’t until I stumbled across experts like Dr. Mary Claire Haver that I realized I was likely in perimenopause. That moment gave me clarity and helped me finally connect the dots.

And I’m not alone. Because perimenopause symptoms overlap with other phases of life - postpartum, stress, or just “getting older” - too many women aren’t given the right language or tools to understand what’s really happening in their bodies. Worse - they may be MISDIAGNOSED. In the US 1 in 5 women ages 40-59 are prescribed anti-depressants but what if the depression they were experiencing was really hormone related?

Awareness Is Rising - but the System Is still behind

Yes, menopause is finally having its cultural moment. From Oprah specials to social media conversations led by doctors and celebrities like Naomi Watts and Halle Berry, the awareness gap is shrinking.

But awareness doesn’t automatically equal care. Research shows that only about 20% of OB-GYNs feel comfortable treating menopause. That means too many women still leave appointments dismissed or misinformed - and continue to suffer unnecessarily.

Here’s what I want you to know: while menopause is unavoidable, suffering through it is not.

Step One: Track Your Symptoms

Perimenopause isn’t diagnosed through a single blood test - it’s considered a clinical diagnosis, based on your age, history, and symptoms. That means showing up to your doctor prepared with a record of what you’ve been experiencing makes all the difference.

Symptoms aren’t limited to hot flashes. In fact, they can range widely because estrogen receptors exist throughout your body. Common (and less commonly known) symptoms include:

Fatigue and sleep disturbances
Mood changes and irritability
Weight gain or changes in body composition
Low libido and painful sex
UTIs, urinary incontinence, or vaginal dryness
Heart palpitations or joint pain
Even strange ones like itchy ears!

Step one to advocate for yourself - start logging what you notice - whether it’s a note in your phone, a journal, or by downloading my free symptom tracker. After a month or two, you’ll have a clear picture to bring into your next appointment. I didn’t think much of my symptoms in isolation and then when I coupled them all together I started to see the big picture.

Know the Facts About HRT

Hormone Replacement Therapy (HRT) is one of the most effective treatments for many perimenopause symptoms, but outdated fears still keep some women from accessing it.

The myth: HRT is dangerous and always raises breast cancer risk.
The reality: The initial studies from 2002 overstated the risks. The Menopause Society now affirms that for most healthy women under 60 and within 10 years of menopause, the benefits outweigh the risks.

If you’re curious about HRT, here are a few steps to take:

Use The Menopause Society’s provider directory to find a doctor trained in menopause care.
Ask about a provider’s stance on HRT before scheduling - this can save you time and frustration.
Bring the latest HRT guidelines with you to your appointment so you can discuss them together.

Making the Most of Your Doctor Visit

Because appointments are often short, preparation is key. Before you go:

Have your symptom tracker ready.
Lead with your concerns - don’t wait for the doctor to ask every question.
Know that certain reasons (like family history of breast cancer or still having periods) aren’t automatic disqualifiers for HRT.
If you’re dismissed, it’s okay to seek a second opinion.

Remember, you are your own best advocate and know your body best!

The Bottom Line

Perimenopause can feel overwhelming, but you don’t have to navigate it alone - and you definitely don’t have to just “suck it up.” By tracking your symptoms, knowing your options, and advocating for yourself, you’ll be far more empowered in your healthcare journey.

These years don’t have to be about struggle. With the right tools and support, they can be a time of strength and renewal.

Want to get started today? Download my free symptom tracker to gain clarity, spot patterns, and walk into your next doctor’s appointment with confidence.

Disclaimer: This blog is for informational purposes only and is not intended as medical advice. Please consult your healthcare provider for guidance specific to you.

FAQ’s About Perimenopause

Perimenopause often begins in a woman’s 40s, but it can start as early as the mid-30s. The average age of menopause (when periods stop for 12 months) is 51, which means perimenopause can last several years.
Treatment options range from lifestyle changes (nutrition, exercise, stress reduction) to prescription options like Hormone Therapy (HT/HRT) or Menopause Hormone Therapy (MHT) For many women under 60 and within 10 years of menopause, the benefits of HRT outweigh the risks.
There are also several telehealth companies that specialize in (peri)menopause such as Midi Health or Alloy.

How to Advocate for Yourself During Perimenopause