What women should know about hormones, symptoms, and the transition no one prepared us for.
There is a phrase I hear from women again and again: “I just don’t feel like myself.” Maybe sleep has suddenly become unpredictable. Patience is shorter. The body that once responded to exercise and healthy eating seems to be playing by different rules. There may be brain fog, fatigue, anxiety, changes in libido, night sweats — or simply a sense that something has shifted.
For many women, this begins well before menopause.
A TRANSITION, NOT A SINGLE MOMENT
Perimenopause is the transitional period leading up to menopause, and it can begin years before the final menstrual period. During this time, hormones fluctuate, and symptoms can occur even while periods remain relatively regular.
IT’S MORE THAN HOT FLASHES
Hot flashes and night sweats may be the symptoms we associate most with menopause, but women can also experience changes in sleep, mood, concentration, sexual health, vaginal comfort, energy and body composition.
But not every symptom in your 40s is hormonal.
Thyroid disorders, anemia, nutritional deficiencies, sleep disorders, medications, metabolic changes, depression and anxiety can produce similar symptoms. Good care shouldn’t begin by assuming hormones are the answer. It should begin by asking the right questions.
HORMONE CARE SHOULDN’T BE ONE-SIZE-FITS-ALL
As hormone therapy has become more visible, so have convenient, protocol-driven approaches to treatment. But women are far more complex than a questionnaire, a set of laboratory values and a predetermined prescription.
When I meet a patient for a hormone consultation, I want to know her story. When did she begin feeling different? How is she sleeping? What has changed in her cycle, mood, relationships, sexual health, energy or body composition? What is her medical and family history? What medications is she taking? Most importantly, what does she want to feel better?
Laboratory testing can provide valuable information, but during perimenopause hormones fluctuate, so numbers must be interpreted within the larger clinical picture.
WHAT ABOUT HORMONE THERAPY?
Hormone therapy remains the most effective treatment for bothersome menopausal hot flashes and night sweats and can offer additional benefits for appropriately selected women. But it isn’t right for everyone. Age, health history, symptoms, individual risk factors and personal preferences all matter, and there are nonhormonal options as well.
Even when treatment is appropriate, good hormone care doesn’t end with a prescription. Finding the right regimen can require adjustment, follow-up and continued conversation as a woman’s symptoms, health and needs evolve.
WOMEN DESERVE A MORE PERSONAL CONVERSATION
Women shouldn’t reach their 40s wondering why their bodies and brains suddenly feel unfamiliar – or believing they simply need to work harder. Menopause isn’t a disease, and aging isn’t something we need to “fix.” But symptoms affecting sleep, work, relationships, sexual health or quality of life deserve attention.
The goal isn’t to turn back the clock. It’s to understand what’s changing, know your options, and feel strong and vibrant moving forward.
Danielle Ruggiero is a Doctor of Medical Science and board-certified Physician Assistant with more than two decades in healthcare. Her approach to hormone and wellness care begins with a comprehensive, one-on-one consultation — combining each patient’s story, symptoms, medical history, lifestyle and appropriate testing to create highly individualized care.
Veda Aesthetics & Wellness
(310) 483-1241
Real Medicine. Real You.
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