Menopause and Hormones

Menopause affects every woman who lives long enough to experience it, yet most women enter this transition with almost no accurate information about what to expect or what help is available. The medical system has historically undertreated menopausal symptoms, and the legacy of a misinterpreted 2002 study continues to create unnecessary fear around hormone therapy. On Pair-A-Docs, we correct the record.

Questions We Answer

• What is perimenopause, and when does it start? Perimenopause — the transition leading up to menopause — can begin years before the final menstrual period, often in a woman's forties. Symptoms include irregular periods, hot flashes, sleep disruption, mood changes, and cognitive changes.
• Is hormone therapy safe? The short answer is yes, for most women. The Women's Health Initiative study published in 2002 was widely misinterpreted, and the medical consensus has shifted significantly. Dr. Ross discusses what the current evidence actually shows.
• What is genitourinary syndrome of menopause (GSM)? GSM refers to the changes in vaginal and urinary tissues caused by declining estrogen. It causes dryness, discomfort during sex, and urinary symptoms — and it is highly treatable with local estrogen and other interventions.
• What role does testosterone play in women's health? Testosterone is not just a male hormone. It plays an important role in women's energy, mood, and sexual desire — and levels decline with age. We discuss the evidence for testosterone therapy in women.
• How does menopause affect mental health? Hormonal changes during menopause can significantly affect mood, anxiety, and cognitive function. Dr. Tammy Nelson discusses the psychological dimensions of this transition and what support is available.
• What lifestyle factors affect menopause symptoms? Sleep, nutrition, exercise, and stress management all affect how women experience menopause. We discuss the evidence-based lifestyle interventions that can make a real difference.