MANY WOMEN WHO START GOING THROUGH PERIMENOPAUSE HAVEN’T EVEN HEARD OF THE TERM AND, ASIDE FROM HOT FLASHES, DON’T KNOW WHAT TO EXPECT. What are the symptoms, the struggles, and even the joys that come through this transformational change? Learn what you need to know now, no matter what your age.
Jen’s story
Jen Brown certainly had never heard of perimenopause. When she started having symptoms in her mid 40s, she would sit at work, being unable to concentrate, and wondered if she was just getting old. On top of that, she was tired and moody all of the time.
Jen was shortly into a new job and was working around the clock. She first attributed her symptoms to stress.
“I really had no idea what was going on, because the only symptom people talked about in popular culture was hot flashes,” she says. “I think a lot of that has to do with the fact that it’s physical, you can’t deny it’s happening.”
Jen had never been introduced to the subject; her mom is part of the “silent generation,” a generation characterized by not talking about themselves and their feelings. So, Jen dealt with the symptoms as best as she could alone, until one day she brought them up to her gynecologist. The doctor told her that she didn’t need any treatment yet, and that Jen should just wait.
Jen Brown.
“Everybody was still under the information that it was going to give you cancer if you took estrogen,” she says, “and the guidance was to do it [hormone therapy] for the shortest amount of time at the lowest dose.”
Jen toiled on, living with her symptoms the best she could.
“In retrospect, I thought ‘if you’re sick or you’re not feeling well, nobody’s going to tell you to just hold off.’” She later returned to her doctor.
Jen’s gynecologist did prescribe hormone therapy, and Jen says that she intends to stay on it for the rest of her life. She did, however, have progesterone intolerance, which, Jen says, can make one mildly depressed to suicidal. No one had warned her about that side effect.
She found herself on vacation with her family in a beautiful French town, but not wanting to be there.
“I was so depressed and had no idea why,” says Jen. “I had been on hormone therapy for a few weeks.”
Jen’s experiences took her to social media, where she started sharing them with others. She believes women should educate themselves about peri/menopause’s persistent mental symptoms, such as brain fog.
“I find that I cannot pay attention to things I don’t care about or don’t interest me,” says Jen. “But maybe that’s a blessing, because if you’re doing something just for the money or because you think you have to, that’s not really living life to the fullest.”
Jen went through menopause at the age of 51 last year. Her physical symptoms are mostly gone.
Carol’s story
Because of Carol Holladay’s breast cancer diagnosis five years ago, she’s unable to have hormone therapy. Thus, says Carol, “I switched my nightstand to a tower fan” because of the relentless hot flashes that started when she finished chemotherapy.
“Last night, I sweated through every bit of my clothes as I was watching a movie with my kids,” Carol says. “They were bundled up. I had the air conditioning on at 68. I could just not get cool.”
But despite the intense hot flashes, it’s the symptoms women may not realize are related to menopause she believes should be talked about.
“I’ve got weight gain in places I’ve never had before,” she says. “My skin will blow up in rashes for no reason. My vagina is drier than the desert. And I’ve got hair I’m losing on my head but growing on my chin—what’s happening?!”
She feels that while conversations about men’s hormones are commonplace, even encouraged, women get labeled as “crazy” and as “emotional wrecks.”
And then there’s the forgetfulness.
Carol Holladay.
“When I started going through it, it’s like ‘do I have early-onset Alzheimer’s or something, because why do I forget everything if I don’t write it down?” she says.
Other symptoms are irritability
and impatience.
“I have no patience for driving,” Carol says. “Shopping doesn’t bring me joy anymore. Things don’t fit you the way they used to. I think to myself ‘do I need to go to Lane Bryant? What’s going on?’”
She finds herself being drawn to more solitary activities.
“Now, I find more joy walking on the beach or taking pictures when I used to be more about being social and getting to know people,” says Carol. “But I think taking care of yourself mentally and physically is really important. Sometimes, it’s just taking my dog for a walk, organizing the house, concentrating on my personal happiness zones and not depending on the outside factors of life.”
Carol hasn’t had her period in five years, and her symptoms persist.
Cherlette’s story
Cherlette McCullough had a hysterectomy in February 2024. It set her on the course toward menopause, and triggered hot flashes, brain fog and body aches.
“Nobody talks about those of us who aren’t candidates for HRT (hormone replacement therapy),” says Cherlette. “It’s a different type of suffering.”
“For a while, I managed my symptoms naturally with supplements and lifestyle changes, things like staying hydrated, watching my diet, using essential oils and keeping a consistent sleep routine,” she adds. “I focused on movement, mindfulness and managing stress, because I’ve learned how much emotional balance affects physical balance.”
Recently, her doctor prescribed a low-dose estrogen patch to help regulate Cherlette’s hormones more effectively.
“It’s been a gentle adjustment,” she says, “and I’m still very intentional about combining it with holistic practices like prayer, rest and self-care. Menopause is a personal journey, and I’ve learned that listening to your body and partnering with your doctor makes all the difference.”
Cherlette McCullough.
She says that menopause taught her the power of surrender, self-awareness and acceptance, especially after her hysterectomy.
“That experience changed my body and my rhythm in ways I didn’t expect,” says Cherlette. “It forced me to slow down, listen to and honor my body instead of pushing it to perform the way it used to. I had to re-learn what strength looks like—less about endurance and more about gentleness and grace.”
Cherlette officially hit menopause in February 2025.
Karen’s story
In her 40s, Karen Buckalew started noticing increasing anxiety, problems sleeping, volume loss in her skin, feeling hot and an overall feeling that something just wasn’t right.
“At the time, I didn’t understand that it was perimenopause,” says Karen. “Like so many women, I thought I was just stressed or aging. I was placed on an anti-anxiety medication by my physician.”
“Then, at age 49, my gynecologist insisted that I stop my birth control and wait 12 months to see if I had a period,” she continues. “While I still experienced hot flashes and trouble sleeping, the anxiety/depression and brain fog were the hardest, and it felt like I had lost myself.”
After discussing her symptoms with a hormone-trained physician, Karen was weaned off the anti-anxiety medication and began hormone therapy.
“Within 72 hours of starting transdermal estrogen and micronized progesterone, it was as if the lights turned back on,” she says. “The depression and anxiety faded, the curtain lifted and I felt like a new person. It was truly life-changing and reaffirmed how powerful the right, individualized hormone therapy can be.”
The epiphany spurred Karen to help others find relief; she is now a board-certified nurse practitioner and a Menopause Society-certified provider, the founder and owner of Boutiq Medical Clinic.
Karen Buckalew.
“I watched my mom suffer the long-term consequences of not being offered hormone therapy,” says Karen. “She had a total hysterectomy at a young age and was estrogen deprived her whole life. She developed heart disease, dementia and nearly every symptom related to menopause. Seeing her struggle made me determined to do better for other women.”
Karen is now post-menopausal.
Just the Facts
What exactly are menopause and perimenopause? Simply put, menopause is the one-day anniversary after 12 months of not having your menstrual cycle. So, for example, if the last day you had your period was on Dec. 1, 2024, you hit menopause on Dec. 1, 2025.
“Going through menopause means you lose estrogen,” says Dr. Karolina Skrzypek, founder and CEO of Naturamed. “It happens because we’re coming to that period in our lives where we don’t have as many eggs left. We’re not ovulating as regularly.”
This phase, called perimenopause, says Skrzypek, can happen 10-15 years before you go through that year of not having your menstrual cycle.
She likens the process to a roller coaster.
“Let’s say you go to Universal Studios or Disney and have been on the roller coasters before—you know what to expect. But then starting in perimenopause, you go on a new roller coaster, and you just don’t know where you’re going to end up,” says Skrzypek. “You don’t know what symptoms you’re going to have. It’s just a crazy ride. But it’s really a way for your body to get through these last years of having fertility, and unfortunately, it doesn’t happen in the regular pattern that we’re used to.”
Dr. Karolina Skrzypek, founder and CEO of Naturamed.
Symptoms such as brain fog, hot flashes and low libido are common, she says but women are also at an increased risk of heart attack, strokes and reduced bone density.
“If you’re having symptoms at least several times a week and it’s interfering with your life, you need to be seen by a professional,” says Skrzypek. “Your symptoms need to be reviewed, because yes, sometimes it’s hormones, but sometimes it’s the effects of your hormones changing.”