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Navigating the Change: Your Perimenopause Playbook

Navigating the Change: Your Perimenopause Playbook



This is your Women's Health Podcast podcast.

Welcome, listeners, to the Women’s Health Podcast. I’m thrilled you’ve tuned in today for an essential conversation about perimenopause—a chapter in women’s health that is often shrouded in mystery, but which deserves to be met with clarity, courage, and empowerment. My goal is for you to walk away not just informed, but truly equipped to take control of your health journey or support someone you love through this transition.

So let’s get right to the heart of today’s topic. Perimenopause isn’t just a clinical term; it’s a lived experience for millions of women, typically kicking in during our 40s, though it can begin earlier for some. This is the time leading up to menopause, where estrogen levels become irregular, and the body starts signaling change. Symptoms range widely—from irregular periods, hot flashes, and night sweats to mood swings, sleep disruptions, and changes in concentration. According to Mayo Clinic, some women breeze through it, while others can find every day a challenge.

It’s time to talk solutions. Today, I’m joined by Dr. Samantha Miller, a renowned women’s health specialist from Franciscan Health. We dig into the realities and the myths. Here’s a glimpse of that conversation.

First, I ask Dr. Miller: What are the earliest signs someone might be entering perimenopause? She explains that changes in menstrual patterns—heavier, lighter, more or less frequent—are usually the first clue. Hot flashes and sleep issues often follow, but she notes that perimenopause doesn’t look the same for everyone.

Next, I want to know: With all the confusing information out there, what truly works to ease symptoms? Dr. Miller emphasizes that “Hormone therapy is still the most effective tool,” especially for hot flashes and night sweats, but that newer research shows risks are often lower when treatment is started in perimenopause, not years later. For those who can’t or choose not to use hormones, options include low-dose antidepressants, lifestyle overhauls, and symptom-targeted therapies—like fezolinetant, a non-hormonal medicine designed specifically for moderate to severe hot flashes.

Of course, I ask about popular alternatives. Dr. Miller encourages a healthy skepticism—bioidentical hormones that are FDA-approved are safe and can help, but custom-mixed compounded hormones are less regulated and lack solid research backing. Herbal supplements may show up in your online searches, but she cautions: talk to your doctor first, as many aren’t well regulated and could interact with other medications.

Finally, I want practical tips listeners can act on now. Dr. Miller stresses the importance of an active lifestyle: consistent exercise, strength training, a Mediterranean-style diet, prioritizing sleep, and mind-body practices like yoga or mindfulness meditation. These help minimize symptoms and guard against long-term impacts like bone loss, heart disease, and weight gain, all of which become more likely in our 40s and 50s.

Here are my key takeaways from this episode: Every woman’s perimenopause experience is unique and valid. There are options—both medical and lifestyle-focused—that can make a big difference. Advocating for your own health and finding a provider who listens is essential. Remember, talking openly about these changes is an act of self-respect and strength, not only for ourselves but for the next generation.

Thank you for tuning in to the Women’s Health Podcast. Please remember to subscribe so you never miss an episode. This has been a quiet please production, for more check out quiet please dot ai.

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