It wasn’t until Arianna Sholes-Douglas wanted to kill her husband that she wondered if she might be going through perimenopause. (To be clear, she Googled “how to poison someone” to make herself laugh and cut through her irrationally bad mood. Sometimes dark humor works!)

She was in her late 30s to early 40s and symptoms were stacking up: night sweats, hot flashes, awful sleep, seemingly PO’d nonstop. “I was still getting my period, but I felt like I was dealing with PMS all the time,” she says. “That’s when I was like, ‘Is perimenopause happening here?’ ”

When Sholes-Douglas realized the answer was yes, she was relieved—but embarrassed and annoyed that she hadn’t figured it out sooner. After all, she’s a gynecologist. “If it didn’t even enter my consciousness that my symptoms had to do with hormones—and I’m a women’s health specialist—I wondered what other women were up against.”

The answer: a lot of confusion, misinformation, and negative cultural baggage about being so, ya know, hormonal. (Cue eye roll.) While 6,000 women hit meno every day, most don’t know exactly what to expect, when to expect it, and what to do about it, says JoAnn Pinkerton, MD, a professor of obstetrics and gynecology at the University of Virginia Health System, who specializes in midlife health.

“If it didn’t even enter my consciousness that my symptoms had to do with hormones—and I’m a women’s health specialist—I wondered what other women were up against.”

Thankfully, it’s 2022 and this is (at last!) starting to change. New companies and brands are popping up left and right with products aimed at helping women in perimenopause and beyond. Memes of a 50-year-old, pole-dancing J.Lo have given us new #Goals on what middle age can look like. This may seem like meno overload, but ultimately, all of this progress is making it more likely that we’ll feel comfortable talking to friends, partners, even coworkers about it, says Dr. Sholes-Douglas, who is also the author of The Menopause Myth: What Your Mother, Doctor, and Friends Haven’t Told You About Life After 35.

The sooner you understand what to expect, the better your odds of navigating the phases with ease. Ahead, the latest science, savior products, and must-know health hacks to get across that finish line.

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Perimenopause, for some, can be the hormonal roller coaster, says Chrisandra Shufelt, MD. “The same symptoms we see during menopause can actually start during perimenopause.” Mind-blow! A timeline to clue you in to where you’re at…

How To Find A Menopause Specialist Who *Really* Gets It

Once you’re done baby making, working with a specialist can be life-changing, says Dr. Pinkerton. But they’re tough to find. Fewer than one in five U.S. obstetrics and gynecology residents receives formal training in menopause medicine, per a Johns Hopkins survey.

To make the search easier, go to the NAMS website ( and plug your zip code into their Find a Menopause Practitioner portal. “These providers are certified to help women through perimenopause, and they take a test to prove it,” says Stephanie Faubion, MD, director for the Mayo Clinic’s Center for Women’s Health and medical director of NAMS. NAMS-certified pros also attend continuing education courses to make sure they remain current on their advice and protocols, she adds.

Remember: “You could see your ob-gyn…or an endocrinologist, internal medicine specialist, or nurse practitioner who specializes in midlife health,” says Dr. Shufelt. The key is making sure your practitioner is trained (and has a genuine interest) in the many changes that occur.

Can’t find a specialist near you? This is one area where telehealth works well. “You can get a lot of personalized advice from a virtual appointment,” Dr. Shufelt says.

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Internal thermostat malfunctioning? This wearable was created by MIT scientists to send cooling or warming sensations to the wrist, where there are lots of thermoreceptors that’ll change your perception of how hot or cold you are.

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The company’s mission is simple: to allow women to care for their bodies holistically during this time—with very specific symptom-targeted supplements and topical body products. They also host “couch conversations” with big names, like Gloria Steinem.

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Finally: a beauty brand geared toward women on the meno path. With potent products for everything from dry skin to incontinence and vaginal dryness, the brand and its playful marketing remind you the best is yet to come.


Now for a mobile app to help you decipher what’s going on: The calendar view lets you look for patterns or triggers at a glance, and it’s also a useful snapshot to bring to your doc. And check out the community forum to share insights, frustrations, and experiences with others. Free,

How To Adjust Your Workout Routine When You Hit Menopause

Once you hit your 40s and 50s, it’s time to tweak your strength-training approach. Why? The proteins that prompt muscle contraction have a lot of estrogen receptors, says physiologist Stacy Sims, PhD—which means when estrogen tanks during peri, your muscles’ ability to engage properly takes a hit. “Lifting heavier weights forces those strong muscle contractions, which makes up for the lack of estrogen.”

This life stage is all about greater loads and fewer reps. Sims suggests building up to a weight with which you can do four or five sets of 6 reps, max. “Add 10 percent more weight to what you currently consider heavy for you and see how many reps you can do with proper form,” says Sims. “If you can eke out only 1 or 2 reps during your fourth set, you know you’re lifting heavy enough.”

If weights are a new frontier for you, use this as reason to give them a shot. You’ve got nothin’ to lose—and stronger bones and joints, stability, and sweet muscles to gain. *Grabs kettlebell*


An Update On Hormone Therapy

Ask your mom or aunt about hormone replacement therapy (HRT)—using synthetic estrogen and progesterone to supplement the levels that tank after menopause—and they’ll tell you about headlines that linked it to cancer, after research in the ’90s suggested HRT had more negative than positive effects. Well, it later came out that the study was inadequately executed and interpreted. Plus, experts reanalyzed the study and conducted fresh research, proving the benefits and calling the cancer connection into question. In short, this treatment has come a looong way, Dr. Faubion. What every woman needs to know now:

The treatment got a new name.

It’s known simply as hormone therapy (HT) these days, says Dr. Faubion—which is more accurate compared to the former name, hormone replacement therapy. “We’re not trying to replace the estrogen and progesterone the ovary used to make,” she says. “We’re just supplementing if needed for symptom relief.”

Not everyone requires HT.

In fact, if you sail through meno with minimal symptoms, your doc might not even mention it to you. “We use HT only if it’s necessary,” says Dr. Faubion. You likely won’t hear about it unless it’s been a year since your last period. (Symptoms during the peri years? You’re more likely to get an Rx for low-dose BC.)

It doesn’t involve some scary hormone blast overload.

Get this: With HT, you’re taking in roughly one-fifth the amount of estrogen found in the Pill. “A lot of women don’t realize that if they’ve ever taken hormonal birth control, they’ve already taken higher doses of estrogen than what’s used for menopause symptom management,” says Dr. Faubion.

HT brings other health benefits.

While it’s prescribed only to treat meno-related issues, research shows it can also strengthen your bones and protect your heart. It may also protect brain regions that are vulnerable to Alzheimer’s, found a recent study. “The benefits far outweigh the risks for women in their 50s,” says Dr. Faubion.

This article appears in the March 2022 issue of Women’s Health. Become a Women’s Health+ member now.