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Perimenopause & Menopause: 10 Things You Should Know

By Christina Hanna, MPH, CHES • Last Updated 11/24/2025

If you’ve ever thought, “I just don’t feel like myself lately,” you’re not alone and you’re not imagining it. That phrase echoed throughout The Menopause Society’s 2025 Annual Meeting, where our Versalie brand team gathered insights from leading experts in women’s midlife health. 

This was our third year attending, and each time we walk away with new knowledge and deeper compassion. Here are the top takeaways we believe every woman should know and discuss with her doctor. 

1. Perimenopause can start earlier than you think 

Many assume menopause symptoms begin after age 50, but experts recommend that providers start conversations as early as 35–40. Perimenopause is gradual transition that can span years. And with 6,000 women entering menopause daily in the US, it’s time to talk about it more openly, with our friends, families, and our healthcare providers. 

2. ‘Not feeling like myself’ is a valid symptom 

It’s not just hot flashes or irregular periods. People going through this transition report sleep disturbances, anxiety, mood swings, brain fog, skin tingling, and even changes in body odor. These symptoms are real, even if they’re hard to measure. 

If you’ve ever felt dismissed or confused by your symptoms, know that your experience is valid. 

3. Hormones aren’t the whole story 

Menopause hormone therapy (MHT) can help some, but it’s not a one-size-fits-all solution. Estrogen levels fluctuate unpredictably, making treatment complex. Lifestyle changes, mental health support, and personalized care are just as important. 

4. Sleep and menopause: Why better rest improves midlife health 

Poor sleep isn’t just exhausting — it’s linked to weight gain, mood changes, and heart health. Experts emphasized that sleep quality often worsens during midlife. Addressing it can help improve everything from diet to emotional well-being. 

5. Trauma history can affect menopause symptoms 

Women with a history of trauma, whether in childhood or adulthood, may experience more severe menopause symptoms, including night sweats, depression, and cardiovascular issues. Trauma-informed care isn’t optional — it’s essential. 

6. Your heart health deserves attention 

Heart disease is the leading cause of death in women, yet awareness is declining. Midlife is a critical time to assess blood pressure, cholesterol, and sleep. Women’s symptoms often differ from men’s, so don’t ignore subtle signs and symptoms. 

7. Bone health starts now 

Osteoporosis risk begins during perimenopause. Bone density and strength declines earlier than many expect, and early screening can help prevent fractures. Estrogen therapy may help, but so can strength training, calcium-rich diets, and regular monitoring. 

8. Vulvar and vaginal health is often overlooked 

Postmenopausal changes in the vulva and vagina, like dryness and pain, are common but rarely discussed. Treatments include topical therapies, pelvic floor physical therapy, and multidisciplinary care. 

Don’t hesitate to bring these symptoms up with your provider. You deserve comfort and care. 

9. Breast cancer screening is evolving 

New guidelines suggest risk assessments by age 25 and earlier screenings for high-risk individuals. Dense breast tissue is a significant risk factor, and AI tools are helping personalize screening strategies. 

10. You have choices and the right to make them 

Whether it’s contraception, hormone therapy, or lifestyle changes, you deserve to understand your options. Ask questions. Seek evidence. And remember: choosing to treat, not treat, or defer is your right. 

Final thought: There’s zest after this 

Perimenopause isn’t just a list of symptoms. Let’s shift the conversation from fear to possibility. Your brain, heart, bones, and spirit all deserve care. And you deserve to feel like yourself again. Maybe even a stronger, wiser version. 

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