What I Wish My Doctor Had Told Me

Instead of "try meditating more."

I spent three years struggling with symptoms before I discovered the term perimenopause. Three years of escalating migraines, worsening depression, sleep disruption, rage I couldn't explain, brain fog that made me question my sanity, and skin that aged a decade in what felt like overnight.

And during those three years, I saw doctors. Multiple doctors. I described my symptoms. I asked for help.

Here's what I wish they had told me.

1. Perimenopause can start way earlier than you think

I thought menopause was something that happened in your 50s. Hot flashes, then your period stops, then it's over. That was the extent of my education.

What nobody told me: perimenopause — the transition to menopause — can start in your late 30s or early 40s. For some women, even earlier. And this transition can last 4 to 10 years.

I was 38 when my symptoms started getting bad. I didn't connect them to hormones because I thought I was "too young" for that.

I wasn't too young. I just wasn't informed.

2. The symptom list is enormous — and hot flashes are just the beginning

When I finally found Dr. Mary Claire Haver's book The New Menopause, I saw a list of over 70 symptoms associated with perimenopause and menopause. Seventy.

Here are just a few that nobody warned me about:

I had been experiencing multiple symptoms on this list for years. But because no one told me they could be connected to hormonal changes, I thought I was just falling apart.

3. Your depression and anxiety meds may work better WITH hormone therapy

This one makes me genuinely angry.

I've managed depression for years. I knew what my baseline was. When perimenopause hit, my depression worsened significantly — to the point where I knew it was getting dangerously bad.

What I wish someone had told me: antidepressants and anti-anxiety medications often work better for perimenopausal women when used alongside hormone replacement therapy. The hormones create a foundation that helps the other medications do their job more effectively.

Instead, I white-knuckled it for years, thinking my meds had just stopped working.

4. HRT is not the scary thing you've been told it is

My physician told me just last year, after I had already started HRT, that I shouldn't use HRT because my mother is a breast cancer survivor. End of conversation. No nuance, no discussion of my individual risk factors, no explanation of the actual research.

What I wish she had told me: The fear around HRT largely stems from a misinterpreted study from the early 2000s (the Women's Health Initiative). The headlines were misleading. The data has since been re-analyzed and clarified. For many women — especially those who start HRT in early menopause — the benefits significantly outweigh the risks.

I lost years of quality of life because of outdated, fear-based information.

5. Blood tests aren't always helpful during perimenopause

Here's a fun one: your hormones fluctuate so wildly during perimenopause that a single blood test might not show anything "abnormal." You could test on a day when your estrogen happens to be in a normal range, and your doctor might tell you everything's fine.

Meanwhile, you're not sleeping, your brain isn't working, and you want to scream at everyone you love.

Perimenopause is often a clinical diagnosis — meaning it's based on your symptoms and history, not just lab work. A doctor who dismisses your experience because your labs look "normal" doesn't understand how this transition works.

6. There are doctors who specialize in this — and telehealth options exist

After years of getting nowhere with my young female PCP (who, for the record, should have known better), I found Winona — a telehealth company specializing in menopause care.

I took an online quiz on a Sunday afternoon. A board-certified physician in my state responded within 30 minutes. She answered my questions, approved a treatment plan, and I had my medications by Thursday.

Four days. After years of being dismissed.

Menopause specialists exist. Certified menopause practitioners exist. The North American Menopause Society has a provider directory. You don't have to keep begging doctors who don't get it.

7. This can go on for years — and you don't have to just "tough it out"

The median duration of hot flashes alone is 7.4 years. The full perimenopause transition can last a decade. Some symptoms persist well into postmenopause.

This isn't a phase you just push through. This is a significant chunk of your life. And there are treatments that can help — if someone will actually offer them to you.

You deserve to feel like yourself. You deserve sleep. You deserve a brain that works. You deserve to not be dismissed with "well, you're at that age."

8. You will probably have to advocate for yourself

This is the hardest one.

In a perfect world, our healthcare providers would be educated about perimenopause and menopause. They would ask about our symptoms proactively. They would offer evidence-based treatments without us having to beg.

We don't live in that world yet.

So until we do: read the books, bring the research, find the specialists, switch providers if you have to. Your quality of life is worth the fight.

The books that changed everything for me

If your doctor isn't giving you the information you need, these will:

This is why I started this website. So that maybe you don't have to spend three years wondering what's wrong with you.

You're not broken. You're not crazy. You're not "just stressed."

You're in perimenopause. And you deserve better care than most of us are getting.

— Shea

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I am not a medical professional. This is my personal experience and should not be taken as medical advice. Please consult with a healthcare provider about what's right for you.