I believe I am in perimenopause but my cycle is still almost perfectly regular. I’m 41, had one ovary removed at 28. I have many symptoms about 2 years on which I recently learned are associated with perimenopause – brain fog, sleeplessness, fatigue, anger, migraines – but can it be perimenopause with no changes in my cycle? Thank you!

I was an athlete in my late teens and early 20s and had hypothalamic amenorrhea for ~10 years during that time. Will this have any implications for when I start perimenopause?

Is there an age at which you absolutely have to stop combined OCPs because of cardiac, cancer, or other health risks (assuming an otherwise average risk woman)? On them for fun hormonal acne in my 40s. Also, will I finally be finished with acne after menopause?

I am 39, and I started premature menopause at age 38 (FSH >130 several times, ultrasound of ovaries, no period for over a year, etc.). With several dr.’s (a very research-oriented OBGYN, a GP, and an endocrinologist) all in consensus that the cause is “unknown,” I feel pretty great. What I feel terrible on is estrogen (despite my levels being close to zero)? How much estrogen replacement do I actually need? I’m super healthy, I exercise a lot, including lots of weight-bearing activity. I climb big mountains. I just feel AWFUL when I’m on estrogen, but I understand that I will need it for the next 12 ish years. What should I do?

I was told by a doctor once that spending 10 years on birth control will delay Menopause by the same amount of time. Is that true?

On Tuesday, you said “high cholesterol and high blood sugar that can crop up as we move into our 40s and 50s.”
Yes! That! But why?????? I’ve always been healthy, always blood pressure on the low end of normal and always normal, healthy labs. I always ate healthy: no chips, no soda, not too much sugar, little to no fast food, healthy meals with chicken, fish, or tofu, and, of course, my night cheese, a family tradition since I was young:). And suddenly after my 2nd child at 37, the weight didn’t really come off after pregnancy. After my 3rd at 42, the weight keeps going up 3-5 lbs every 3months(I’m weighed when I get my depo shot). And now (I’m 45) my doctor says I’m “pre-diabetic” and have high cholesterol. WTF!!! I don’t think I’ve changed anything so what’s happening and how do I reverse it when nothing seems to have caused it in the first place?! Hate that dieting or Ozempic is my doctor’s solution when I’m not ready to do either. I’ve never dieted and I’m not going to start with 3 young, impressionable daughters in my house one of whom already mentioned needing to burn calories at age 9; they’re all perfectly healthy and small for their ages (we’re a small family). I’m not so much concerned about the weight, though I know I need to move more, but the labs just make no sense and I imagine it’s all connected. What is going on?

So thankful for the Hot Flash newsletter! I’m 46 and am in perimenopause. I am also a breast cancer survivor and am taking Tamoxifen. I have frequent and intense hot flashes and struggle to sleep. I’m having a difficult time finding any options that will help manage these symptoms without affecting the efficacy of the Tamoxifen. Any suggestions would be greatly appreciated. Thank you!

I’m in my mid-30s with a very regular cycle, but in the past year I’ve had a lot of breast pain (tenderness, etc. – like a pre-teen growing boobs kind of pain). It’s uncomfortable and particularly bothers me when I’m working out. There does not seem to be a pattern – it’s not at the same moment in my cycle every month, for example. I talked to my OBGYN who ruled out anything serious and said “it sounds hormone-related.” But my question: Why would this be happening? Why all of a sudden? How common is this? And is there anything I can do about it?

Can you talk about premature menopause/primary ovarian insufficiency? I’ve experienced it at age 36/37 and am taking hormone replacement therapy. Since developing menopausal symptoms so early, I have learned about more and more people experiencing early menopause. Is there any data that it’s happening more often? Is there any data about long-term health if you have this condition? It would also be great to include those of us in our 30s in the general discussion! Thank you!

Add me to the list of people asking about primary ovarian insufficiency. I went through menopause at 38. I tried vaginal estrogen and HRT and had terrible bleeding, then needed a hysteroscopy and biopsy to rule out uterine cancer. Needless to say, it scared me from ever trying it again. I’ve gone to multiple doctors, who range from telling me it’s very important to use HRT for bone and heart health, to others who say it’s really my choice and if I can handle the side effects, to being told a hysterectomy is an option if I don’t want to worry about abnormal bleeding, hyperplasia, and uterine cancer. I am also worried about breast cancer and the mixed evidence on synthetic vs micronized progestin. It feels like an impossible choice to make: increase risk of breast and uterine cancer or risk of heart disease and osteoporosis.

I cannot get a simple answer on how at risk for osteoporosis & heart disease am I without using HRT? How much estrogen is needed to provide bone health? How do I weight the risks and benefits of these decisions? I don’t have many menopausal symptoms, so it seems odd to take hormones to prevent future conditions I may never get. Help please! Feeling very confused and alone.

I am 46 and for the past 4 years will go 4-6 months with no period, then I will either spot or every so often have a full fledged period. My doctor did lots of tests including a uterine biopsy. All she said was I have an “aging uterus” and this is all normal. Realistically, how long could this go on before it stops altogether and should I be concerned at all about an unwanted pregnancy? It seems unlikely but I’m not really sure.

Entering my 40s and now developing acne?! What gives? To be fair, it’s probably not full blown acne but definitely more pimples around my chin area and I’ve read that can be related to hormonal fluctuations? Especially if not something experienced in earlier life.

I would love an answer on this!

Should we pursue hormone replacement therapy? I’ve read so much about the hormone change being a big deal and related to developing dementia. Please advise!

As we enter our post reproductive years/perimenaupause, what dietary changes should we be making to help mitigate weight gain? Snacking vs. three big meals, more protein, less carbohydrates? Any general recommendations?