Perimenopause and menopause can cause a variety of issues and symptoms for women over thirty. I experienced changes in how I felt daily and monthly that I wanted to get in front of. From super dry skin to not feeling like myself mentally to debilitating headaches to unexplained insomnia — I got sick of my doctor brushing off how this was impacting my everyday life. And I didn’t want to treat it with things I wasn’t comfortable taking regularly.

Instead, I took a seminar, Inner Peace Wellness, led by Jill Baker, Family Nurse Practitioner, and Polly Ely, MFT. You can also see another post on these beautiful learnings here. Along with this great seminar that taught me so much, I sat down with the CEO of the organization Let’s Talk Menopause, Donna Klassen, to answer all of my burning questions about perimenopause and menopause symptoms to ensure I was on the right track to better health through all of it. 

1) What are the most common symptoms of menopause?

Menopause can cause depression, anxiousness, irregular heartbeat, dizziness, sleeplessness, hot flashes, day sweats, night sweats, chills, irritability, weight gain, hair loss, and more. All of these symptoms, according to the National Institute of Health, are normal and just a part of sexual maturation called menopause. It is not a disease or condition, even though people experience many symptoms without treatment. Not only are we usually told to minimize our suffering with these typical symptoms, but the duration we are required to feel crappy with this full-body takeover, according to the National Institute of Aging, can take up to 14 years.

2) What’s the average age of menopause, and how can women feel more supported through this transition?

The average age of menopause sufferers is 45 to 55, give or take a few years for perimenopausal symptoms, which is several years before that. There is an excellent quote by Tricia Posner, a British nonfiction writer and author of This Is Not Your Mother’s Menopause, where she writes, “Our mothers were largely silent about what happened to them as they pass through this midlife change. But a new generation of women has already started to break the wall of silence.” 

Donna Klassen and Samara Daley are two of those women who founded the national nonprofit called Let’s Talk Menopause. These women have interviewed Oprah and many other prominent people who have been more vocal on this topic, and their website hosts a plethora of staggering stats that can help women feel less alone on the journey.  For instance, 27 million, representing 20% of the workforce, are in some phase of menopause transition. So, harnessing facts on average menopause age windows and finding the proper support can help.

The organization started in 2021, but the idea came to Donna, a Licensed Clinical Social Worker, in 2019 after her own experience with menopause. She went through surgical menopause after having breast cancer and found the healthcare around menopause and the education to be lacking. “I’m a therapist and a social worker, and I’ve worked most recently in the last 10-15 years around reproductive mental health, helping with struggles during postpartum, the perinatal period, and postpartum. So, I have experience with mental health around these hormonal shifts. And one of the things about menopause is that it often causes a lot of mental health symptoms,” she says. Getting support, understanding the average age to be on the lookout for changes, and knowing where to go for support can help.

3) What can you look out for regarding the signs and symptoms of perimenopause? 

According to Donna, “There are three windows of vulnerability for women. The first is puberty and periods, the second is the perinatal period (pregnancy and postpartum), and the third is perimenopause. But a lot of people don’t know that they are in perimenopause versus others since everyone’s experience is different, and we don’t have any visibility into when menopause will hit.” The key symptoms of irritability that happen during the perimenopause phase can be hard to distinguish and diagnose. 

The more significant transition that does get the most focus, and we know for certain, is menopause because when you’re in this phase, you’re always in it, and there is a distinct marker of no period for over a year to determine it. However, symptoms of perimenopause can start four to 10 years before your final period. And what’s confusing is you don’t know when that final period will be. 

4) Why are perimenopause and menopause symptoms so hard to treat?

Unfortunately, hormone treatments have gotten a bad reputation. There was an extensive study that happened in 2002 that has been looked at again and reevaluated, as it overstated the risk of breast cancer. At that time, about 50% of women were taking hormone therapy, and after that study, it dropped to just 5%, and now it’s just barely above 5%. “Part of it is not knowing that options are limited because women have generally been understudied, under-researched, and not enough money has been dedicated to studying menopause. The risks have been overstated versus acknowledging that they are generally safe,” says Donna. 

The North American Menopause Society made its recommendations in 2022 and encouraged people to do a risk-benefit analysis with their medical provider. “But the main problem is, is that after that study happened, menopause was taken out of the curriculum in medical school,” says Donna. Today’s doctors, including GYNs, don’t have a lot of education about menopause. Eighty percent of OB-GYNs said they felt unprepared coming out of school to talk to a woman about menopause. If the doctors and the providers aren’t informed, how are the patients supposed to know what’s happening? The overarching issue is that women are not educated, and doctors are not educated about basic facts and what happens during this time.

5) How do perimenopausal symptoms differ amongst ethnic groups?

“There was an extensive research study called SWAN, and it shows that black women and Latina women have more prolonged menopause symptoms, and their hot flashes start earlier and last longer,” says Donna. The same study shows that hot flashes not only affect sleep—they can affect your heart. New research is coming out that it’s not just being hot.

6) What other new research have you heard or seen about menopause?

“Systemic estrogen alone (for women without a uterus) studies show that it reduces your risk of breast cancer. Estrogen plus progesterone studies show a small increase in the risk of breast cancer,” says Donna. We’ve been taught to fear getting breast cancer with hormone therapy and instead not looking at the whole picture. But another way to look at this time is instead of a window of vulnerability, it’s also a window of opportunity. It’s a time to focus on good health relating to your bones, heart, and brain, which all get impacted when estrogen is lower since it lubricates every body part.

7) What other things get impacted when we enter menopause?

Many people don’t know about the Genitourinary Syndrome of Menopause (GSM), which is a new term. It’s essentially referring to the vaginal atrophy that happens during this process due to the lack of lubrication. It encompasses a vast constellation of symptoms, like vaginal and urinary issues, including vaginal dryness. “Estrogen is a lubricant, so when you become dry, intercourse can be painful, there are increased urinary urges and leaking, and also increased UTIs, which can be deadly,” says Donna. This is because the urinary wall becomes thinner, and the lining is thinner and shortens. So therefore, there’s no barrier between the anal wall and the vaginal wall, which increases the risk of UTIs. 

8) What treatments can help with vaginal dryness when estrogen decreases in menopause? 

One treatment is local vaginal estrogen. Some don’t directly contain estrogen called Interosa but instead include DHEA, which converts to estrogen in the body. It is another route to take and discuss with your doctor if you experience painful sex with dryness. There is also a hyaluronic acid called Revaree which can be used in between intercourse to hydrate and moisturize vaginal tissues naturally. “But be mindful and cautious as always when selecting products since supplements in the US are not as regulated,” says Donna. The FDA recently approved a safe medication for hot flashes called Veozah (fezolinetant).

9) Are there any other tests or symptoms to watch out for that can help manage menopause?

Unfortunately, right now, the guidelines say to wait to get your first DEXA scan, which is a scan to measure how much bone mass you have until you are 65. A menopause-informed provider can help. You can go to, which links you to the North American Menopause Society, now called the Menopause Society. They have a list of certified providers, and these are providers who have more training in menopause in particular.

10)  What else can we do to support more research on menopause?

There is a bill in the works with Yvette Clark, a Brooklyn congresswoman. It has yet to be introduced, so it’s just a bill. However, a coalition of doctors and other advocates is working hard to get this passed. “It will give more money for research and redo that study from 2002 to do a more comprehensive study on hormone therapy. There has been a lot of talk, and in the last couple of years, menopause has sort of come out of the shadows, but we still have a lot of work to do,” says Donna. The goal is to ensure that women’s health gets studied more and that there’s the money to do so.

You can go to and sign up for monthly updates. You can also listen to our full episode 104: Getting In Front of Menopause Symptoms—New Help for 30’s+, which details the above in greater detail. And if you want to read more advice, check out our article on 4 Mom Survival Tips That Help During Menopause.