A common refrain from patients is, “I don’t feel like myself,” or, “I’ve gained weight, but I haven’t changed my eating or exercise habits.” Often, they see their doctor because of trouble sleeping, low energy, weight gain, depression or irritability. Blood work may reveal high cholesterol or low thyroid function, leading to medications and advice to eat healthier and exercise. They follow those recommendations but still don’t feel better. Even when lab results improve, they may wonder if the symptoms are in their head.

When women’s hormones fluctuate during perimenopause and menopause, systems are affected. Less recognized symptoms include dry skin, short-term memory problems, rapid pulse rate, cramping, nausea, sleep disturbances, joint and muscle pain and anxiety. These symptoms may be hormone-related.

Historically, menopause was viewed as a normal decline. Fear surrounding hormone replacement contributed to decreased use in the 1990s and 2000s, and concerns persist despite research showing potential benefits of HRT, including preventing osteoporosis and improving sleep.

Finding a practitioner trained in menopause health can help women understand symptoms, consider testing and discuss hormone replacement options. Choosing treatment is a partnership between a woman and her doctor.

The symptoms of perimenopause and menopause are not all in your head, nor are they a normal part of getting older. HRT should be a conversation women have with their medical provider.