March 27, 2026
77. Is It Perimenopause? 100+ Symptoms and How to Advocate for Yourself, with Meghan Rabbitt
Are you in your late 30s or your 40s and wondering if your sudden mood swings, brain fog, or even itchy ears are just stress—or if they are the start of perimenopause? You’re NOT alone, and it is perfectly normal to feel confused.
In this episode of Mind Your Midlife, Cheryl is joined by veteran health journalist Meghan Rabbitt, author of the incredibly comprehensive new book, The New Rules of Women’s Health: Your Guide to Thriving at Every Age. We dive into why we need to move beyond "bikini medicine" and look at the whole picture of women's health. Meghan shares her expert research on decoding perimenopause, prepping for doctor appointments, and what your past pregnancies might reveal about your future heart health.
If you are ready to stop second-guessing your symptoms and start getting the care you deserve, this episode is for you.
What You’ll Learn:
✔ The Symptom Checklist: Perimenopause encompasses over 100 different symptoms, including surprising ones
✔ How to Prep for the Doctor: Treat your doctor's appointment like a meeting with your accountant by bringing a prioritized list of your symptoms
✔ The "Advocate" Strategy: Bringing a trusted friend or partner to your appointment is a game-changer
✔ The Upsides of Menopause: The transition can lead to increased confidence, stepping into your own power, and caring less about the little things
🎯 OMG Moment:
Track your symptoms. Know yourself. You'll be empowered to speak up and to get the care - and the discussions about that care - that you need.
Take Action Today:
- Read the Book: Pick up a copy of Meghan's book, The New Rules of Women’s Health, to educate yourself on everything from gut and brain health to menopause.
- Find Meghan Online: Follow her on Instagram @meghanrabbitt or visit thenewrulesofwomenshealth.com for ongoing advocacy tips.
Take a little bit better care of yourself in midlife.
*Start your day with Energy Fizz and GreenSynergy Elixir: cherylpfischer.com/recommendations (and use the code ARBONNE10)
🌸 Liked this episode? Share it with fellow Gen X women navigating hormone balance, an empty nest, and/or self-confidence!
🫶 Love this show? Leave a review to help more women over 50 find us.
💡Want menopause advice, mindset shifts, or support with midlife transformation?
- Book a free Mindset Coaching / Intro Call: cherylpfischer.com/coaching
Let’s talk health after 50, self-talk, and redefining aging for women — without the “midlife crisis” narrative. Every week I'm adding new success strategies for midlife women.
Connect with Cheryl, Midlife Coach: Instagram | LinkedIn | Website
00:45 - What Perimenopause Really Means
04:26 - Track Symptoms Like A Pro
06:15 - The Surprising Symptom List
14:38 - Preparing For Doctor Visits
15:18 - Hormone Therapy Timing And Safety
20:53 - Other Treatments Plus Unexpected Upsides
25:40 - Hot Flashes And Heart Health Links
28:17 - What To Do If Dismissed
30:39 - [Ad] I Am That Content Creator Podcast
30:40 - (Cont.) What To Do If Dismissed
33:51 - The New Rules Of Women’s Health
37:37 - One Takeaway And Final Call To Action
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Perimenopause.
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We've talked about menopause quite a bit on this podcast.
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And in the show notes, I'm gonna link some of the episodes.
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Truly, we have talked about it a lot and looked from different angles, but we haven't necessarily talked about perimenopause.
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And that can be anywhere from late 30s up into 50s.
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So let's talk about it.
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Welcome to Mind Your Midlife, your go-to resource for confidence and success, one thought at a time.
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Unlike most advice out there, we believe that simply telling you to believe in yourself or change your habits isn't enough to wake up excited about life or feel truly confident in your body.
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Each week, you'll gain actionable strategies and, oh my goodness, powerful insights to stop feeling stuck and start loving your midlife.
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This is the Mind Your Midlife podcast.
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One of the things we need to do is figure out what in the world does perimenopause mean?
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So technically, the definition of menopause is if you have gone 12 months without having a period, on that day when you hit 12 months, that's menopause.
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Anything after that, you're postmenopausal.
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Anything before that, from the time that you start having symptoms, your body maybe starts changing hormone levels, various processes that could go on for years, is perimenopause.
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So as you might imagine and maybe have experienced yourself, how do you know?
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How do you know what's going on?
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How do you know if you can manage this yourself or or you need a doctor's help in some way or another?
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How do you know if you're not just having a bad day or a bad week or you're too stressed out?
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That's what we want to talk about.
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And my guest today, Meghan Rabbitt, is the author of the new book, The New Rules of Women's Health: Your Guide to Thriving at Every Age.
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Now, she has always specialized in writing about women's health and wellness, and has written for many publications, including Women's Health, Oprah Daily, Prevention, Maria Shriver's Sunday Paper, and more.
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And I have to tell you, if you're listening, I have never seen, and you're going to hear me say this in the episode, I have never seen a guide to women's health that is this comprehensive.
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It is going to walk you through every stage of life.
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And it's not just about menopause or pregnancy.
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It's about gut health and brain health and all these things.
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Truly amazing.
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And I will make sure that the link is in the show notes.
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And so Meghan is here with us today to talk about what she found in researching this book, focusing on this whole question of what in the world is perimenopause and what's going on with it.
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So welcome Meghan.
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Thank you so much for having me.
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I'm excited to talk about this because we're going to come at a subject that is really important that we talk about a lot, and we're going to come at it from a little bit different angle.
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So we're going to talk about perimenopause today.
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And I think in my head, the trickiest thing, or I guess one of the tricky things about perimenopause is to even know whether you're in perimenopause.
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When does it actually start?
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How do I know?
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Am I just being forgetful or whatever the symptom is?
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So how can women recognize this a little more clearly?
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Yeah, I think the first thing to understand, what I now understand based on all the reporting I did for my book, is that if you're feeling a little confused because you're not really sure if this is a symptom of perimenopause or something else, like join the club.
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You're really like, take a deep breath, you're normal.
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It's really confusing, right?
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Because there are over a hundred different symptoms that we now know actually constitute perimenopause or might constitute perimenopause.
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So I think that's first and foremost.
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Like take a deep breath.
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Let's all collectively sigh and say, wow, this might be hard to navigate, but I'm up for it.
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So here we go.
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So then, you know, really, I think what another big trend in what I heard from doctors and researchers and other clinicians taking care of women in midlife is that we really have to track everything that's going on for us.
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So get out your notebook, take out your notes app on your phone and really keep track of your symptoms, not just your cycle.
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I think when it comes to menopause and the menopause transition, a lot of us think it's our period that really matters the most.
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And that does matter.
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It's now more than ever before, perhaps.
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It's really important to keep track of that cycle because during perimenopause, our cycles tend to change and that can give our doctors clues.
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But really, symptoms, you know, everything and anything, even if you think it's not part of perimenopause, write it down and have a conversation with your doctor.
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That's a great point because I think sometimes we get into the doctor's appointment and we're kind of trying to explain that something's a bit wrong, and then we can't remember what we meant to say, and the doctor goes, you're fine, you know.
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Totally, totally.
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You know, and I think also when we talk about it's such a great question because when we talk about these symptoms of perimenopause, it's important to just name a few.
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So I opened up the page of my book where I name, you know, a bunch of them in addition to the common ones, right?
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And so when we think about these symptoms, we're in addition to menstrual cycle changes, we're probably going to think about hot flashes and night sweats.
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Night sweats, interestingly enough, are just a hot flash that happens during sleep.
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They're no different.
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It's the vasomotor symptoms of menopause.
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Genito urinary syndrome of menopause, formerly known as vaginal atrophy.
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So these are changes that happen in the vaginal canal and in our vulvar tissues due to the decrease in estrogen and changes in other hormones happening.
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I think a lot of us understand sleep disturbances are going to happen.
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You know, that's a common one.
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Same thing with mood changes.
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I'll speak personally as a woman solidly in perimenopause.
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I can feel when my moodiness, it almost feels a little hormonal.
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I feel ragey in a way that feels extra than normal or or a little teary, you know.
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So so that, and then you brought up too, brain fog, cognitive issues, really, really common.
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But in addition to those more, you know, uh talked-about symptoms, there are things like anxiety, depression, low or no libido.
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How about this one?
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Dry and itchy skin, like you feel like your skin is crawling, or itchy ears, thinning hair, wrinkles.
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And then we've got, you know, things like dry mouth, dry eyes, a burning tongue and gums, constipation, lightheadedness.
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So these are some of the more subtle symptoms, I think, that you might not think, could that possibly have to do with menopause?
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And perhaps yes.
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All the more reason to have your book at hand, too, to be able to look at that list, right?
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Well, yeah.
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And I think that's a a great point in terms of, you know, whether it's my book or whatever source of information you go to, an understanding of what we're going through, what's potential in this life, big life change, is really important to know because if it's on your radar, then you can say, huh, maybe this is something I need to talk to my doctor about.
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Yeah.
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I agree.
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And the funny thing about this is in my experience, meaning my own as well as people I've talked to, these things happen on such wildly different timelines.
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For me, I had the weird wakes uh wake up at night kind of thing, and I had a few hot flashes for a long time.
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But then when I was really going into actual menopause, is when all the other stuff hit and the itchy ears.
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I had no idea.
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Um that drove me truly, I'm telling you, bananas.
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And it is the weirdest thing, but it was driving me bananas, and I didn't even know why.
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I didn't know that that was a symptom.
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What in the world?
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But it that was really bad.
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Yeah, and I think, you know, Oprah has been really forthcoming about saying she woke up with heart palpitations.
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You know, that can be a symptom of the menopause transition where she was like, I'm having a heart attack.
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And sure enough, it was part of the menopause transition.
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And so, yeah, these things that can not only drive us crazy perhaps, but also be really scary and make us go to the dark place and make us think, uh-uh, what is majorly wrong with me?
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And I think, you know, again, maybe there is something majorly wrong, not to say that to scare people, but to say, look, if you have an intuitive feeling that like I need to see a doctor right now, who listen to that feeling, right?
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And if you're wondering if some of these changes that are happening to your body, to your mind, to your emotions, if you're wondering if they're part of the menopause transition, if you're if that means you're in perimenopause, you know, keep track of the symptoms.
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See if you can spot any trends.
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And then when you go to your doctor, really say, look, I want to show you a list of what I've been dealing with.
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My hunch is that it's perimenopause based on what I know.
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What do you think?
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And then I had a doctor tell me this, which I thought was such a good tip.
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Organize that list in order of priority when it comes to how much the symptom is really messing with your life, is impacting your life, is affecting your everyday activities.
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Because then you're really giving your doctor clues into what's really like the biggest bummer for you so that you can then focus on those issues in your appointment and a probably a short visit.
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Yeah.
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Well, and I guess that maybe tells them where to go next to, ideally.
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Absolutely.
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And it can help them put puzzle pieces together, you know, and say, hmm, yeah, based on all of that you're telling me and your age and what's happening with your cycles, yeah, you're in perimenopause.
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Let's start treating these symptoms.
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And so I think that's, yeah, we really have to take ownership and uh about of our bodies.
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I think as women, we know that we have to be our own best advocate.
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But sometimes it can get a little murky in terms of, well, how do I do that?
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And that is one very concrete way to do it.
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You know, I had another doctor who I interviewed for the book tell me, you would never think to go to your accountant without your binder full of tax information and returns and bookkeeping or whatever it is you need to do your taxes.
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And I think that's really what we the attitude we have to take when we go to see our doctors.
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It's like, I'm gonna come prepared so that you can best help me.
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You know what?
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That's such a great point because I had an experience with a doctor who kind of poo-pooed my symptoms and said, that doesn't sound like anything bad enough that we need to treat.
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Let's just wait and see.
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And I kind of left going, wait a minute, I don't understand.
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And what I had been doing was always choosing women doctors, assuming that, and I still do that, but assuming that automatically any woman doctor would totally see where I was coming from and absolutely understand.
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But yeah, we all experience this so differently.
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I don't think that was, I don't think that was valid of me to assume that.
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I needed to come in maybe with more information.
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It's a great point.
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Yeah, and I I also love and choose if I can female doctors.
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I think it there's a the way, there's a way I feel really comfortable with them.
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And that said, I will say that I have a male gynecologist now, and I absolutely love him because he's listening to me.
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We're talking proactively about hormone therapy and when it might be right for me.
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And and I think that is part of it.
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I come to him with this level of engagement and knowledge, but then he is the kind of clinician who really loves that.
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His eyes light up when I come to him with information, you know?
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And so I think it's really important for us to clue in to that.
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You know, if you do your homework and go to a doctor and and her eyes light up, wow, like that's probably you want on your healthcare posse, right?
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You know, that's someone you want on your team.
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And if someone looks annoyed that you're coming to her with information you read or questions about something, then, you know, if you if you can, if you have choice, it's probably time to fire that doctor and hire a new one.
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Yeah, which is really not a hard thing to do anymore for assuming you're in a fairly urban-ish place.
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Hopefully, you know, as you say, hopefully people have choice.
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Not always.
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Yeah.
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Uh, but that's a great point.
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And actually, I I'm gonna segue from what you just said into let's talk about hormone therapy a little bit, because that's certainly one of the options.
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And I do want to kind of talk about other things as well, but that's one of the options for making this whole period of our lives more smooth and for dealing with the symptoms.
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However, speaking just for myself, I didn't even think about it until I was 53.
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And then I was like, should I should I even look into it?
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Like, when should I do it?
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And if I had been in my mid-40s and just starting to have symptoms, it just never occurred to me.
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So is there a point at which it's too early to talk about hormone therapy?
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How do we deal with that when when we're kind of just starting into this process?
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I think it's such a great question.
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And I feel like you are asking a question that so many women have.
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I can say that I have fielded this question because as I'm out in the world talking about this book in audiences, that is what women want to talk about the most.
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Menopause hormone therapy.
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How early is it to start or how late is it to start?
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And so he, I want to share what I learned in my reporting.
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So I interviewed a nurse practitioner, an incredible menopause specialist, Heather Quayle.
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And she said in her practice, what she does, and I believe a lot of physicians do this as well, a lot of healthcare clinicians, say, we're gonna treat your symptoms.
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And and that certainly among menopause specialists, they will tell you that can be as early as your 30s.
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And so if you another reason to clue into your symptoms, right?
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And so if you're having hot flashes or mood swings or genital urinary syndrome of menopause, you know, things are really changing.
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And a doctor can talk to you and say, huh, based on everything I'm seeing, it's looking like you're likely in perimenopause.
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Most doctors will treat your symptoms with hormone therapy if if you're a candidate.
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Now, I will also say it's really personalized, right?
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And so every doctor I talk to also says you have to have a really detailed conversation that takes into account your personal health history.
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You know, do you have a history of smoking?
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Do you have a history of blood clots that might impact your uh, you know, whether or not you can use hormone therapy?
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Do you have a history of cancer?
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You know, and again, that's not to say that if you have had breast cancer or it runs in your family that you won't be a candidate.
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That thinking has changed a lot.
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That said, you have to be really open and forthcoming with that information so you can have a conversation about whether or not treatment is right for you.
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I think when it comes to is it too late for me to have hormone therapy, that's a whole other issue where, you know, there is a timing hypothesis of hormone therapy.
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What doctors now think is that within about 10 years of you entering menopause, which let's be clear, menopause is one day in time when it's been one year since your last menstrual cycle.
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And so after menopause, you'll be in postmenopause your entire life.
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But usually most doctors are going to say, let's try to do hormone therapy within that 10 years of menopause because the benefits are gonna outweigh the risks.
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After that point, risks might be a little higher.
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Again, it's a really personalized case-by-case basis, but I think knowing that is really empowering, right?
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It's like for your listeners, they can say, okay, now I have this baseline knowledge.
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When I go into my doctor to talk about hormone therapy, at least we don't have to unpack all of that.
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At least I have the basics so that we can just dive right into my case, my history, whether or not it's right for me.
00:17:31.779 --> 00:17:33.139
Yeah, I appreciate that.
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That's a very good point.
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And I really think for a lot of women, I mean, this is the reason you get the question I just asked all the time, but I really think for a lot of women, until we've actually hit menopause, that 12 months has happened, we don't think it would be the right time for this because aren't these menopause treatments, you know?
00:17:52.180 --> 00:17:53.539
Yes, absolutely.
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Such a great point.
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And what Dr.
00:17:54.900 --> 00:18:12.259
Quill said is like, listen, if I treat symptoms, and if we then treat your symptoms and they start getting better, even if you're in your 30s, your late 30s, and we're treating your symptoms with estrogen andor progesterone and you're getting better, you're probably in perimenopause, right?
00:18:12.259 --> 00:18:14.179
And so we're gonna keep you on the therapy.
00:18:14.179 --> 00:18:17.779
And so, yeah, I think it's really they're great questions.
00:18:17.779 --> 00:18:23.059
I think we are collectively talking more about menopause and hormone therapy.
00:18:23.059 --> 00:18:24.980
And this is a great thing, right?
00:18:24.980 --> 00:18:30.339
But because we're talking more about it, and it's not just that all women are terrified to take it, right?
00:18:30.339 --> 00:18:35.139
Which I think for years it was like, no way, I don't even want to talk about hormones.
00:18:35.139 --> 00:18:43.779
And now most of my peers are like, oh yeah, like let's let's talk about this, you know, as as potentially having way more benefits than than detriments and risks.
00:18:43.779 --> 00:18:46.819
But I think because we're talking about it more, we have more questions, you know?
00:18:46.819 --> 00:18:51.460
And and I think it really points to in an ideal world, educate yourself about the basics.
00:18:51.460 --> 00:18:59.299
There's a whole section in my book that's just on what doctors want us to know, facts about hormone therapy that they continuously debunk.
00:18:59.299 --> 00:19:08.419
And if we have those facts, then at least we have this baseline knowledge so that when we go, again, we can get into the nitty-gritty.
00:19:08.819 --> 00:19:09.220
Yeah.
00:19:09.220 --> 00:19:11.699
And I appreciate that section in your book, actually.
00:19:11.699 --> 00:19:24.099
I know exactly what you're talking about because you really walked through the studies, the the misinterpretation of data, what happened around 2002-ish, wasn't it?
00:19:24.099 --> 00:19:26.740
And how we got where we are today.
00:19:26.740 --> 00:19:30.659
And that was really helpful because we all hear bits and pieces pieces of that.
00:19:30.659 --> 00:19:30.899
Yeah.
00:19:31.220 --> 00:19:31.460
Yeah.
00:19:31.460 --> 00:19:35.299
And in this day and age, it's hard to know what who to trust or what to trust, right?
00:19:35.299 --> 00:19:40.500
We are just bombarded with information and misinformation and disinformation.
00:19:40.500 --> 00:19:49.460
And so it really is incumbent upon us to do our homework, try to figure out the facts so that then we can move forward, you know?
00:19:49.859 --> 00:19:50.179
Yeah.
00:19:50.179 --> 00:19:51.779
Yeah, I agree.
00:19:51.779 --> 00:20:05.859
Okay, so in addition to hormone therapy, did you learn about any other options or good ideas as far as helping us get through this sort of roller coaster perimenopause period without too much trouble?
00:20:06.259 --> 00:20:13.779
Yeah, I mean, I think really it it takes having the right doctor because that person is good.
00:20:13.779 --> 00:20:15.539
And when I say doctor, I want to be clear.
00:20:15.539 --> 00:20:21.859
This could be a nurse practitioner, it could be a doctor of osteopath, you know, it's it's not just an MD, right?
00:20:21.859 --> 00:20:27.299
Though I do think it's important that we look into the credentials of the people caring for us.
00:20:27.299 --> 00:20:44.339
And so I will say that, you know, if you're clear that you want a medical doctor or someone who's done a residency, for example, or has a specialty, like has gone through extra training to do the menopause certification, if possible, look for that, you know, to make sure for just ease, I'll just say doctor.
00:20:44.339 --> 00:20:54.500
So really it is important to have a doctor you can trust because in in midlife, there are some symptoms that can come up that they're just they're they feel quite personal.
00:20:54.500 --> 00:21:07.619
They feel, you know, it has to do with our, you know, our bodies and our sexuality and a lot of the the things that we identify with that make us feel feminine and and like a woman.
00:21:07.619 --> 00:21:11.699
And so I think our doctors have heard everything, they've seen everything.
00:21:11.699 --> 00:21:26.179
We have to see someone where we feel comfortable talking about things like painful sex or zero sex drive, no libido, or dry vagina, you know, like these are really important things to to name so that we get the treatment we deserve.
00:21:26.179 --> 00:21:28.819
Yeah, you know, so I think that's really important a doctor.
00:21:28.819 --> 00:21:35.779
I think when it comes to other other ways to think about how to treat these symptoms, there are other options, for example, for hot flashes.
00:21:35.779 --> 00:21:38.500
So there are non-hormonal treatments for hot flashes.
00:21:38.500 --> 00:21:58.980
There's, you know, I yeah, two in the book I name antidepressants actually, and some other prescription medications can help treat the hot flashes, as well as cognitive behavioral therapy, has been shown to be very beneficial for particularly night sweats, you know, when you're where you're waking up in the middle of the night and can't sleep because you're hot flashes.
00:21:59.379 --> 00:21:59.699
Yeah.
00:21:59.699 --> 00:22:00.659
And you know what?
00:22:00.659 --> 00:22:12.019
That one's very interesting to me because it it surprised me that cognitive behavioral therapy, which is typically with a therapist, um, and that is a specialty that they might focus on.
00:22:12.019 --> 00:22:13.779
How can that change hot flashes?
00:22:13.779 --> 00:22:15.220
It's kind of amazing, you know?
00:22:15.220 --> 00:22:16.339
Yeah.
00:22:16.659 --> 00:22:21.779
And I think what uh amazed me is that you don't need to be in this therapy forever.
00:22:21.779 --> 00:22:26.099
Like oftentimes it works in just like a six-session chunk.
00:22:26.099 --> 00:22:29.139
So I think that's really interesting as well.
00:22:29.139 --> 00:22:36.179
And I also think, too, it's important as we talk about a lot of the downsides or really difficult symptoms of menopause.
00:22:36.179 --> 00:22:38.339
I think these are very important to name, right?
00:22:38.339 --> 00:22:40.339
It helps us take it out of the shadows.
00:22:40.339 --> 00:22:45.460
It helps us be able to, you know, have coffee with a girlfriend and be able to talk about these things.
00:22:45.460 --> 00:22:54.579
Unlike my mother's generation, for example, my mom's in her 70s, and they didn't talk about their hot flashes or or anything related to this transition, right?
00:22:54.579 --> 00:22:57.460
They just kind of, you know, what About their business.
00:22:57.460 --> 00:23:04.259
And a lot of times these women suffered through symptoms because their doctors certainly weren't going to be prescribing hormone therapy.
00:23:04.259 --> 00:23:10.099
But I do think that in addition to talking about all the downsides, it's really important to talk about some of the upsides as well.
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