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Menopause Smart Guide

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Menopause Smart Guide

“A woman is the full circle. Within her is the power to create, nurture, and transform.” – Diane Mariechild

Little did I know when I was in my teens, 20s, and 30s that big changes were coming. During those years, change for me involved going to college, getting married, starting a business, writing books, and having children. Somehow these events blended together into a cohesive whole.

But what about “The Change,” the one that can completely transforms your entire physical, emotional, and mental sense of self? Sure, my mother had given me the talk about puberty and periods, and I learned about it in school, but no one clued me in on menopause. What did I know about that change when I was younger or even as I was entering it?

Nothing. Absolutely nothing.

The only recollection I have about my mother talking to me about menopause, was when she would tell her how bad her hot flashes were. Even then, I didn’t really understand why she was having them. I just knew that she did. Even after she had a hysterectomy, I was in my late teens at the time, she never explained to me what the operation was for or what would happen to her next. And I didn’t ask.

My mother never spoke to my grandmother about menopause, and my mom never spoke to me about it. It just wasn’t spoken about back then.

Thankfully, things are changing.

Now that I’m in menopause and have been on my own menopausal journey for more than ten years, I have the luxury of experience, retrospect, and wisdom. So here is my message to my younger self and all the younger women out there who will someday face “The Change,” as well as my peers who are in this with me right now. Below are some of the things I wish I had known before I arrived at the menopausal stage of life so that I would have had time to prepare for them starting in my thirties.

Read about menopause stages

Understanding perimenopause, menopause, and postmenopause

Menopause is often used as a blanket term to describe the hormonal changes and their accompanying symptoms that women and individuals born with a uterus go through around midlife. However, there are three stages to this process of change:

• Perimenopause is the time leading up to menopause. This stage can begin as early as age 35, but it typically occurs in women in their 40s. Perimenopause can last anywhere from two to 12 years. It is characterized by irregular periods, hot flashes, sleep issues, mood swings, weight gain, low libido, forgetfulness, and vaginal dryness. These symptoms are associated with the fluctuation of hormones, including estrogen, progesterone, testosterone, and cortisol, among others.
• Menopause is defined as the absence of a period for 12 consecutive months (or 365 days). That means a woman is in perimenopause until she reaches that milestone. It is technically just one day.
• Postmenopause is the stage of life that follows menopause. I often say that menopause and postmenopause are the same, since both involve the complete cessation of menstruation. Hormone fluctuations during postmenopause tend to calm down significantly, which can mean fewer symptoms for many of us. However, we are all unique and experience menopause differently, so some women continue to have symptoms even once they are in postmenopause. It’s important to note the dramatically lower levels of estrogen in postmenopause place women at a greater risk for osteoporosis, heart disease, and dementia.

Know the symptoms of perimenopause, menopause, and postmenopause

When I was in perimenopause and suffering with many symptoms including hot flashes, night sweats, increased anxiety, frozen shoulder, insulin resistance, weight gain and insomnia, I did some digging and found out there were 34 “recognized” symptoms of menopause. However, that number didn’t seem right to me so in 2017 I started to personally track menopausal symptoms and came to discover (through my own anecdotal research, medical journals, and by speaking with others) that there are in fact 85 or more signs and symptoms of menopause. That’s way more than the 34 I had heard about. If you’re curious as to what those symptoms are, I listed all of them on my website here.

Listen to your body

During the eight years I was in perimenopause, I gained 15 to 20 pounds, lost and gained weight seemingly overnight, and in addition to what I mentioned above, I also experienced rage, mood swings, body hair, body odor, bruises, and pain all over my body, among other symptoms. But when I asked people what was happening, I couldn’t get any answers.

So, I looked for them myself, which is why I’m so passionate about my research. Whenever I learn something, I share what I learn with my amazing community in my newsletter and on my TikTok and Instagram pages.

My biggest takeaway from my 22+ years as an educator in the health and wellness space is to listen to your body. If you’re in the age range of perimenopause or menopause and are experiencing symptoms associated with this transition, I want to encourage you to consult with health care professionals who are trained in menopause. Empowering yourself by doing your own research, and talking with other women who are experiencing the same things, is important so you understand you are not alone!

What you should know about stress, adrenals, and cortisol

Stress, the adrenal glands, and cortisol (a stress hormone produced by the adrenals) have an intimate relationship. In the years before perimenopause, progesterone keeps levels of cortisol in a healthy range and stress under control. With the onset of perimenopause, however, progesterone levels begin to drop, and so does its control over stress and cortisol.

Consistently high levels of cortisol can cause the adrenals to be overwhelmed and cause severe tiredness, low mood, insomnia, weight gain, digestive problems, low libido, and food cravings—all symptoms also associated with perimenopause and menopause. At the same time, the perimenopause and menopause years can be stressful for other reasons, as many women in midlife are dealing with lifestyle changes such as teenagers or empty nest syndrome, caring for aging parents, relationship issues, financial worries, and more. Unmanaged stress contributes to high cortisol levels and worsening menopausal symptoms.

If on the other hand your adrenals reach the point where they can’t make enough cortisol, you can experience adrenal insufficiency. This is characterized by extreme fatigue, weight loss, low blood pressure, salt cravings, low blood sugar, abdominal pain, nausea, diarrhea, and darkening of the skin.

Once our ovaries take their much-deserved break, our adrenal glands take over making our hormones, but if they are tired and can’t do their job, our body pays the price and women may experience more (and possibly more intense) symptoms than those whose adrenal function is optimal.

All this to say, doing our best to manage stress levels prior to going into perimenopause and menopause is really important.

Why you need to manage stress and how to do it

As discussed above, unmanaged stress is unhealthy for your adrenals, but it also negatively affects all of our bodily processes. That’s why learning how to manage stress is critical to our overall health. Finding activities that relax our nervous system, and then adopting them into our lifestyle can help us better deal with daily stressors. These may include light exercise (swimming, yoga, biking, strength training), deep breathing exercises, meditation, visualization, walks in nature, and dancing. The more options we choose to enjoy, the better.

You can also nourish your adrenals and in turn, help rebalance your cortisol levels. Taking care of your adrenals can include getting 7 to 9 hours of sleep every night, reducing or eliminating caffeine and alcohol from your diet, focusing on eating whole foods, eliminating ultra-processed foods (they have little to no nutrition), practicing stress reduction daily, and considering using supplements that help the body with stress such as adaptogens, magnesium and probiotics.

Nourish your body and mind

I began focusing on eating healthier foods when I was in my early thirties, but I wish I started sooner. The earlier we make the connection between what we eat and how we feel, the more energy, vitality and stamina we will have as we enter into perimenopause and menopause.

The good news is it’s never too late to start! Focus on eating more clean, high-quality protein (plant and/or animal sources), healthy fats (olive, coconut oil, avocado), fiber (25 to 35 grams daily), and organic fresh fruits and vegetables, whole grains, nuts, and legumes (in moderation). Eliminate ultra-processed foods, alcohol, and added sugars in your diet.

Give yourself the gift of patience

The perimenopause years and beyond are times when your body is recalibrating. Giving yourself the time, space and permission to move through the transition is really important. Try to stay positive in your thoughts and actions, and when you feel frustrated and angry, allow yourself to feel the feelings and then try to flip the switch when you can. Mindset plays a huge role when dealing with symptoms.

Get tested

Your body is always speaking to you, but sometimes you have to listen a little deeper to get the messages. That’s where testing can help.

As your body starts to transition into perimenopause, things can change and shift. Speak to your doctor or health care provider about checking your thyroid (TSH, Free T3, Free T4 and TPO and TG – thyroid antibodies), ferritin (stored iron levels), and vitamin D (25-hydroxy vitamin D).

Vitamin D insufficiency and deficiency are very common, and it’s essential to remedy low levels vitamin D as it is involved in calcium and phosphorus absorption, mood, controlling infection, and reducing inflammation.

Since hormones are a driving force in a woman’s health, I recommend checking your hormones via blood test (although you should know there is no single blood test that can confirm if you are in perimenopause). I also like the DUTCH test (dried urine test for comprehensive hormones), an at-home test that helps identify hormonal imbalances (sex, adrenal, melatonin and their metabolites). This test alone is a wealth of information and you can order it through a health care practitioner.

I believe we should all be tested for A1C, fasting insulin and fasting glucose. These are important markers for insulin resistance, which we are more prone to in this phase of life, and diabetes.

The IL-6 (interleukin 6) test gives you information on levels of this inflammation marker in your bloodstream. Elevated IL-6 can indicate inflammation, autoimmune disorders, cardiovascular disease, and infections.

Bottom line

No woman should enter her perimenopausal and menopausal years without information on what to expect and how to pave the road for a healthier journey. I encourage all older women to mentor their daughters, granddaughters, nieces, and friends. We all have the power to create, nurture, and transform.


DUTCH test. Precision Analytical Inc.

Menopause & me. The North American Menopause Society

Andrea Donsky, Nutritionist (R.H.N.)
Founder, &
Media Health Expert, North America
Menopause Educator & Researcher
Follow me on TikTok: @andreadonsky

If you enjoyed this article check out Menopause; moving beyond taboo.


  • Her expertise as a Nutritionist and an Entrepreneur to educate the public on living a naturally healthy lifestyle. Andrea inspires people to make healthier choices through her businesses, media appearances, podcast, books, articles, videos, and speaking engagements.

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