What Is Perimenopause? Navigating Changes in Women's Health and Wellness

Ari Horesh -

Understanding Perimenopause: A Comprehensive Guide

Perimenopause, a transitional phase leading up to menopause, is a topic that has garnered significant attention due to its profound impact on women's health. In a recent dialogue between Dr. Sara Gottfried and Dr. Andrew Huberman, the complexities and implications of perimenopause were discussed in depth, shedding light on its various aspects.

What is Perimenopause?

SARA GOTTFRIED: Perimenopause is the period before your final menstrual cycle, lasting up to 10 years for some women. It often begins with menstrual cycles getting closer together and can include symptoms like poor sleep and increased anxiety due to changes in estrogen receptors.

The Brain and Perimenopause

A remarkable aspect of perimenopause is its effect on the brain. Research, including that by Lisa Mosconi at Cornell, indicates a significant decline in cerebral metabolism during this phase.

"From around age 40, there's about a 20% decline in glucose uptake in the brain from premenopause to perimenopause and then postmenopause." - SARA GOTTFRIED

SARA GOTTFRIED: Perimenopause seems to be a precursor to Alzheimer's disease. Insulin resistance and sensitivity are also involved, affecting brain health.

Hormone Therapy: A Controversial Yet Vital Topic

The discussion touched upon hormone therapy, a subject fraught with controversy yet essential in the context of perimenopause and Alzheimer's risk.

"Many women are hesitant to take hormone therapy due to fears stemming from the Women's Health Initiative (WHI) study, but it's crucial in managing symptoms and potentially reducing Alzheimer's risk." - SARA GOTTFRIED

Perimenopause Symptoms: More Than Just Nuisance

SARA GOTTFRIED: Symptoms like hot flashes and night sweats are often dismissed as mere nuisances. However, they are significant biomarkers of cardiometabolic disease, increased bone loss, and brain changes.

The Brain's Role in Perimenopause

An enlightening aspect of the discussion was the emphasis on the brain's role in driving perimenopausal symptoms, not just the ovaries.

"Many of these symptoms in perimenopause are not driven by the ovaries but by the brain." - SARA GOTTFRIED

Conclusion: A Call to Action

This insightful conversation between Dr. Gottfried and Dr. Huberman highlights the need for a more nuanced understanding and approach to perimenopause. It's a call for women to be more proactive about their health, especially during this critical phase, and for the medical community to reevaluate and broaden its approach to women's health during midlife.