Perimenopause, Explained

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One perimenopause topic a week, every number sourced. Hot flashes, 3 a.m. wake-ups, HRT risks in real numbers, lifting weights after 40: what's happening in your body, how long it lasts, and what the research says helps. Short episodes, about 5 minutes, with the sources for every number in the show notes. Free 2-minute perimenopause stage check: https://perimenostage.com/ Narrated with AI voices; every number is checked against its source. For information only, not a substitute for advice from your own doctor.

Episodes

  1. 2d ago

    Weight, belly fat and muscle in perimenopause: what changes and what works

    Same weight, different body. What the menopause transition does to fat and muscle, why the belly changes, how to check your waist at home, what works, what HRT and weight-loss medicines do and don't do, what doesn't work, and when a bigger belly needs a doctor. 28-day meal plan built around your protein target, day 1 free before you pay: https://perimenostage.com/meal-plan Meal + strength plans, $39 for both: https://perimenostage.com/body-bundle Free 2-minute stage check: https://perimenostage.com/ One perimenopause topic a week, every number sourced. Follow for the next one: periods in perimenopause, and when to worry. Chapters 0:00 Intro 0:21 Same weight, different body 0:55 The belly 1:29 What works 2:11 Food, protein and bones 2:56 HRT and weight-loss medicines 3:36 What doesn't work 4:04 When it's something else 4:34 Wrap-up Sources • Fat gain doubles and lean mass falls through the transition, weight rises at one pace: SWAN, PubMed 30843880 • Visceral fat only after menopause, fat burning −32%, 156 women: PubMed 18332882 • Waist over 35 inches and how to measure: NHLBI, NIH • Exercise cut fat, waist and visceral fat, 101 trials, 5,697 women: PubMed 37388207 • 150 minutes a week plus 2 strength days: CDC activity guidelines • 1–2 lb a week, 5% loss: CDC, Steps for Losing Weight • Weight loss eased hot flashes: PubMed 20625026 • Mediterranean and DASH eating: review 2026, PubMed 42303129 • 1.2 g of protein per kg if you exercise: PROT-AGE, PubMed 23867520 • Protein and calcium in foods: MedlinePlus • Fewer calories, same nutrients: Office on Women's Health • Age, diet plus exercise, no spot reduction: British Dietetic Association • HRT doesn't add weight, 22 trials: Cochrane, PubMed 10796730 • HRT and abdominal fat −6.8%, 107 trials: PubMed 16918589 • GLP-1 drugs in menopause: Spanish Menopause Society 2026, PubMed 42664617 • Tirzepatide and the pill: Zepbound prescribing information • Hidden drugs in weight-loss products: FDA • Creatine 3 g a day for 2 years: PubMed 31257405 • Thyroid, bloating and ovarian cancer symptoms: NHS For information only, not a substitute for advice from your own doctor. A swollen belly that doesn't go away, especially with feeling full quickly, needs a doctor; with vomiting, stomach pain or fever, get seen the same day.

    Weight, belly fat and muscle in perimenopause: what changes and what works

  2. Oct 23

    Strength training for perimenopause: what lifting does for muscle, bone and hot flashes

    Same scale, different body. Here's what the menopause transition does to muscle and bone, what strength training changed in the trials (bone density, hot flashes, belly fat), how much is enough, the six movements that cover the whole body, how to start safely with osteoporosis or bladder leaks, and the four tests to take in week one. Week 1 of our 12-week strength plan is free: https://perimenostage.com/strength-plan?utm_source=podcast&utm_medium=audio&utm_campaign=ep05_strength Free 2-minute stage check: https://perimenostage.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ep05_strength Chapters 0:00 Intro 0:27 Same scale, different body 1:12 Bone 1:53 Hot flashes and sleep 2:34 Belly fat 2:59 How much is enough 4:07 Starting safely 4:57 Week one 5:28 Wrap-up Sources • Through the transition lean mass falls and the rate of fat gain doubles, until about 2 years after the final period; weight rises at one pace: SWAN, PubMed 30843880 • 8–36% of people under 60 have sarcopenia; 27 trials, 1,989 women aged 40–60: most muscle from 3 strength sessions a week for at least 6 weeks, more after 12 weeks: review 2023, PubMed 37964288 • Spine bone density −10.6% over 10 years, −7.38% in the 3 years around the final period: SWAN, PubMed 21976317 • LIFTMOR, 101 postmenopausal women with low bone mass, 8 months: spine bone density +2.9% vs −1.2%: PubMed 28975661 • Moderate to severe hot flashes −43.6% vs −2.0% after 15 weeks of strength training 3 times a week: Swedish randomized trial, PubMed 31239119 • Aerobic exercise improved insomnia scores, pooled data from 546 women: MsFLASH, PubMed 29165623 • Exercise added muscle and reduced body fat, waist and visceral fat, 5,697 postmenopausal women: meta-analysis, PubMed 37388207 • Minimum 2 strength days plus 150 minutes of moderate activity a week: CDC, Physical Activity Guidelines for Americans • At least 1.2 g of protein per kg of body weight a day for people who exercise: PROT-AGE expert group, PubMed 23867520 • No serious adverse events in resistance training trials, 452 postmenopausal women: PubMed 36283059 • Osteoporosis: avoid deep forward bending of the spine; after a spinal fracture keep impact to brisk-walking level: UK expert consensus, PubMed 35577538 • Bladder leaks and pelvic floor exercises: Office on Women's Health • Week 1 tests: 30-second chair stand, push-ups, side plank, carry: Perimenostage 12-Week Strength Plan For information only, not a substitute for advice from your own doctor or physical therapist. Chest pain, fainting or severe breathlessness during exercise: stop and call 911.

    Strength training for perimenopause: what lifting does for muscle, bone and hot flashes

  3. Oct 22

    HRT, explained: benefits, risks and the real numbers

    "HRT causes cancer." "HRT saved my life." Here are the actual numbers: what hormone therapy is, what it helps, what the 2002 Women's Health Initiative trial really found after 18 years, the remaining risks per 1,000 and per 10,000 women, why patches and pills differ for blood clots, and what "bioidentical" means. Free 2-minute stage check: https://perimenostage.com/hrt/benefits-risks?utm_source=podcast&utm_medium=audio&utm_campaign=ep04_hrt Chapters 0:00 Intro 0:26 What HRT is 1:02 What it helps 1:41 The 2002 headline 2:27 The risks, in real numbers 3:26 Choosing the type 4:10 The first three months 4:41 When to talk it through 5:05 Wrap-up Sources • Hot flashes about 75% less frequent on estrogen; low-dose vaginal estrogen improves symptom severity by 60–80%: JAMA review 2023, PubMed 36749328 • Sleep problems, low mood and anxiety with menopause; fracture risk on HRT: NICE guideline NG23 • Spine bone density −7.38% in the 3 years around the final period: SWAN, PubMed 21976317 • All-cause mortality 27.1% vs 27.6% after 18 years, WHI trials, 27,347 women: PubMed 28898378 • +12 / −19 serious events per 10,000 women a year at ages 50–59: WHI, PubMed 24084921 • Breast cancer, about 5 extra cases per 1,000 women on combined HRT for 5 years: NHS, HRT risks • Blood clots, odds 1.58 for tablets vs 0.93 for patches, gels and sprays: UK case-control study, PubMed 30626577 • Benefits generally outweigh risks under 60 or within 10 years of the last period: The Menopause Society 2022, PubMed 35797481 • 86% of women didn't know compounded hormones aren't FDA-approved: US survey, PubMed 25692877 • Side effects in the first months: NHS, HRT side effects For information only, not a substitute for advice from your own doctor. Pain or swelling in one leg, a new breast lump or bleeding beyond 6 months on HRT: get checked. Chest pain or sudden breathlessness: call 911.

    HRT, explained: benefits, risks and the real numbers

  4. Oct 21

    Why you wake at 3 a.m.: perimenopause and sleep

    Waking at 3 a.m., soaked or wide awake, is one of the most common complaints in perimenopause. In the SWAN study of 3,045 women, trouble falling asleep and staying asleep became more common through the transition. Here's why it happens (night sweats, hormones, mood and a learned wake-up habit) and what the research says helps you sleep again. Free 2-minute stage check: https://perimenostage.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ep03_3am Chapters 0:00 Intro 0:19 What changes 0:44 Three reasons 1:27 When it counts as insomnia 1:42 What helps 3:16 At 3:07 itself 3:55 When it's something else 4:24 Why it matters 4:53 Wrap-up Sources • Sleep through the menopause transition, hot flashes, hormones and hormone use (SWAN, 3,045 women): PubMed 18652093 • CBT for insomnia by phone in women with hot flashes (insomnia score −9.9 vs −4.7 points; 84% vs 43% in the no-insomnia range at 6 months): MsFLASH trial, PubMed 27213646 • Menopause-specific CBT for sleep problems linked to hot flashes: NICE guideline NG23 • Hormone therapy and hot flashes (about 75% fewer): JAMA review 2023, PubMed 36749328 • Bedtime micronized progesterone in perimenopause (review, limited trial evidence): Prior 2011, PubMed 24753856 • Insomnia and fatigue among the top menopause symptoms in women 40–60: 2023 survey, PubMed 37667324 • Memory in SWAN: PubMed 19470968 • Sleep needs, long-term insomnia, sleep habits, sleeping pills: NHS, Insomnia For information only, not a substitute for advice from your own doctor. Loud snoring with gasping or daytime sleepiness, or sleep problems with low mood, deserve a doctor's look.

    Why you wake at 3 a.m.: perimenopause and sleep

  5. Oct 20

    Hot flashes: why they happen, how long they last, and what actually helps

    A hot flash is a sudden wave of heat through the face, neck and chest. Between 50 and 75% of women get hot flashes or night sweats in the menopause transition, and in the SWAN study frequent hot flashes lasted a median of 7.4 years. Here's what's happening in your body, how long they last, and what the research says helps. Free 2-minute stage check: https://perimenostage.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ep02_hotflashes Chapters 0:00 Intro 0:16 What a hot flash is 0:38 Why it happens 1:21 How common, and how long 1:59 At night 2:41 In the moment 3:09 Options that work 4:18 When it isn't menopause 4:46 Takeaways Sources • How common: PubMed 36749328; 2023 review, PubMed 37388717 • Why it happens (the brain's thermostat, neurokinin B): PubMed 37388717 • How long (SWAN, 3,302 women): PubMed 25686030 • Night sweats and sleep (SWAN): PubMed 18652093 • CBT for insomnia in women with hot flashes: PubMed 27213646 • Hormone therapy and non-hormonal options: PubMed 36749328; The Menopause Society 2022 position statement, PubMed 35797481; The Menopause Society 2023 nonhormone therapy statement, PubMed 37252752; NICE NG23 • Lifestyle and triggers: NHS, Hot flushes For information only, not a substitute for advice from your own doctor. Sweats with a fever, cough or weight loss, or palpitations with chest pain, need medical attention.

    Hot flashes: why they happen, how long they last, and what actually helps

  6. Oct 19

    Perimenopause, explained: what's happening, how long it lasts, and what helps

    Perimenopause is the transition to menopause, and it can start years before your last period. Estrogen doesn't slide gently down in perimenopause: it swings. That's behind hot flashes, joint pain, palpitations, low mood, memory slips and more. In the SWAN study, frequent hot flashes lasted a median of 7.4 years. Here's what perimenopause is, how long it lasts, how it's diagnosed, and what the research says helps. Free 2-minute stage check: https://perimenostage.com/?utm_source=podcast&utm_medium=audio&utm_campaign=ep01_explained Chapters 0:00 Intro 0:27 What perimenopause is 1:30 The symptoms nobody connects 2:35 How long it lasts 3:15 Getting a diagnosis 4:04 What helps 5:01 When not to wait 5:21 Wrap-up Sources • Estrogen swings, progesterone falls: Prior 1998, PubMed 9715373; Hale 2009, PubMed 18978637 • Stages of the transition: STRAW+10 staging system; menopause usually between 45 and 55: NHS • Hot flashes or night sweats in 50–75% of women: JAMA review 2023, PubMed 36749328 • Joint or muscle pain in 71% (16 studies): PubMed 33299396 • Palpitations in SWAN: PubMed 36256921 • High depressive symptom scores in women with no history of depression (4.3× as likely): PubMed 16585466 • Memory in SWAN: PubMed 19470968 • About 1 in 5 women with almost no symptoms (SWAN symptom clusters): PubMed 29326841 • How long hot flashes last (SWAN, 3,302 women): PubMed 25686030 • Diagnosis from symptoms at 45 and over, without blood tests: NICE guideline NG23 • Thyroid problems in about 1 in 8 women: American Thyroid Association • Hormone therapy and non-hormonal options: PubMed 36749328; The Menopause Society 2022 hormone therapy position statement, PubMed 35797481; The Menopause Society 2023 nonhormone therapy statement, PubMed 37252752 • CBT for insomnia in women with hot flashes (84% vs 43%): MsFLASH trial, PubMed 27213646 For information only, not a substitute for advice from your own doctor. Bleeding 12 months or more after your last period, or palpitations with chest pain, breathlessness or fainting, need medical attention.

    Perimenopause, explained: what's happening, how long it lasts, and what helps
  • 6 Episodes

About

One perimenopause topic a week, every number sourced. Hot flashes, 3 a.m. wake-ups, HRT risks in real numbers, lifting weights after 40: what's happening in your body, how long it lasts, and what the research says helps. Short episodes, about 5 minutes, with the sources for every number in the show notes. Free 2-minute perimenopause stage check: https://perimenostage.com/ Narrated with AI voices; every number is checked against its source. For information only, not a substitute for advice from your own doctor.

Information

  • Creator
    Perimenostage
  • Years Active
    2026
  • Episodes
    6
  • Rating
    Clean
  • Copyright
    © Perimenostage
  • Show Website
    Perimenopause, Explained