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Ask Elektra Anything: (Peri)menopause: The Good (really!), the Bad, and the Unexpected

Today we sat down with Elektra’s founding physician, Dr. Anna Barbieri, for an Ask Elektra Anything session. The topic was “(Peri) Menopause: The Good (really!), the Bad, and the Unexpected”. We covered a lot of ground. Questions ranged from vitamins and supplements (more on that in our next Ask Elektra Anything on 9/30) to brain fog, anxiety, hot flashes and beyond! We’re sharing a few of the most popular questions and answers below.

What can women do to prepare for perimenopause?

The first thing to do to prepare is to learn what perimenopause is and what it can entail. Many women are taken by surprise when their period becomes erratic and other symptoms suddenly crop up. It can be helpful to ask older female relatives what their experience was like because the topic might not come up otherwise!

First, the facts. The word “perimenopause” literally means “around menopause”. It refers to the transition phase between a woman’s first symptoms and full-blown menopause, which is marked by 12 consecutive months without a period. After that, you’re in menopause for the rest of your life, i.e. “post-menopause.” Perimenopause typically begins 8-10 years before menopause when women are in their early- to mid-forties.

One way to think of this hormonal shift is akin to puberty, but several decades later…perhaps right when your kids are going through puberty themselves! For some, it can be pretty seismic and for others, it’s less noticeable. If you experience symptoms (among the most common are worse PMS, irregular bleeding, mood swings, and sometimes, hot flashes), know that you’re not alone. Also, expert help is out there. With a plan for managing symptoms, many women find this is the beginning of an exciting new era of newfound freedom (making more time for me!) and possibility (who do I want to be in my 2nd half of life? Take some inspiration from J Lo!).

Jennifer Lopez Quote

How can I manage my hot flashes!?

Hot flashes – and night sweats, their nocturnal partner – aren’t fun for anyone. Up to 75% of women experience them during their menopausal transition. The good news is that there are things you can do to get relief.

First, consider your environment. Temperature control is key. Fans, cooling sheets, and the AC dial are your friend. Perhaps add a blanket for your bed partner. Paced breathing and yoga have been studied and shown to help (really!).

Next, Dr. Barbieri recommends tracking your hot flashes to determine how often they occur, how severe they are, and whether they are brought on by specific triggers. Tracking for a week can be helpful to understand any patterns. People, places, or things can all be hot flash triggers! In general, alcohol and hot spicy food are common triggers.

Woman cooling off in a store freezer

There are also supplement and medication options available. Soy extracts aka soy isoflavones, black cohosh, vitamin B6 are some examples. There is a wealth of evidence supporting the use of hormone replacement therapy and other non-hormonal pharmacological interventions to treat hot flashes so please seek medical help if you’re struggling!


If you want to connect with a provider trained in menopause, reach out to Elektra and we can help you find an expert, or visit the North American Menopause Society’s list of certified practitioners here.

I’m 50 years old, have not been through menopause yet, and my doctor says I can stay on birth control pills. Is this ok?

Great question! This may be safe as long as there are no other contraindications (or issues that might increase health risks). Oral contraceptives can help regulate periods and reduce bleeding and pain, and improve other symptoms of perimenopause. Whether this is a solution that works for you at a given age depends on your individual health history and needs and should be discussed in detail with your doctor.