Dr Galy at 23MD has been dealing with perimenopause for over a decade now, and he finds it still remains unclear to most people what this actually is. He has noted  that the same misinformation just keeps making the rounds.

During his consultaions, Dr Galy always tries to clarify these questions for his patients. In this article, he tries to highlight some of the most common myths and debunk the confusion that has grown up around the perimenopause.


Myth 1: Until my periods stops, and I start sweating, I haven’t started perimenopause.

Many women with vague symptoms that they know are linked to their hormones are often dismissed by their practitioners, because they still have regular periods and are not sweating. Unfortunately, many in the medical profession do not realise or even accept that subtle changes in sleep, mood, anxiety levels, energy, libido and weight control, are in fact ALL linked to the changing hormone landscape in women.

There are many signs of perimenopause… any of which could be your first sign that your hormones are shifting. With such a wide variety of symptoms, it’s no wonder that many women ( and practitioners !) don’t connect these to a perimenopausal hormonal imbalance. The most common symptoms are :

  • Heavy period
  • Irregular periods
  • Anxiety
  • Irritability
  • Mood swings
  • Depression
  • Fatigue
  • Weight gain
  • Cravings
  • Hair loss
  • Brain fog
  • Forgetfulness
  • Low libido

But from what age can this happen? Declining progesterone levels can start as early as the mid 30’s, and unless the physician is able to recognise these symptoms as possibly related to changing hormone levels, and then willing to investigate these sympotms appropriately, it’s going to a difficult decade ahead of you until the sweats finally become obvious to the practitioner that your hormones were in decline,  and appropriate treatment  is offered. That’s why it’s critical to pay attention to your body. If you’re not feeling like yourself, consider the possibility that hormone shifts are beginning, and seek help from a practitioner who can listen, interpret AND investigate your symptoms properly. Dr GAly at 23MD has focused on this, and can be contacted here. 

Myth 2:  Gaining weight is inevitable

Weight gain is very common because hormonal shifts make your body distribute fat differently and in different places. It’s no longer as simple as “calories in + exercise = calories out.”

As you transition into perimenopause and menopause, your ovaries make fewer sex hormones, and your body may respond by trying to protect itself. Its preferred method of protection is to store fat, especially around the waist, hips, and thighs. Fat stored in these areas also produces more estrogen, which in turn, leads to more weight gain. Add stress to the mix with higher cortisol production and it’s a recipe for weight gain, especially around the waist and thighs.

Despite these changes, you can still achieve a healthy weight. One of the best things you can do to help yourself is eat right, and exercise correctly! If your first reaction to weight gain is to cut back calories, think again. That throws your body into stress mode and cortisol kicks in. Excellent nutrition and shifting to carbohydrates with LOW GI RATINGS  will, for many  but not all women, help balance their hormones, including insulin and this results in a gradual return to natural weight. If this is not working for you, seek help from a practitioner who can listen, interpret AND investigate your symptoms properly.

Myth 3: If I have a hysterectomy and leave my ovaries, my hormones will stay in tact.

Removing your womb is a big decision, and a big surgical procedure. It is very hard on your body. It affects your whole body, and has other implications for you as well.  So the decision to do this should not be taken lightly. A hysterectomy can create hormone imbalances overnight instead of over months or years. Even if your ovaries are left intact, there’s likely disruption of the blood supply to them which will keep them from fully functioning. So hormone changes are very likely indeed. Changes may be less severe when you keep your ovaries, but they are unpredictable. Many women need estrogen, progesterone and testosterone replacement to feel their best after a hysterectomy.

If you have had a hysterectomy,  MOST IMPORTANTLY, don’t let your doctor tell you that you don’t need progesterone because you don’t have a uterus. You have progesterone receptors all over your body (not just in your uterus). These are present in your spinal colum, breast tissue, and bladder. They need love too. And that’s why progesterone is a great protector hormone, its not just for your uterus.

Myth 4:  Progesterone and progestins are the same thing

ABSOLUTELY NOT. These are different types of hormones, with markedly differing actions.

PROGESTERONE is a bioidentical hormone that is exactly like the hormone your body makes. It acts on receptors that are present in uterine, ovaries, breast and nervous tissues.

PROGESTINS (found in birth control pills, IUDS, depo shots) are different structurally. They primarily act on receptors in uterine and ovarian tissue. So they DO NOT have the feel-good benefits of progesterone.

These words are loosely used interchangeably all the time, and it  creates all kinds of confusion. While it may seem like a minor point, it is not at all a minor issue. There are MAJOR differences between their actions, and this is what makes progesterone easier, and safer, to use that progestins.

Unfortunately, the medical community and some regulatory agencies have lumped women’s sweet and lovely bioidentical progesterone in with progestins. But progestins are not bioidentical. Progestins (i.e. medroxyprogesterone, Provera, Prempro, birth control pills) are not your friends. They can produce severe side effects including increased risk of breast cancer and blood clots, abnormal menstrual flow, fluid retention, nausea, and depression.

On the other hand, progesterone is bioidentical. It is the same chemical compound that your body makes. In addition to counteracting the effects of estrogen to avoid fluid retention, it is helpful for bone health, nerve health and keeps you feeling pleasant and calm.

Side effects are extremely rare with natural progesterone. The most common ones are alteration of your cycle and drowsiness.

If you remember one thing about perimenopause: 

PLEASE REMEMBER THIS –> PROGESTERONE is a perimenopause woman’s BFF.

It is the main hormone that is low during her perimenopause, and can easily been replaced using Bio-Identical forms of progesterone. 

I hear from women all the time who are desperate to find out what’s going on with their bodies. And it’s always a relief for them to learn that what they are experiencing is common, and best of all, CAN BE TREATED WITH PROGESTERONE!

If your are experiencing any of these and would like to discuss your options,, please contact us.

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