Perimenopause, Menopause & You: What’s Really Going On—And How We Can Help
- Atlas Rising
- Oct 21
- 3 min read
Lately we’ve been seeing a wave of women walking in with the same cluster of questions:
“Is this stress…or perimenopause?”
“Why is my weight changing?”
“Why do I feel anxious at night?”
“What happened to my pelvic floor—and my libido?”
If that’s you, you’re not alone. This season of life is big, and it deserves better conversations, better support, and better tools.
Below is how we think about it in the clinic—clear, compassionate, and practical.
Perimenopause vs. “I’m just stressed”
Both can be true. Chronic stress has likely been simmering in the background for years. Then sex hormones begin to shift (often in the mid-30s to mid-50s), and that stress load collides with real, biological changes.
Common early clues:
Periods become irregular or “different” (lighter, heavier, or unpredictable)
Sleep changes, night sweats, hot flashes
Heart pounding or occasional palpitations
Mood shifts, anxiety, “edge” or brain fog
Dizziness or “off” equilibrium sensations
Weight creeping up—especially midsection—despite “nothing changing”
Vaginal dryness, lower libido, discomfort with intimacy
New or worsening pelvic floor symptoms (urgency, stress leaks)
Quick reframe: none of this means you’re “broken.” Your body is adapting.
Our job is to support that process so you feel like you again.
Why symptoms cluster (the short version)
When estrogen begins to decline, other hormones adjust: progesterone, testosterone, DHEA—and the stress system (HPA axis). Stress chemistry (adrenaline/epinephrine and cortisol) often rises, which can tug on insulin.
That “stress–sugar” loop can:
Disturb sleep and mood
Drive cravings and fat storage
Make workouts feel harder and recovery slower
Aggravate hot flashes and night sweats
Add in the pelvic floor: hormone shifts can reduce tissue tone and blood flow, so leaks, urgency, or pain with intercourse can appear—even if you’ve never had them before.
Step 1: Get your bearings (testing that actually helps)
We like to start with data, then personalize:
Bloodwork: thyroid, fasting glucose/insulin markers, lipids, inflammatory clues, plus a baseline sex-hormone snapshot.
Saliva testing (when helpful): daily cortisol rhythm; sometimes sex hormones, depending on context.
This tells us where you are so we can build the right plan.
Step 2: Support the whole system (not just one hormone)
Every woman is different, but our scaffolding is consistent:
Calm the HPA axis (stress system)
Gentle nervous-system work, breath, sleep hygiene, sunlight, and targeted adaptogens (chosen for you, not from a random TikTok).
Steady blood sugar
Protein-forward meals, fiber, minerals, and smart carb timing—so cortisol and insulin stop playing ping-pong with your energy and appetite.
Nourish liver & detox pathways
Your liver helps metabolize hormones. Support here can ease “traffic jams” that worsen symptoms.
Target sex-hormone balance
Botanicals (e.g., when appropriate—wild yam complexes, shatavari, tribulus, etc.) or, for some, referral for HRT with a trusted provider.
We muscle-test and adjust over time—because your chemistry and response matter most.
Move smarter, not just harder
During high-stress windows, we bias toward strength, walking, mobility, and recovery—then layer intensity intentionally.
Pelvic floor & intimacy: say it out loud (and fix it)
Hormone shifts can weaken pelvic floor tone and reduce lubrication and sensation. This can impact confidence, spontaneity, and joy.
Two big supports we love:
1) Emsella® (the chair you sit on, fully clothed)
Uses focused electromagnetic stimulation (HIFEM) to create supramaximal pelvic-floor contractions you can’t achieve voluntarily.
Recruits a broader swath of muscle fibers and retrains brain-to-muscle signaling.
Typical series: 6 sessions (28 minutes each). Many feel changes by session 3–4; we reassess after 6.
Helps with stress/urge/mixed incontinence, pelvic support, and as a foundation for sexual wellness.
Safety first: We’ll screen for contraindications (e.g., implanted metals/electronics, pumps, pregnancy, certain medical conditions).
2) Sexual wellness support
Hydration, local moisturizers/lubricants, tissue support
Emsella protocols focused on blood flow and sensitivity
Hormone and botanical support when appropriate
“Can I still lose weight in perimenopause/menopause?”
Yes—when we unhook the loop first. If stress chemistry and blood sugar are dysregulated, your body will fight fat loss. We pair metabolic coaching with tools like red-light therapy (for fat-cell shrinkage and skin tightening) and strength training, then we adjust weekly based on scans and how you feel. It’s not a crash; it’s a system reboot.
What to expect with us
Conversation & testing → understand your stage and stress profile
Plan → HPA calming, blood-sugar strategy, nutrition, movement, sleep, botanicals or HRT referral if indicated
Pelvic floor → Emsella series if you’re a candidate
Course-corrections → we tweak every 2–4 weeks based on your response
This isn’t about “pushing through.” It’s about partnering with your physiology so life feels doable—and good—again.
Ready to talk?
If you’re navigating perimenopause/menopause symptoms—or you’re just not sure what’s normal—drop a question below or reach out. We can discuss testing, program options, and whether Emsella belongs in your plan. We’re here to help you move through this season strong, supported, and fully yourself.
Friendly note: This post is educational and not medical advice. We’ll always personalize recommendations to your history, labs, and goals.
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