3 Things I Wish More Women Knew About Menopause, From An MD

For far too long, the reality of menopause challenges has been notoriously understudied in research—hurting the quality of advice provided to women on how to best navigate (and combat) those side effects.

Thankfully, menopause has finally been getting much-deserved time in the spotlight lately. 

To keep this momentum going (and provide you with reputable, science-backed information), I tapped board-certified internal medicine doctor, menopause expert, member of the New Chapter Wellness Council, and author of Unlock Your Menopause Type Heather Hirsch, M.D.

Television and film have stereotyped menopause struggles as hot flashes and mood swings—but those aren't the only two side effects women should be mindful of.

In fact, Hirsch says every time she polls her clients, the two biggest challenges are always sleep trouble and brain fogginess. 

She clarifies: "Brain fog means different things to different people." Sometimes, it's a change in cognition or things like memory recall, but other times it's feeling less motivated."

Hirsch even reports that more women express daily limitations caused by brain fog, even compared to mood changes and hot flashes. Much of the time, this is because those clients have experienced similar struggles during their menstrual cycle and learned to live with it, but brain fog is a new and particularly challenging arena.

I've seen more menopause-focused supplements on the market lately, so I had to ask Hirsch what she recommends.

She tells me that there are some supplements she thinks everyone dealing with menopause and perimenopause will benefit from, but after that, you should tailor your routine to address your unique needs. 

"For my menopause clients, there are two things that I almost always recommend universally—the most vital things for me are vitamin D and calcium," she says.

Hirsch explains, "Estrogen is protective for the bones1, but we lose estrogen as we go through menopause. So without that protective benefit of estrogen, we really want to make sure that our bones are strong." Hence, the recommendation for this supplement duo of calcium2 and vitamin D3—both of which help to support bone health.*

"The average age of menopause in the U.S. is 51 and perimenopause 47. But I have clients in their 20s, 30s, and 40s, so that's just the average age," Hirsch says, adding that, "This image of it being your mom's thing is really harmful." 

If you hyper-focus on this average age, you may overlook some early signs because it seems years and years away. But perimenopause (which is often when women experience challenges as their estrogen starts to decline and then fluctuate heavily) can last for over seven years4. So yes, the menopause transition can start earlier than you think.

Now, while you shouldn't jump to conclusions (assuming that brain fog is an automatic sign of menopause), you should keep track of unusual experiences and present them to your physician during your checkup. 

Hirsch suggests women keep an eye out for less buzzy menopause struggles like brain fog and sleep trouble. When seeking supplement support, she recommends starting with vitamin D and calcium and then tailoring your approach to address your needs.

Finally, she wants women to understand that menopause and perimenopause can start earlier than you think, so don't talk yourself out of the possibility if you're not yet at the "average" age.