5 Things No One Told You About Perimenopause

2 women on a couch


Julia: Thing 1 - No one told us that perimenopause was a thing.

Ellie: That’s so true. All we were told was that menopause was a time later in life where we might get hot flashes, and then we wouldn’t get our periods anymore and we’d be all dried up FOREVER.

Julia: And as you and I now know, that belief is full of untruths. In fact, menopause is a retrospective diagnosis, only achieved when you have not had a period for 365 days. PERImenopause is the time leading up to that. It can begin as early as your late 30’s but most often in your 40’s, and it can cause a bevy of symptoms that last anywhere from 4 months to 14 years.

Ellie: Given that it lasts so long and causes so many physical and mental changes, it’s insane that our doctors rarely talk to us about it, and therefore most women don’t even know about it. 

Julia: Which is why it’s so important that we spread the word, because if we tell our friends they will tell their friends and then people will be better prepared, and able to seek out treatments that will make them feel better. 

Julia: With that, give us Thing 2.

Ellie: Can I rhyme it?  All of it?  As in, the entire list?

Julia: Could I stop you?  How about you rhyme and I’ll do the science part?

woman who's frustrated

Ellie: Thing 2 - Kindly tell Heidi you know her anxiety’s not about whether the kitchen is tidy. 

That was my way of saying that many women at this age experience increased anxiety, and they believe it is caused by pressure coming from responsibilities in their personal lives or careers or THE WORLD, and while all of these are very real stressors, the fluctuations in their hormones could be exacerbating the anxiety. 

Julia: The scientific explanation is declining levels of estrogen. Because that hormone feeds serotonin, also known as the “happy chemical,” the drop in estrogen can trigger anxiety.

Ellie: Thing 3 - Advise Cousin Gwen that low estrogen's why her libido is low and her hoo-ha is dry.

Julia: No one calls it a hoo-ha.

Ellie: Maybe they should.

Julia: Moving on! You incorporated a little bit of the science in your poem by naming estrogen again. It is true that in most cases, a lower libido during menopause is due to decreased hormone levels. These decreased hormone levels can lead to vaginal dryness and tightness, which can cause pain during sex. Fortunately, there are many safe and easy treatments for these issues, including HRT, or Hormone Replacement Therapy, sometimes also referred to as MHT, or Menopause Hormone Therapy.

Ellie: Thing 4 - Inform Marisol about Cortisol - it’s the cause of her brain fog and energy fall.

Julia: Look at you, bringing up Cortisol!

Ellie: Yeah, but no matter how many times you explain it to me, I still can’t remember what it is. 

Julia: Cortisol is known as the ‘stress hormone’. It does good things like increase energy, stabilize blood pressure, and neutralize inflammation. But declining levels of estrogen and progesterone during perimenopause can stress the body, causing it to constantly pump out cortisol. Heightened cortisol could lead to HPA Axis Dysfunction (hypothalamic-pituitary-adrenal or HPA). High cortisol can cause the following symptoms, which are also symptoms of perimenopause:

  • Insomnia
  • Low energy, even if getting adequate sleep
  • Frequent colds
  • Cravings for unhealthy foods
  • Digestion problems like bloating
  • Weight gain, especially around the middle
  • Low sex drive
  • More aches and pains
  • Low mood

Ellie: Coincidence? I think not. 

Julia: I want to try the final rhyme.

Ellie: I want to witness it.

woman fanning herself

Julia: Thing 5 - Tell your boss Dot it’s why she sleeps hot: Hypothalamus it IS, the A.C. it is NOT.

Ellie: Nice one! And I know the explanation for this. Once again, it’s that old reduction in estrogen that fools the hypothalamus (which is the part of the brain that regulates body temperature) into believing that the body is too hot, which is why a night sweat occurs in an effort to rid the body of this fictional excess heat.

Julia: I would award you some sort of health certification if I could, but such things are beyond my power.

Ellie: I’ll settle for a pat on the back.

Julia: What if I treat you to some Erin’s Faces Silk Cream instead? I know how much you love it.

Ellie: I think everyone reading this should treat a friend to something from Erin’s Faces in honor of Menopause Awareness Month in October (MAM). 

Julia: Happy MAM, Ellie.

Ellie: I AM a happy ma’am. 


Ellie Dvorkin Dunn is an entertainer/writer/host who is best known as one half of the hilarious comedy music duo "Mel & El", hailed as "outrageous" by The New York Times and "ready for prime time" by The New York Post.  She has performed as a storyteller on Risk!, Generation Women, and No, YOU Tell It!, and her writing will be featured in the soon-to-be-released book "Moms Who Kill", a collection of essays by comedians who also happen to be mothers.

Julia Granacki is a certified Pilates mat instructor/writer/performer/host best known for her work on "Hot Mess" the webseries.  She is a published poet and has performed as a storyteller on No, YOU Tell It! She is a graduate of the Institute for Integrative Nutrition with an emphasis on female hormone health.  She received her Bachelor of Fine Arts from the University of Central Florida.  To become a client, visit juliagwellness.com

Together they host the Circling the Drain Podcast which is all about perimenopause.  AND they're both wonderful humans who Erin loves 😊.


  • Erin's Faces

    Deana – yay!! I’m so happy you love their podcast – aren’t they wonderful?! And so grateful you like ours too – thank you! xoxo

    Tracie – I’m so sorry it was such a challenging time for you – thank you for sharing your experience in case it can help someone else. So glad you’re on the other side of it! xo

  • Tracie

    Great article, and as a “former sufferer” from early 40’s, can say that this was the worst period of my life – hormones always “fine” when blood tested, no HRT per blood clots when preggers forever ago (an no clotting disorder) and later suggestions that SSRI, SNRI, diet, exercise, therapist, perfect life, crazy life really dont seem to help as well as “other reasons”. As a therapist, the only way to CBT your way through is to remember “this too shall pass” and consider HRT if you can. When done we’ll, I’ve heard life changing. My cure? Partial hysterectomy, keep lovely ovaries, still get many PMS physical symptoms but mood is finally back to 30’s stable (even with 2 babies then)!

  • Deana

    Omg I checked out the podcast and it is ahhhhmazing! I have already binged 4 episodes! I have really been missing Erin’s pod and wanting something besides true crime. This totally fits the bill! As a 48yo I 100% relate to this and love the way they present the show. Totally hooked! ☺️

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