Expert Menopause Q&A: What Every Woman Deserves to Know

Throughout my career—as an internal medicine physician, a Menopause Society Certified Practitioner, and now Chief Medical Officer at Midi Health, the largest virtual clinic focused on perimenopause and menopause—I’ve dedicated myself to helping women navigate the hormonal shifts of midlife. And one thing is clear: Menopause raises a lot of questions, and far too few women get clear, informed answers.

Midlife is full of changes. Seemingly overnight, you might face stubborn weight gain, poor sleep, dry skin, itchy ears, burning mouth, relentless fatigue, painful sex, brain fog, mood swings that swing from rage to tears—and of course, hot flashes and night sweats.

To help you navigate this life stage, I’m addressing some of the most frequently asked questions we’ve seen in the r/midihealth community on Reddit. While I can’t offer specific medical advice, I can share evidence-based information to help you make confident choices about your health.

Menopause unfolds over years and begins in perimenopause, the phase leading up to menopause. During this time (when you are still getting your period), estrogen and progesterone levels fluctuate, often triggering symptoms. Perimenopause usually begins in your mid-40s, though it can start as early as your 30s or as late as your 50s. For most women, perimenopause lasts about four years, but for some, it can last up to a decade.

Symptoms can be more severe in perimenopause than they are in menopause, but the medical guidelines for how to treat perimenopausal women are minimal. Too often, women are told to white-knuckle it and just wait for menopause. At Midi, we’re here to help women get the care they deserve.

Menopause isn’t a stage—it’s a milestone defined as the point when you’ve gone 12 consecutive months without a period. At this stage, your ovaries have stopped releasing eggs, marking the end of fertility and your periods. On average, this happens at the age of 51, but can often range between age 45 and into the later 50s.

The years that follow menopause are considered postmenopause, and you’ll remain in this stage for the rest of your life. Estrogen levels remain low, and while symptoms don’t magically disappear, many women find they improve or fade with time.

During perimenopause, hormone testing is often unnecessary. Hormone levels fluctuate daily—even hourly—so a single blood test may not give an accurate picture and can be misleading. Your symptoms can often provide a much clearer picture as we build a care plan that supports you.

Testing can be helpful if you are questioning early menopause or if your symptoms are vague and you’re wondering if perimenopause could be a possible cause. However, the results need to be interpreted in the context of your symptoms and medical history (for example, if you have an IUD or are on birth control pills, that can interfere with results).

For women not on oral contraceptives, changes in their periods are an indicator of perimenopause, with cycles often getting closer together and then further apart. Tracking your periods and symptoms (such as mood, sleep, energy, and other patterns) in a journal or app can provide valuable clues and guide your clinician toward the right solutions.

Yes—you absolutely should. Every woman should have informed care and conversations around these changes and the available solutions. It helps to come prepared: Write down what you’ve noticed, when it started, and how it’s affecting your daily life. Focus on clear goals, such as improved sleep, a more stable mood, or increased comfort.

If you feel dismissed, aren’t getting the answers you need, or if your provider doesn’t have the required expertise, consider a second opinion or seek out a menopause expert, like Midi’s clinicians. Menopause symptoms can impact your bones, heart, and overall well-being. Relief and evidence-based care aren’t luxuries—they’re your right.

For overall health and healthy aging, key supplements include vitamin D, fiber, magnesium (I recommend magnesium glycinate as a more bioavailable form), creatine, and omega-3s. These nutrients support bone strength, heart health, brain function, and longevity, and many women don’t get enough through diet alone.

For targeted support, supplements like black cohosh may help with hot flashes, while certain forms of magnesium can improve sleep. If you’re experiencing hair thinning—a common symptom during menopause—a clinically proven supplement like Nutrafol Women’s Balance can offer additional support as part of a broader care plan.

Absolutely, and they’re often the best place to start. Regular exercise plays a powerful role in so much of our health. It’s not just about burning calories—physical activity can decrease the incidence of breast cancer and prediabetes and improve sleep. Menopause can accelerate bone loss, so strength training helps protect bone density, preserve muscle mass, and support metabolism. Aerobic activities, such as walking, swimming, cycling, or running, lower the risk of heart disease and certain types of cancer.

Nutrition is just as important. Fiber- and protein-rich, plant-forward meals help stabilize blood sugar and mood during menopause and can also help with weight management.

Managing stress is also key. Mindfulness practices, meditation, and cognitive behavioral therapy can all help ease symptoms like hot flashes. And don’t overlook the power of good sleep. Prioritizing restorative rest—by keeping your bedroom cool and maintaining a consistent bedtime—can help reduce fatigue and strengthen your resilience.

Sometimes lifestyle changes aren’t quite enough, so I want women to know that there are other effective options, too. Hormonal and non-hormonal medications can provide personalized relief as part of a comprehensive care plan.

All of these changes and information can be overwhelming, particularly at a time when life may also bring additional stressors, such as job, family, and financial concerns. It can be hard to know where to start. At Midi, we’re here to help you feel empowered to live your best years, fully and confidently.

We partnered with Midi Health to bring you expert-backed insights from leading menopause specialists. Want to ask your own questions? Join the conversation on Instagram: Follow @nutrafol and @midihealth for expert Q&As.

Dr. Kathleen Jordan, MD, is Chief Medical Officer at Midi Health, the leading virtual care clinic focused on women’s midlife health. A practicing internist, she has helped thousands of women navigate menopause and beyond. She shared her expertise and experience as part of Nutrafol's partnership with Midi Health.

This column is for informational purposes and does not replace personalized medical advice. To discuss your unique symptoms, health history, and wellness goals with a clinician who specializes in midlife and get a personalized Care Plan, book a Midi visit at joinmidi.com.