Many women begin noticing changes in their late 30s and early 40s—trouble sleeping, mood shifts, weight gain, or feeling more anxious than usual. Yet when they seek medical care, their lab tests often come back completely normal.

In this episode, Dr. Brandi Sinkfield speaks with menopause specialist Dr. Leah Millheiser about the early stages of the menopause transition and why perimenopause is often overlooked in clinical care.

Dr. Millheiser explains why hormone levels fluctuate dramatically during this phase of life, why lab testing may not always capture what’s happening in the early stages of perimenopause, and why many women feel their symptoms are treated individually rather than understood as part of a larger hormonal transition. The conversation explores common symptoms and why these changes can begin years before menopause itself.

Dr. Sinkfield also reflects on how learning more about perimenopause has changed the way she views patient care in her own clinical practice, highlighting how hormonal changes can affect metabolism, cardiovascular health, brain function, and overall well-being.

This episode is the first in a multi-episode series exploring perimenopause, menopause care, sexual wellness, and the evolving role of digital health technologies in women’s health.

Topics Discussed

• Early signs of perimenopause

• Why many women experience symptoms years before menopause

• How the Women’s Health Initiative shaped menopause care for decades

• Why hormone testing alone may not diagnose early perimenopause

• Mood changes, anxiety, and sleep disruption during the menopause transition

• Why weight gain is often the symptom that brings women to the doctor

• Emerging technologies like continuous glucose monitors in menopause research

• How to find clinicians who specialize in menopause care

Key Takeaways

Perimenopause can begin years before menopause itself. Many women experience symptoms while their menstrual cycles remain regular and lab tests appear normal.

Hormone levels fluctuate dramatically during the menopause transition. Because of this, lab tests alone may not always detect early perimenopause.

Symptoms often appear across multiple body systems. Perimenopause can affect metabolism, sleep, mood, cardiovascular health, bone health, and sexual health.

Weight gain is one of the most common reasons women seek care. Changes in metabolism during perimenopause can contribute to shifts in body composition.

Finding a menopause specialist can make a significant difference. Resources such as The Menopause Society help women loca

Disclaimer
The information in this podcast is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition or treatment.

The personal views expressed by guests on Women's Digital Health are their own. Their inclusion here does not constitute an endorsement from Dr. Brandi, Women's Digital Health, or associated organizations.

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Edited by Steve Woodward at podcastingeditor.com/