Dr. Janette Gray, internal medicine physician, hormone expert, author of The Truth about Sex Hormones, and medical director and founder of Perfect Balance Health, is sharing 10 key signs every woman should know about menopause.
“Although menopause is natural, for many, it can lead to a hormone imbalance and deficiency, which is an often overlooked yet widespread and silent epidemic,” warned Dr. Gray. “Millions of people are either undertreated or not treated at all for hormone imbalance, suffering needlessly from fatigue, weight gain, poor sleep, loss of sexual function, and an overall poor sense of vitality. What makes this lack of treatment even more dangerous is that untreated hormone deficiency can cause heart attacks and even dementia.”
Dr. Gray’s 10 Key Signs Every Woman Should Know About Menopause
1. Irregular Periods for 90 Days: If your menstrual cycle becomes unpredictable for three consecutive months, with periods arriving early, late or skipping entirely, this is often the first sign of perimenopause beginning.
2. Night Sweats and Hot Flashes: While hot flashes get attention, night sweats that soak through pajamas and sheets are actually reported by 85% of menopausal women and can start years before periods stop.
3. “Menopause Brain”: Difficulty finding words, forgetting names or experiencing brain fog isn’t your imagination. Declining estrogen directly affects cognitive function and memory processing.
4. Sleep Disruption Pattern Recognition: Waking up between 2 a.m. and 4 a.m. regularly, even without night sweats, indicates hormonal shifts affecting your natural sleep-wake cycle.
5. Joint Pain: Unexplained aches in hands, knees or shoulders that worsen in the morning could be estrogen-related inflammation, not just aging.
6. Mood Changes That Aren’t “Just Stress”: Sudden irritability, anxiety or feeling emotionally overwhelmed without obvious triggers often begin two to three years before periods end.
7. The Bladder Wake-Up Call: Increased urgency, frequency or minor leakage when laughing or sneezing signals pelvic floor changes from hormonal decline.
8. Skin and Hair Texture Changes: Thinning hair, dry skin despite moisturizing or adult acne appearing after years of clear skin reflect shifting hormone levels.
9. Weight Shifting to Middle: Gaining weight specifically around the waist, even with unchanged diet and exercise, indicates metabolic changes from decreased estrogen. While most people associate testosterone with men, women need it too, and hormone replacement therapy with estrogen and testosterone goes a long way toward eliminating midsection weight gain.
10. Start Watching at 45: While the average menopause age is 51, symptoms can begin as early as mid-40s, and women with a family history may experience changes even earlier.
“As soon as you notice perimenopause symptoms, it’s a good time to discuss these health changes with your doctor and get your hormone levels tested,” advised Dr. Gray. “Women who choose hormone replacement therapy or bioidentical hormone replacement therapy get the most health benefits, including relief from hot flashes, better sleep, improved mood and libido, better cardiovascular health, protection from Alzheimer’s, and stronger bones when they start early.”
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About Janette Gray Dr. Janette Gray is an internal medicine physician and recognized pioneer in integrative medicine and bioidentical hormone replacement therapy with over three decades of clinical experience. As founder and medical director of Perfect Balance Health in San Diego, she has dedicated her in-clinic and telehealth practice to helping adults of all genders achieve optimal wellness through personalized Hormone Replacement Therapy (HRT) and comprehensive weight management programs. Dr. Gray’s evidence-based approach combines traditional medical expertise with cutting-edge hormone therapies to address fatigue, metabolic dysfunction, decreased libido, and age-related wellness concerns. A passionate advocate for healthy aging, Dr. Gray exemplifies her treatment philosophy through her own active lifestyle as a competitive pickleball player, participating in tournaments across the United States.
