From Dismissed to Empowered: What Every Woman Needs to Know About Perimenopause and Menopause

When Your Health Feels Like a Circus Act...

When doctors told me 'it's just anxiety,' I knew something deeper was happening. Trusting your instincts isn't just important, it's essential. Your body is speaking. Are you listening? 🤍

For me, it wasn’t just one symptom, it was a perfect storm. Picture juggling flaming torches while riding a unicycle on a tightrope… and someone keeps adding more torches. That’s what my health felt like.

I was diagnosed with Lyme disease. At the same time, I had spinal issues that led to neck surgery which, looking back, probably wasn’t necessary. Don’t get me wrong, I did have spinal problems, but not to the level that surgery should have been the first answer. A lot of my neurological issues were tied to the Lyme, but at the time, doctors thought it was all coming from my spine.

It felt like the trifecta of medical chaos: Lyme disease, surgery, and a laundry list of symptoms no one could connect. Like trying to solve a jigsaw puzzle when half the pieces are from different boxes.

And in the middle of it all? I was told, more than once, “This is just anxiety.” The solution was always the same: medication. No deeper digging. No curiosity. Just a prescription pad and a pat on the head.

The Piece No One Bothered to Mention

I lived in that space for a long time, searching for answers, wondering why I still felt like something was missing. And it’s wild to me now, because looking back, a big piece of what I was experiencing could have been perimenopause. But not one doctor even mentioned it.

Think about it: when was the last time your doctor asked about your cycle when you complained of anxiety, brain fog, or insomnia? It’s like diagnosing car trouble without ever looking under the hood.

It wasn’t until I sat down with Dr. Jennifer Hopkins, Dr of Nursing Practice (DNP) and founder of Mindful Medicine, that things finally started to click.

What “Estrogen Dominance” Really Means (and Doesn’t Mean)

Here’s something that blew my mind. When women hear “estrogen dominance,” most assume it means sky-high estrogen. We picture our bodies swimming in excess.

Wrong.

Dr. Jen explained it this way: being “estrogen dominant” doesn’t necessarily mean you have a lot of estrogen. It means you have more estrogen compared to progesterone. You could have normal, or even low, estrogen levels, but if progesterone is lower, you’re still considered estrogen dominant.

That imbalance can show up in so many ways. One day your mood might swing so fast you feel like Jekyll and Hyde. Another day you’re dealing with bloating that makes even your comfiest clothes uncomfortable. Insomnia creeps in and suddenly 3 AM feels like your new best friend. Your cycle starts shifting in ways that leave you out of balance. And then there’s the brain fog—the kind where you walk into the kitchen and can’t remember why you went there in the first place. Spoiler: it wasn’t for the laundry.

It’s not about one hormone being “bad.” It’s about ratios. Think of it like cooking. If someone says your recipe has too much salt, maybe the real problem is you didn’t add enough pepper.

The Domino Effect Is Real

Hormones don’t live in silos. They’re more like dominoes. When one tips, the rest follow. That’s why an imbalance can throw your entire system out of whack: your mood, your weight, your sleep, your energy, even your tissues.

Yes, Dr. Jen used a “beef jerky tissue” analogy that had me both laughing and cringing at the same time. And let’s be honest, you’ll never look at the snack aisle the same way again.

Beyond Hot Flashes: The Symptoms No One Warned Us About

Here’s what really stuck with me: perimenopause doesn’t always look like hot flashes.

Sometimes it’s anxiety attacks that pop up out of nowhere, like a surprise quiz you never studied for. Sometimes it’s joint pain that makes you feel decades older than you are. Heart palpitations might send you spiraling into worry. Weight gain seems to show up and stick around no matter what you do. Your memory plays tricks on you. And sleep? Forget it. Nights get long, and days get exhausting.

No wonder so many women spend years being misdiagnosed.

The Science Behind "Brain Fog": Your Brain Actually Changes

Here’s something that might blow your mind (pun intended). When we talk about perimenopause and menopause, it’s not just hot flashes and mood swings. Your brain actually changes. Physically. Structurally. Functionally.

Dr. Lisa Mosconi, a neuroscientist at Weill Cornell Medicine and author of The Menopause Brain, has been proving what women have been saying all along: we’re not crazy and we’re not losing our minds. Her brain imaging studies show dramatic changes before, during, and after menopause in how the brain looks, connects, and even fuels itself.

Think of it like your brain going through a renovation project. The contractors—your hormones—pack up and leave, so the brain has to figure out how to rewire the system.

Gray matter volume drops in areas that handle attention, concentration, language, and memory. In plain English, that means the departments running your daily cognitive tasks suddenly have fewer workers on staff. Connectivity shifts too, some areas tied to reproductive functions become less connected, while other areas pick up new pathways. And your brain’s energy grid changes, pulling glucose differently and not burning it as efficiently. It’s like the power grid is temporarily running at reduced capacity.

The good news is these changes are not permanent decline. Research shows many of them are temporary and improve once you’re fully through menopause. In fact, some women even see gray matter rebound, along with sharper memory and better cognitive performance afterward.

Dr. Mosconi calls these “intelligent adaptations.” Your brain isn’t breaking down—it’s evolving. You’re not losing yourself. Your brain is rebalancing so you can step into the next stage of life with resilience.

Okay, So How Do We Advocate for Ourselves?

As Dr. Jen says: “Women need to start standing up for themselves and getting the care they DESERVE.”

That starts with being prepared. Before your appointment, keep a symptom journal for at least a month and note how things connect to your cycle. Write down your questions ahead of time.

During your visit, get specific. Instead of saying “I feel anxious and tired,” you might try, “I’ve been experiencing anxiety that gets worse in the two weeks before my period, along with insomnia that started six months ago. I’d like to explore whether hormonal changes could be contributing.”

And don’t be afraid to ask direct questions: Could my symptoms be related to perimenopause? What hormone tests make sense for me right now? What options do I have beyond medication? Can you refer me to a menopause specialist?

So What Do We Actually Do About It?

Dr. Jen and I talked about the full spectrum of options, from traditional medicine to integrative supports. On the medical side, there are treatments like Hormone Replacement Therapy, bioidentical hormones (which are different from synthetic versions), and even newer approaches such as red light therapy or inhaled hydrogen.

But we also explored lifestyle tools that can make a real difference. Grounding—yes, walking barefoot in your yard actually has science behind it. Breathwork to calm your nervous system. Intentional stress reduction that isn’t fluff but has measurable effects on your hormones. These aren’t quick fixes, but they are powerful supports.

Finally, the Validation We’ve Been Waiting For

That’s why conversations like the one I had with Dr. Jen matter so much. Once you have the language, the science, and the context, you realize you’re not “crazy,” you’re not “too sensitive,” and you’re definitely not alone.

When you’ve been dismissed with “it’s just anxiety” for years, finally hearing someone explain what’s happening in your body feels like someone handed you the manual you should’ve had all along.

If you’re in midlife, or standing at the edge of it wondering what’s ahead, I want you to know this: you’re not weak, you’re not imagining this, and you’re definitely not alone. You’re experiencing real physiological shifts that deserve real attention.

You deserve more than “it’s just anxiety” or “welcome to getting older.” You deserve care that listens, tests, explains, and partners with you in finding answers.

If this resonates, I cover it in depth with Dr. Jen in Episode 3 of The Shifted Podcast. It’s part science, part humor, and all about giving women the tools we deserve.

🎧 Listen to Episode 3 of The Shifted PodcastApple Podcast: https://podcasts.apple.com/us/podcast/the-shifted-podcast-with-amira-evolved/id1833659590Spotify: https://open.spotify.com/show/1VCNumbWwWhGjUnaybdGMaGoodpods: https://goodpods.com/podcasts/the-shifted-podcast-with-amira-evolved-704122

Connect with Dr. Jennifer Hopkins

If you’re ready to take the next step and want a provider who will actually listen, Dr. Jen is a great resource. She even offers virtual visits, which means she can see patients all over the country. Call to see if she’s available for you.

Mindful Medicine: Email: mindfulmedicine4@gmail.com Phone: (607) 727-6079

Remember: you deserve care that takes you seriously. You deserve answers that make sense. And you absolutely deserve to feel empowered in your own body, at every stage of life.

Keep Shifting,

~Amira

Have you experienced medical dismissal during perimenopause or menopause? Share your story in the comments. Your experience might be exactly what another woman needs to hear to advocate for herself.