Questions Women May Have About Perimenopause
Dr. Steven R. Goldstein, MD
Perimenopause Specialist NYC
What Is Perimenopause?
• Transitional phase before menopause
• Can begin in late 30s
• Caused by fluctuating estrogen & declining progesterone
• Different from menopause (which involves a complete stop in estrogen production)
Perimenopause is not just "early menopause"—it’s a unique hormonal phase marked by irregular hormone patterns. These shifts, especially the imbalance between estrogen and progesterone, create a wide range of symptoms.
What are the Symptoms of Transition?
• Irregular periods
• Mood swings
• Trouble concentrating
• Anxiety, fatigue, and sleep issues
• Changes in sex drive
Patients often describe feeling “not quite themselves.”
This isn’t surprising—your body is on a hormonal rollercoaster, and the symptoms can appear without warning or clear triggers.
Common Patient Questions
Dr. Goldstein’s patients often ask:
• “Why are my cycles so erratic?”
• “Why do I feel moody and unfocused?”
• “Is this just aging, or something more?”
These questions are valid and common. A cycle swinging from 24 to 36 to 22 days can wreak havoc on emotional and cognitive stability. Understanding why this happens is the first step toward managing it.
What’s Happening in Your Body?
• Estrogen fluctuates unpredictably
• Progesterone production decreases
• Hormonal imbalance affects mood, metabolism, and brain function
Think of your hormones as a symphony. In Perimenopause, the instruments play out of tune— estrogen rises and falls sharply, while progesterone drops steadily, creating both physical and emotional disruption.
What About My Periods?
• Gushing, skipping, or non-stop periods are common
• These patterns are hormonal, not necessarily alarming
• Medical evaluation can rule out other causes
A major source of worry is period unpredictability.
While it can be unsettling, these symptoms are often tied to Perimenopause and can be managed effectively with the right care.
Weight Gain and Body Changes
• Hormones affect metabolism
• Weight may shift to midsection
• Diet and hormones both play roles
Many women ask if the rest of their life will be “a fork, a lettuce leaf, and a pill.” Weight gain can feel inevitable, but it can often be mitigated with tailored medical and lifestyle interventions.
Medical Treatments Available
• Hormone therapy (when appropriate)
• Lifestyle adjustments
• Non-hormonal medications for mood or sleep
• Individualized treatment plans
There’s no one-size-fits-all solution. Dr. Goldstein, a leading Perimenopause Specialist NYC emphasizes personalized care. Treatments range from hormone therapy to non-hormonal strategies depending on symptoms and medical history.
Addressing Libido and Mental Health
• Hormonal shifts can impact sex drive
• Emotional and psychological symptoms often overlooked
• Support is available—you're not alone
Sex drive and mood are deeply tied to hormonal health. These are legitimate medical concerns, not just emotional or relational issues, and they deserve proper attention and care.
Natural Remedies— Fact or Fiction?
• Popular: dong quai, yam root, soy, black cohosh
• Scientific backing is limited or mixed
• Always consult with a specialist before use
Natural remedies can sound appealing, but not all are effective—or safe. Dr. Goldstein advises combining evidence-based medicine with informed conversations about supplements.
Why See Dr. Goldstein?
• 25+ years as a top NYC gynecologist
• Past President: North American & International Menopause Societies
• Author and Certified Menopause Practitioner
• Personalized care during Perimenopause
Dr. Goldstein, a Perimenopause Specialist NYC brings not only clinical experience but leadership in menopause medicine. If you’re in your late 30s or 40s and noticing changes, a consultation can bring clarity and relief.
Schedule a consultation with Dr. Steven R. Goldstein for personalized guidance