Perimenopause

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Kudzai Dombo, MD

Kudzai Dombo

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Perimenopause isn’t one story—it’s thousands. Discover real voices, expert advice, and personalized care options for your unique experience with Alloy.

Perimenopause Symptoms Are Different for Every Woman | Alloy

Perimenopause Isn’t One Story: Here’s Why Every Voice Matters

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Monica Molenaar

Sharon Malone, MD

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Signs that perimenopause is ending include increasingly irregular periods, fewer headaches, more stabilized mood, intensified hot flashes, and worsening sleep disturbances. Understanding these changes helps women anticipate the onset of menopause and explore effective treatments such as hormonal therapies and non-hormonal options for symptom relief.

How Long Does Perimenopause Last? Signs That It's Ending - Alloy

How Long Does Perimenopause Last?  4 Signs Perimenopause Is Ending

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Low-Dose Birth Control Pill

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Sharon D. Malone, MD

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Opill is a progestin only birth control pill that can be safely used for perimenopausal women who are asymptomatic, in need of birth control and have contraindications to the use of combination oral contraceptives. Progestin only pills are over 90% effective, making them the most effective over the counter contraceptive on the market

Progestin-Only Birth Control Pill & Perimenopause | Alloy

Here’s What You Need to Know About the New OTC Birth Control Pill & Perimenopause

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Vivian Manning-Schaffel

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Estrogen Alone and Joint Symptoms in the Women’s Health Initiative Randomized Trial

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Is the scale moving despite no changes to your diet? Learn the real causes of perimenopausal weight gain and discover expert-backed strategies to take control.

Perimenopause Weight Gain - How to Put a Pause on It | Alloy

Perimenopausal Weight Gain: What You Need to Know

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Mayo Clinic. “Perimenopause.

Cleveland Clinic. “Perimenopause.

Johns Hopkins Medicine. “Introduction to Menopause.”

Camila Hirotsu,⁎ Sergio Tufik, and Monica Levy Andersen. “Interactions between sleep, stress, and metabolism: 

Juan Pablo Del Río, María I. Alliende, Natalia Molina, Felipe G. Serrano, Santiago Molina and Pilar Vigil.

Harvard Medical School. “How does exercise reduce stress? Surprising answers to this question and more.” Harvard Health Publishing.

Qi X, Yun C, Pang Y, Qiao J. “The impact of the gut microbiota on the reproductive and metabolic endocrine system.” Gut Microbes. 2021;13(1):1-21. doi:10.1080/19490976.2021.1894070. 

Paweł Milart,corresponding author Ewa Woźniakowska, and Wojciech Wrona. 

Medical (clinical)

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If you are experiencing irregular periods in your 40s, you may be in perimenopause. Find out how you can relieve perimenopause symptoms with Alloy.

What Causes Irregular Periods in Your 40s? Perimenopause

In My 40s & Having Irregular Periods: Am I in Perimenopause?

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Woman holding blister packet of low-dose birth control pills.

Discover how birth control may help ease menopausal symptoms. Get the facts on how it works and whether it’s a good fit for you.

Low-Dose Birth Control & Menopause: Managing Your Symptoms

Low-Dose Birth Control

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Find Your Plan - Standard - External

Cheyenne Buckingham

Cheyenne Buckingham is a medical writer for Alloy Health

Dr. Michelle Montville

Michelle Montville

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Discover how at-home hormone tracking works in perimenopause, its key limitations, and why your symptoms are the most important factor in getting personalized care.

At-Home Hormone Testing for Perimenopause & Menopause | Alloy

At-Home Hormone Testing: What to Know During Perimenopause and Menopause

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Menopause and Oral Health: Clinical Implications and Preventive Strategies.

Effect of Whey Protein Supplementation in Postmenopausal Women: A Systematic Review and Meta-Analysis.

Understanding the Link Between Hormonal Changes and Gingival Health in Women: A Review.

Burning mouth syndrome.

Burning Mouth Syndrome Etiology: A Narrative Review.

Oral implications of osteoporosis.

Hormonal changes during menopause and the impact on fluid regulation.

Probiotics and Prebiotics: Any Role in Menopause-Related Diseases?

Stephanie Culver

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Learn how declining estrogen during perimenopause causes dry mouth, sensitive gums, and Burning Mouth Syndrome, along with practical tips to protect your oral health.

Get Relief of Dry Mouth & Sensitive Gums During Menopause - Alloy 

“Estrogen receptors are present in the oral mucosa and salivary glands, and declining estrogen leads to several interconnected problems and complaints”

Why Your Oral Health Can Change During Perimenopause and Menopause

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Anna Johnson

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GLP-1 receptor agonists for weight loss for perimenopausal and postmenopausal women: current evidence.

Long-term persistence of hormonal adaptations to weight loss.

Semaglutide, a once-weekly human GLP-1 analog, does not reduce the bioavailability of the combined oral contraceptive, ethinylestradiol/levonorgestrel.

GLP-1 medication and weight loss: Barriers and motivators among 1659 participants managed in a virtual setting.

Interactions between glucagon like peptide 1 (GLP-1) and estrogens regulates lipid metabolism.

Menopausal Hot Flashes: A Concise Review.

Dr. Judith Barreiro

Dr. Judith Barreiro, MD, is a board-certified gynecologist with over two decades of experience providing high-level surgical and clinical care to women in the Tampa Bay area. 

Dr. Judith Barreiro - OBGYN

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Learn how peptide therapy works, how GLP-1 medications differ from HRT, and what research says about using peptides for menopause and weight management.

Peptides in Menopause: Evidence, HRT Differences & Safety Risk

A practical, evidence-based guide to peptides, GLP-1 medications, and menopause hormone therapy

Peptide Therapy - How It Can Help During Menopause

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Find Your Relief Plan - Standard - External - LG

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Discover the $20B National Strategy to Close the Women's Health Gap. Learn how leading medical groups plan to transform research, data, and care for women.

The National Strategy to Close the Women’s Health Gap Explained

The $20 Billion Moonshot: Inside the National Strategy to Close the Women's Health Gap

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Mayo Clinic — Perimenopause: Symptoms and causes.

The Menopause Society (formerly North American Menopause Society) — Perimenopause.

Harvard Health Publishing — Perimenopause: Rocky road to menopause.

Cleveland Clinic — Perimenopause: Age, Stages, Signs, Symptoms & Treatment.

American College of Obstetricians and Gynecologists (ACOG) — Perimenopausal Bleeding and Bleeding After Menopause.

ACOG — Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women (relevant for perimenopausal heavy bleeding).

Irene N. Wahba

Dr. Irene Wahba is a board-certified obstetrician-gynecologist with over 25 years of clinical experience.

Dr. Irene Wahba

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Yes, you may experience phantom periods or go 6 months or more without bleeding. Perimenopause cycles become irregular because estrogen and progesterone levels fluctuate and disrupt the normal menstrual cycle. 

Are Irregular & Phantom Periods Normal during Perimenopause?

Estrogen & Progesterone The Dance Behind Your Menstrual Cycle

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The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society.

Menopause and the vaginal microbiome.

Vulvovaginal atrophy.

Vaginal estrogen for genitourinary syndrome of menopause: a systematic review.

Vaginal lubricants and moisturizers: a review into use, efficacy, and safety.

The genitourinary syndrome of menopause.

Association between vaginal microbiota and vaginal inflammatory immune markers in postmenopausal women.

Hormonal Treatments and Vaginal Moisturizers for Genitourinary Syndrome of Menopause : A Systematic Review.

The etiology and management of recurrent urinary tract infections in postmenopausal women.

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Declining estrogen during menopause alters local pH balances across your body. Learn how these shifts cause dry skin, burning mouth, and recurrent UTI symptoms.

How Menopause Affects Your Body's pH: Skin, Mouth, & Vagina

Signs and Symptoms Your PH Balance Might be Off Due to Menopause

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Pharmacological and metabolic effects of drospirenone as a progestin-only pill compared to combined formulations with estrogen.

[Contraception for women after 40: CNGOF Contraception Guidelines].

Are we overestimating the stroke risk related to contraceptive pills?

Use of hormones and risk of venous thromboembolism.

Hormonal Contraceptive Formulations and Breast Cancer Risk in Adolescents and Premenopausal Women.

Contraception: Menarche to Menopause.

Effects of estrogens and progestogens on the renin-aldosterone system and blood pressure.

Kathryn Williams

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Wondering if Slynd is right for perimenopause? Learn how this estrogen-free birth control pill prevents pregnancy and manages heavy bleeding.

Using Slynd During Perimenopause: Benefits, Symptoms, and Safety

Understanding the role of drospirenone‑only contraception during the menopause transition

Slynd: A progestin-only alternative for managing perimenopause and menopause symptoms

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Hadley Mendelsohn

Premature ovarian insufficiency, early menopause, and induced menopause

Anti-Müllerian hormone for the diagnosis and prediction of menopause: a systematic review.

Hormone replacement therapy in young women with primary ovarian insufficiency and early menopause.

Ovarian aging: mechanisms and clinical consequences.

Ovarian aging in humans: potential strategies for extending reproductive lifespan.

Menopausal osteoporosis: screening, prevention and treatment.

The menopausal transition period and cardiovascular risk.

Onset of the Menopause Transition: The Earliest Signs and Symptoms.

Amy Hayes

Amy Hayes Headshot

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Difficulty conceiving can sometimes signal early changes in ovarian function rather than a standalone fertility issue. Conditions such as perimenopause, early menopause, and premature ovarian insufficiency affect hormone production and egg supply years before the final menstrual period. 

Infertility and Ovarian Aging: Early Menopause and POI - Alloy 

How fertility changes, ovarian aging, and menopause timing intersect in your 30s and 40s

Infertility and Ovarian Aging: Understanding Early Menopause and POI

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Management of perimenopausal and menopausal symptoms.

The Menopause Transition: Signs, Symptoms, and Management Options.

Perimenopause: From Research to Practice.

Duration of menopausal vasomotor symptoms over the menopause transition.

Cognitive Problems in Perimenopause: A Review of Recent Evidence.

Body composition and cardiometabolic health across the menopause transition.

Management of the Perimenopause.

Perimenopausal abnormal uterine bleeding.

Effects of mind-body exercise on perimenopausal and postmenopausal women: a systematic review and meta-analysis.

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Menopause and perimenopause can bring a wide range of physical, cognitive, emotional, and sexual symptoms driven by shifting estrogen and progesterone levels. While hot flashes and irregular periods are well known, many women also experience sleep disruption, brain fog, mood changes, vaginal dryness, metabolic changes, and skin or joint symptoms. These symptoms often appear in clusters and may evolve across stages of the menopause transition. Recognizing common patterns can help distinguish typical hormonal changes from symptoms that warrant medical evaluation and guide appropriate treatment options.

The 34 Symptoms of Menopause & Perimenopause: The Full List

Understanding symptom clusters, stages of the menopause transition, and when it’s time to talk with a clinician

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Dietary intake and menopausal symptoms in postmenopausal women: a systematic review.

The role of diet in managing menopausal symptoms: A narrative review.

Nutritional interventions in treating menopause-related sleep disturbances: a systematic review.

A dietary intervention for vasomotor symptoms of menopause: a randomized, controlled trial.

Lifestyle and Behavioral Enhancements of Sleep: A Review.

Darwana Ratleff Todd

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Certain eating patterns—such as high sugar intake, excess caffeine, alcohol use, or skipping meals—may worsen symptoms like fatigue, anxiety, and sleep problems by destabilizing blood sugar and stress responses. Balanced meals rich in protein, fiber, and whole foods may help support steadier energy, metabolic health, and overall symptom management in midlife.

Cortisol and Menopause: Do Certain Foods Cause Stress Spikes?

Understanding stress hormones, blood sugar, and nutrition during the menopause transition

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Growth hormone reduces inflammation in postmenopausal women with abdominal obesity: a 12-month, randomized, placebo-controlled trial.

The endocrine system and ageing.

Menopausal obesity--myth or fact?

Sarcopenia, hypermetabolism, and aging.

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Sermorelin is a synthetic peptide that stimulates the body to release growth hormone by activating the pituitary gland. Interest in the therapy has grown in midlife wellness circles because aging is associated with declining growth hormone and IGF‑1 levels, which may affect body composition, muscle mass, sleep patterns, and metabolism. However, evidence for sermorelin itself—particularly in perimenopausal women—is limited, and many claims about energy, weight loss, or “anti‑aging” benefits are extrapolated from broader research on the growth hormone axis. Understanding the physiology, evidence gaps, potential risks, and how sermorelin differs from established menopause treatments helps patients make informed decisions with their clinicians.

What is sermorelin peptide and does it help with menopause?

How this growth‑hormone–releasing peptide works, what the science says, and how it compares with proven menopause treatments

What is sermorelin peptide and how does it work? Does it help with menopause?

Perimenopause

Perimenopause Isn’t One Story: Here’s Why Every Voice Matters

How Long Does Perimenopause Last? 4 Signs Perimenopause Is Ending

Here’s What You Need to Know About the New OTC Birth Control Pill & Perimenopause

Perimenopausal Weight Gain: What You Need to Know

In My 40s & Having Irregular Periods: Am I in Perimenopause?

Low-Dose Birth Control

At-Home Hormone Testing: What to Know During Perimenopause and Menopause

Why Your Oral Health Can Change During Perimenopause and Menopause

Peptide Therapy - How It Can Help During Menopause

The $20 Billion Moonshot: Inside the National Strategy to Close the Women's Health Gap

Estrogen & Progesterone The Dance Behind Your Menstrual Cycle

Signs and Symptoms Your PH Balance Might be Off Due to Menopause

Slynd: A progestin-only alternative for managing perimenopause and menopause symptoms

Infertility and Ovarian Aging: Understanding Early Menopause and POI

The 34 Symptoms of Menopause & Perimenopause: The Full List

Cortisol and Menopause: Do Certain Foods Cause Stress Spikes?

What is sermorelin peptide and how does it work? Does it help with menopause?

Understanding Endometrial Hyperplasia in Menopause: What is Normal?

Hydroquinone vs. Tretinoin with Niacinamide

Spironolactone During Menopause: How It Can Help with Your Thinning Hair

Menopause in the Workplace : Dealing with Brain Fog & Hot Flashes at Work

What Causes Rosacea in Midlife? What Are the Triggers and Best Treatments Options?

What is Melasma and Does Tretinoin Help Treat it?

6 Signs You Need Hormone Replacement Therapy

Early Perimenopause in Your 30s: The 'Millennial Menopause

The Menopause Eye Shift: Vision Changes and Dry Eye

"Estrogen and the 'Internal Tremor'" : Causes of Vibrating and Buzzing Sensations

Perimenopause Headaches vs. Regular Headaches

Menopause Crazy Behavior: Perimenopause Depression

Why Do My Breasts Hurt During Perimenopause and Menopause?

Why Does Menopause Change Body Odor? Causes and Solutions

Perimenopause: What Is it, and How Did We Get Here?

Perimenopause & Headaches

It’s Not Puberty, It’s Perimenopause. Let’s Talk About Acne.