Most people have heard of menopause, but far fewer are familiar with the term perimenopause.

Many of the symptoms associated with menopause actually first present and take center stage during the time before menopause, which is is defined as going 12 consecutive months without a menstrual period. Perimenopause typically precedes actual menopause by a minimum of several years.

​And it’s much more than hot flashes. If you’re wondering if what you’re feeling may be indicative of perimenopause, see what symptoms are most common, especially after ruling out any other medical condition, such as an autoimmune disease, thyroid disorder or vitamin deficiency.

This list of resources is continually updated.

2017: Management of Perimenopause – Southern Medical Association, Oct. 11, 2018 – https://www.youtube.com/watch?v=_scCqMcxijg

Executive Summary of the Stages of Reproductive Aging Workshop: Addressing the Unfinished Agenda of Staging Reproductive Aging, Various Contributors, April 2012 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340903/

Menopause – Mount Sinai - https://www.mountsinai.org/health-library/report/menopause

Menopause Diagnosis and Treatment, Mayo Clinic, Oct. 14, 2020 - https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401

Menopause Symptoms, Mayo Clinic, Oct. 14, 2020 - https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397

Menopause Symptoms Start Long Before Women Stop Getting Their Periods, Study Shows – Forbes, Deb Gordon, July 29, 2021 - https://www.forbes.com/sites/debgordon/2021/07/29/menopause-symptoms-start-long-before-women-stop-getting-their-periods-new-study-shows/

Perimenopause: Hormone Ups and Downs Can Last Years – Amy Burkholder, CNN, Jan. 10, 2007 – http://www.cnn.com/2007/HEALTH/01/10/peri.menopause/

Study Finds Potential Early Sign of Perimenopause –Health Europa, Feb. 14, 2022 – https://www.healtheuropa.eu/study-finds-potential-early-sign-of-perimenopause/113505/

The Brain Fog of Menopause – Jane E. Brody, The New York Times, Dec. 17, 2018 - https://www.nytimes.com/2018/12/17/well/live/the-brain-fog-of-menopause.html

The Truth about the Link between Alzheimer’s and Menopause – Newson Health Menopause & Wellbeing Centre, Jan. 30, 2020 - https://www.newsonhealth.co.uk/news/the-truth-about-the-link-between-alzheimers-and-the-menopause
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Understanding Perimenopause – Sharon Begley - http://www.sharonlbegley.com/understanding-perimenopause

We Need to Know How Menopause Changes Women’s Brains – Kim Tingley, The New York Times, July 21, 2021 - https://www.nytimes.com/2021/07/21/magazine/menopause-brains.html

Researching perimenopause and menopause is like a minefield of do's, don'ts, musts and won'ts. There are so many websites, video channels, social media groups, medical practices, natural health institutes and others out here - all claiming to be the most veritable, empirical source on all things related to the perimenopausal or menopausal woman.

It helps less that most conventional internal medicine doctors, family practitioners and primary care physicians are pretty ill-informed about menopause, with most of them receiving very little training on the subject in medical school. This leaves many women getting either no or bad input from the average doctor, leaving them in an informational rut and yearning for legitimate answers and advice.

Below are some credible organizations, leaders and emerging voices on perimenopause and menopause today. They use real scientific and medical research, and/or experience to back their claims and guidance. While some do offer paid consultations, they all produce and make available an incredible amount of data and information for free. All you must do is take the time to read, listen and make use of the information they've put together for you.

This list of resources is continually updated.

A Vogel UK – From across the pond, menopause advisor Eileen Durward offers advice on lifestyle, homeopathic help, diet and more for perimenopause and post-menopause – https://www.youtube.com/c/AvogelCoUk/videos

Australasian Menopause Society – “Empowering Menopausal Women,” this consortium of physicians and healthcare professionals have a special interest in women’s midlife health and menopause – https://www.menopause.org.au/about-ams  

Ellen Dolgen – A nationally recognized leading voice and author on menopause and women’s health – https://ellendolgen.com/
Her blog is here – https://ellendolgen.com/blog/

International Menopause Society (IMS) – A global collaborative bringing together leading experts on women’s health and menopause, advocating evidence-based treatments and best practices, generally more progressive than U.S.-focused standards - https://www.imsociety.org/
IMS on YouTube: https://www.youtube.com/channel/UC-4OHO-C2exmMFhKwVFgX6A/videos

Jumpstart AIP – The online destination of Kitty Anderson, a self-described Board-certified menopause coach - https://www.jumpstartaip.com/
She also runs a YouTube channel, Create a Menopause Recovery: https://www.youtube.com/channel/UCizbP_luUAbrYisSYUwmolw

KE Garland - Navigating the Change - An inclusive site that aims to reflect the experiences of all women, including those from less represented backgrounds, blending literary content with informational, fact-driven guidance - https://navigatingthechange.com/

Let's Talk Menopause - Founded by Donna Klassen, Christine Maginnis and Samara Daly, a springboard for its eponymous podcast, resources and more, including being the launching pad for the first menopause awareness campaign in New York City. They also have clinical professionals on the Board of Directors - https://www.letstalkmenopause.org/ 

​Menopause Taylor – Retired gynecologist Barbara Taylor, MD, is a vocal proponent of helping midlife women live their best lives, giving guidance on lifestyle, brain health, hormone replacement therapy, diet, exercise and more - https://menopausetaylor.me/
Menopause Taylor on YouTube: https://www.youtube.com/channel/UCSJItwa6IVPGxUVfTHKbwLg

My Second Spring – Started by an Irish mother of four and former investor relations / PR maven as a hub for all things menopausal since 2013, with a decidedly naturopathic bent - https://mysecondspring.ie/
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North American Menopause Society (NAMS) – Nonprofit, multidisciplinary organization focused on the health and quality of life of women at midlife and beyond, offering training for physicians to become certified menopause specialists  - https://www.menopause.org/

Sleep, or rather the lack thereof, is such a common perimenopausal symptom that it merits its own category.

Online groups are flooded with women bemoaning their lack of sleep, just as much as hot flashes.

Perimenopausal women, who’ve never had sleep issues before, suddenly may begin experiencing issues falling asleep (sleep onset) and staying asleep (sleep disruption), either with or even in the absence of night sweats or hot flashes. Even with “sleep hygiene” and over-the-counter medications, many find little to no relief until they try other solutions, like hormone replacement or other medications.

​This is because sleep issues during perimenopause have practically nothing to do with lifestyle habits, sleep hygiene, diet, willpower or much else besides the erratic nature of hormones during this time, which also influences pivotal brain and adrenal functions, too. Combined, these all tie into sleep and one’s ability to attain it.

Note: This list of resources is continually updated.

Antidepressant Management of Insomnia Disorder in the Absence of a Mood Disorder – Pargol K. Nazarian, PharmD, Susie H. Park, PharmD, Mental Health Clinician, 2014 – https://meridian.allenpress.com/mhc/article/4/2/41/37095/Antidepressant-management-of-insomnia-disorder-in

Can Magnesium Supplements Really Help You Sleep? – Anahad O’Connor, The New York Times, Aug. 31, 2021 – https://www.nytimes.com/2021/08/31/well/mind/magnesium-supplements-for-sleep.html

Correlation between Estrogen and Sleep Disturbances – Winona, Nancy L. Belcher, Ph.D., Oct. 8, 2021 – https://bywinona.com/journal/estrogen-and-sleep-disturbances

Decrease in Melatonin Precedes Follicle-Stimulating Hormone Increase during Perimenopause – O. Vakkuri, A. Kivela, J. Leppaluoto, M. Valtonen, A. Kauppila, European Journal of Endocrinology, Aug. 1996 - https://pubmed.ncbi.nlm.nih.gov/8810731/

Effects of Estrogen Therapy on PostMenopausal Sleep Quality Regardless of Vasomotor Symptoms: A Randomized Trial – Climacteric, April 2015 - https://pubmed.ncbi.nlm.nih.gov/25242569/

Effect of Short-Term Transdermal Estrogen Replacement Therapy on Sleep: A Randomized, Double-Blind Crossover Trial in Postmenopausal Women – Clinical Trial, May 1999 - https://pubmed.ncbi.nlm.nih.gov/10231049/

For Some Women, A Connection May Exist Between Poor Sleep and Hormones – The Washington Post, Leigh Weingus, Sept. 18, 2021 – https://www.washingtonpost.com/health/sleep-hormones-link/2021/09/17/603c5534-f538-11eb-9738-8395ec2a44e7_story.html

How Menopause Affects Sleep – The Sleep Doctor, Dr. Michael Breus, Jan. 5, 2018 - https://thesleepdoctor.com/2018/01/05/menopause-affects-sleep/

How to Get Better Sleep during Menopause – Sally Turner, Patient.Info, June 21, 2021 - https://patient.info/news-and-features/how-to-get-better-sleep-during-menopause

Insomnia and Adrenal Fatigue: Why Can’t I Sleep When It’s Time to Go to Bed? – Michael Lam, MD; Justin Lam, Dr. Lam Coaching, 2020 - https://www.drlamcoaching.com/blog/insomnia-and-adrenal-fatigue/

Insomnia Is a Common Side Effect of Menopause: If It’s Happening to You, Here’s Your Action Plan – Parade, Kaitlin Vogel, Aug. 9, 2021 – https://parade.com/1243685/kaitlin-vogel/menopause-insomnia/

Italian Association of Sleep Medicine (AIMS) Position Statement and Guideline on the Treatment of Menopausal Sleep Disorders – Maturitas, November 2019 - https://www.maturitas.org/article/S0378-5122(19)30630-9/fulltext

Longitudinal Study of Insomnia Symptoms Among Women during Perimenopause – Colleen Ciano, Tonya S. King, Robin Redmon Wright, Michael Perlis, Amy M. Sawyer, Journal of Obstetrical Gynecology and Neonatal Nursing, Sept. 5, 2017 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776689/

Melatonin: A Precious Molecule that Decreases with Age – Cultura Pierpaoli, Dr. Walter Pierpaoli - https://culturapierpaoli.ch/melatonin/?lang=en 

Melatonin for Menopausal Sleep Disorders and Quality of Life – Judith L. Balk, MD, Relias Media, Aug. 1, 2011 - https://www.reliasmedia.com/articles/131643-melatonin-for-menopausal-sleep-disorders-and-quality-of-life

Menopause and Insomnia – Healthline, Kimberly Holland, Sept. 10, 2020 - https://www.healthline.com/health/menopause/menopause-and-insomnia

Menopause and Melatonin – University of Utah, May 27, 2021 - https://healthcare.utah.edu/the-scope/shows.php?shows=1_1jocj3fc
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Mirtazapine vs. Trazodone for Sleep – Siestio - https://siestio.com/mirtazapine-vs-trazodone-for-sleep/

Progesterone and Sleep – Leigh Ann Scott, MD, May 1, 2018 - https://www.leighannscottmd.com/progesterone-sleep/

Progesterone Prevents Sleep Disturbances and Modulates GH, TSH and Melatonin Secretion in Postmenopausal Women – The Journal of Clinical Endocrinology and Metabolism, Anne Caufriez, Rachel Leproult, Mireille L’Hermite-Baleriaux, Miriam Kerkhofs, Georges Copinschi, April 2011, Vol. 96, Issue 4 - https://academic.oup.com/jcem/article/96/4/E614/2720877

Safety and Efficacy of Antidepressants in Menopausal Sleep Disturbances – Neurology Advisor, Amit Akirov, MD, Oct. 2, 2020 – https://www.neurologyadvisor.com/topics/sleep-disorders/safety-and-efficacy-of-antidepressants-in-menopausal-sleep-disturbances/

Serotonergic Antidepressants for Sleep Disturbances in Perimenopausal and Post-Menopausal Women: A Systemic Review and Meta-Analysis –  Yu-Shian Cheng, Cheuk-Kwan Sun, Pin-Yang Yeh, Ming-Kung Wu, Kuo-Chuan Hung, Hsien-Jane Chiu, Menopause, Sept. 4, 2020 – https://pubmed.ncbi.nlm.nih.gov/32898019/

Sleep Disturbance and the Menopause – Australasian Menopause Society, Sept. 2018 – https://www.menopause.org.au/hp/information-sheets/sleep-disturbance-and-the-menopause2

Sleep Disturbances during the Menopausal Transition – Geena Athappilly, MD, and Hadine Joffe, MD, NEJM Journal Watch, March 11, 2014 – https://www.jwatch.org/na33784/2014/03/11/sleep-disturbances-during-menopausal-transition

Sleep During the Menopausal Transition: A 10-Year Follow-Up – Nea Kalleinen, Jenni Aittokallio, Laura Lampio, Matti Kaisti, Paivi Polo-Kantola, Olli Polo, Olli J. Heinonen, Tarja Saaresranta, Sleep, Vol. 44, Issue 6, June 2021 - https://academic.oup.com/sleep/article/44/6/zsaa283/6039192

Sleep, Melatonin and the Menopausal Transition: What Are the Links? – Sleep Science, Shazia Jehan, et. al., Jan-May 2017 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5611767/

Sleep Problems during the Menopausal Transition and Early Post-Menopause: Observations from the Seattle Midlife Women’s Health Study – Nancy Fugate Woods, RN, PhD; Ellen Sullivan Mitchell, PhD, Sleep, Volume 33, Issue 4, April 2010 - https://academic.oup.com/sleep/article/33/4/539/2454668

SSRIs for Hot Flushes and Insomnia – Australasian Menopause Society, April 30, 2012 – https://www.menopause.org.au/members/ims-menopause-live/ssris-for-hot-flushes-and-insomnia

Treatment of Insomnia, Insomnia Symptoms and Obstructive Sleep Apnea during and after Menopause: Therapeutic Approaches – Joshua Z. Tal, Sooyeon A. Suh, Claire L. Dowdle, Sarah Nowakowski, Current Psychiatry Review, Vol. 11, Issue 1, 2015 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607064/

When Does Estrogen Replacement Therapy Improve Sleep Quality? – American Journal of Obstetrics and Gynecology, P. Polo-Kantola, R. Erkkola, H. Helenius, et. al., May 1998 - https://pubmed.ncbi.nlm.nih.gov/9609575/

Why Can’t She Sleep? The Gold-Standard Cure for Insomnia You’ve (Probably) Never Heard Of – Margaret Brady, Verily, Sept. 18, 2019 – https://verilymag.com/2019/09/how-our-hormones-affect-our-sleep-insomn

Women, Are Your Hormones Keeping You Up at Night? – Yale Medicine, Jennifer Chen, July 10, 2017 - https://www.yalemedicine.org/news/women-are-your-hormones-keeping-you-up-at-night

Ladies, how are you dealing with sleeplessness? Tell us your strategies in the comments below.