My body composition scan this year surprised me.

I went in expecting to maintain. That was the goal. After entering surgical menopause at 42 following a hysterectomy, I knew that protecting my muscle mass and bone density would require intentional effort. I was prepared to fight to hold onto what I had.

Instead, I found out I had gained 5 pounds of muscle and lost 3 pounds of fat.

At almost 46. Postmenopausal. After 4 surgeries.

I'm sharing this not to brag, but because I am tired of the narrative that muscle loss in menopause is inevitable. I hear it constantly, and I see it repeated all over social media. It is not the whole story.

Here is what actually moved the needle for me.

I wore a night splint every single night. I stretched before my feet even touched the floor every single morning. I iced, I exercised, I modified my shoes. I did everything right. And nothing worked.

Here is the part that still gets me. I am an occupational therapist with decades of clinical experience. Treating musculoskeletal conditions is literally my job. And I could not fix my own plantar fasciitis no matter what I tried.

That is because I was missing the underlying cause.

My plantar fasciitis was one of my first symptoms of menopause. At the time, I had no idea my ovaries had stopped functioning following my hysterectomy. I was estrogen deficient, and my body was telling me in one of the most persistent and painful ways it could. No amount of night splints was going to fix a hormone problem.

My standard lipid panel looked really good. Total cholesterol 162, HDL 69, LDL 80, triglycerides 54. The kind of numbers that get a nod from your doctor and a "you're fine" and nothing else.

But I decided to look deeper. And what I found completely changed my care plan.

I am an occupational therapist, Certified Women's Health Specialist, and Certified Menopause Coach. I went through surgical menopause at 42. Cardiovascular health in midlife women is something I talk about with clients regularly. And still, when I dug deeper into my own numbers, I found something my standard panel had never indicated.

I am sharing this because I know how many women are sitting with a "normal" cholesterol panel, feeling reassured, and never being offered a more complete picture. If you are in perimenopause or menopause, this may be one of the most important things you read this year.

I want to tell you about two clients I worked with recently, because I think their experiences might sound familiar to you.

Both women came to me struggling with sleep. Not just the occasional restless night, but persistent, demoralizing sleep that never felt like enough no matter what they did. In both cases, we had done the work. Their hormone therapy was optimized. Their sleep hygiene was solid. We had looked carefully at lifestyle, stress, timing, and everything else within my scope as an occupational therapist and menopause coach. And still, their sleep wasn't improving the way it should have been.

In both cases, I recommended they follow up with their doctor and ask specifically about a sleep study. And in both cases, that sleep study came back positive for obstructive sleep apnea.

I am sharing this because I think sleep apnea is one of the most underrecognized contributors to poor sleep in women going through perimenopause and menopause, and because the way it tends to present in women is so different from the stereotypical picture that it often goes undetected for years. If you have been doing everything right and still waking up exhausted, this is worth understanding.

Sleep is one of the areas where I spend a significant amount of time in my work, because it touches everything. And sleep apnea is a piece of that puzzle that deserves far more attention in menopause conversations than it currently gets.

So let's talk about it.

Hormone replacement therapy changed my life. I say that without hesitation and I will keep saying it, because I think the decades of fear and misinformation around HRT have caused enormous unnecessary suffering for women who deserved access to it and were denied it.

But I also want to say something that I think gets left out of the conversation far too often.

For most women, hormone therapy is not a quick fix. It is a process. And the expectation that it should feel dramatically different within a few weeks is one of the main reasons women give up on it before it has had a real chance to work.

If you have started HRT and are still not where you want to be, or if you are researching hormone therapy and trying to set realistic expectations before you begin, this post is for you. I want to give you an honest picture of what finding the right protocol actually looks like, because I think it will save you a significant amount of frustration and potentially prevent you from abandoning something that could genuinely help you.

Do you ever feel like managing perimenopause or menopause has completely taken over your life?

You’re trying to eat well, exercise, get enough sleep, manage work deadlines, care for your family, and still carve out a few minutes for yourself. On top of all of that, your hormones are shifting in ways that make everything feel harder than it used to.

You’re not alone. Most women juggling careers, relationships, children, and aging parents feel the same way. The challenge isn’t motivation or willpower; it’s the sheer volume of responsibilities combined with hormonal and neurotransmitter changes that make your usual coping strategies feel like they’ve disappeared overnight.

You notice more hair in your brush.

More in the shower drain.

Maybe your ponytail feels thinner. Maybe your part looks wider. Maybe your texture has changed completely.

And if you’ve found yourself spiraling a little when you see a clump of hair come out… you are not being vain.

Hair is deeply connected to identity, femininity, and vitality. For many women, it feels like part of who we are. So when hair loss starts during perimenopause or menopause, it can feel deeply personal — and emotionally unsettling.

I’ve had very thick, full hair my entire life. While I haven’t experienced significant thinning, I have noticed increased shedding recently. And honestly? Even knowing the physiology of menopause, it’s still hard not to feel a moment of panic.

Let’s talk about why hair loss happens in midlife — and what you can actually do about it.

Menopause affects every woman differently. For some, the transition is gradual and predictable. For others—especially those experiencing early, surgical, or treatment-induced menopause—the changes can feel sudden and overwhelming.

If you’re a hormonally sensitive woman—or what I call a sensitive flower—these transitions may feel more intense. Understanding your body, working with the right provider, and supporting your lifestyle can help you navigate menopause successfully.

As an occupational therapist and menopause coach, there is one pattern I see far too often.

Women are thrown into surgical or treatment-induced menopause and are never given a real plan.

If your ovaries are removed, or your hormones are shut down due to cancer treatment or other medical reasons, there must be a conversation beforehand about how you will support your body afterward. This is not just losing your period. This is an abrupt loss of estrogen, progesterone, and testosterone. These hormones play a critical role in brain health, sleep, mood, sexual function, bone density, cardiovascular health, and metabolic health.

For many women, the best plan includes replacing those hormones unless there is a clear medical reason not to. And if hormone therapy is not an option, you still deserve a plan. You deserve options. You deserve information. You deserve support.

Why So Many Women Are Reconsidering Alcohol in Midlife

January tends to bring a lot of conversations about Dry January. For many women in perimenopause and menopause, it is a time of reflection and reassessment. Hormonal changes often make alcohol feel very different than it once did. What used to feel relaxing can suddenly lead to poor sleep, intense anxiety, hot flashes, and next day regret.

It felt like the right moment to share my personal journey with alcohol and why I chose to give it up for good.

If you’re in perimenopause or menopause, chances are you’ve done a lot of research.

You’ve listened to podcasts.
Saved Instagram posts.
Read articles about hormones, supplements, sleep, stress, and weight changes.
Collected menopause information like it’s your second job.

And honestly? That makes sense.

Learning feels productive.
It feels responsible.
It feels like progress.

But here’s the truth I see over and over again in my menopause coaching practice:

Motion is not the same thing as action.

Brain fog is one of the most frustrating and misunderstood symptoms of menopause. For many women, it is not the hot flashes or night sweats that feel most disruptive. It is the unsettling sense that your brain is no longer working the way it used to.

My own experience with menopause brain fog began after my hysterectomy. Although my ovaries were left intact, they did not continue functioning as expected, and I went into menopause immediately. The cognitive changes came on quickly and were deeply unsettling. I struggled to find words, forgot appointments, and even made small billing errors at work, something I had never done in my entire career.

I began forgetting to respond to emails or follow up with people, despite always being highly reliable. I felt scattered, had trouble focusing, and struggled to concentrate. At my worst, I genuinely feared I might have early-onset dementia.

It was only later that I learned these changes were directly related to the hormonal shifts of menopause. Today, brain fog is the number one complaint I hear from my clients navigating perimenopause and menopause. Many women tell me it is more disruptive than weight gain, sleep issues, or vasomotor symptoms. It is the feeling that your brain is no longer functioning properly.