The whispers about hormones, perimenopause, and menopause have remained frustratingly quiet for too long. Dr. Kristen Markell, a double-board certified OBGYN and certified menopause practitioner, breaks the silence with game-changing clarity in this essential conversation moderated by VEST Member Alison Anthony.

For decades, women experiencing brain fog, anxiety, fatigue, and mood changes during perimenopause have been dismissed or told to "just deal with it." Dr. Markell reveals the biological truth: these symptoms aren't character flaws but natural responses to dramatic hormonal fluctuations that can begin up to a decade before menopause. She expertly explains how progesterone typically declines first, while estrogen levels become erratic with extreme highs and lows—a process many healthcare providers themselves don't fully understand.

The consequences of this knowledge gap are serious. Women's highest risk of suicide attempts occurs between ages 45-49, coinciding precisely with perimenopause. Beyond mental health, these hormonal changes affect bone density, heart health, and cognitive function. Yet many women suffer silently, especially in professional settings where they fear being perceived as weak or incompetent if they acknowledge their symptoms.

Dr. Markell guides listeners through the confusing landscape of treatment options—from hormone replacement therapy and bioidenticals to supplements and lifestyle modifications. She emphasizes that finding the right provider is crucial, suggesting resources like the North American Menopause Society to locate certified practitioners. Most importantly, she frames perimenopause not as a decline but as "a portal into the second half of life"—an opportunity to refocus energy on what truly matters.

Whether you're in your 20s planning for future hormonal health, navigating perimenopause now, or supporting someone who is, this conversation provides the knowledge, validation, and practical guidance to transform how we approach this universal yet uniquely personal journey. Your hormones aren't just about symptoms—they're foundational to how you show up in every area of your life.

For our guest full bio and show notes click here.

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