Dr Naomi Potter’s Guide to Menopause
There’s no doubt that menopause can be tough, but support is out there. We asked Dr Naomi Potter, menopause specialist and co-author of the book Menopausing, for her expertise on navigating your body and mind through this transformative time.
“The menopause is when your ovaries essentially stop working – officially, that’s 12 months after your last period. Perimenopause is the time before that, where you have more turbulent hormonal activity. Perimenopause can last for months, years, or sometimes even a decade.”
“It can be difficult to pinpoint exactly which symptoms are down to perimenopause – this is because they can change all the time, and because you’ve got oestrogen receptors throughout your entire body. The symptoms that everybody associates with the perimenopause and menopause are hot flushes, night sweats and periods changing and stopping, but there are so many more. You can have symptoms from the top of your head to the tips of your toes, from hair loss and eye dryness to palpitations and muscle pain – and that’s what makes it so difficult to diagnose. It really can affect any organ at any time.” Other common effects include: • Mood swings, anxiety and low self-esteem • Brain fog • Difficulty sleeping • Headaches or migraines • Skin changes • Reduced sex drive or discomfort during sex
“There’s often a lot going on when you’re perimenopausal. You may have children, older parents to look after, or a demanding career. It can be hard to work out what’s hormonal and what’s life. If you feel like you’re not coping with everyday challenges like you once did, that’s a hint it could be perimenopause.” Your GP should be your first port of call.
“Lifestyle is really important. There are a number of adjustments you can make… • Cutting down on caffeine is a big one: it’s a really powerful stimulant and probably the most anxiety-inducing. • Exercise is phenomenal! • A balanced diet that’s rich in unrefined foods and low in sugar. • Smoking: it’s terrible. You have to stop.”
“There are a lot of common misconceptions about the menopause and the perimenopause. “I'm too young“ is probably the biggest one - we frequently see women younger than 40 experiencing perimenopause symptoms. Probably the biggest concern among my patients is, “Am I ever going to feel like 'me' again?“ The answer is, invariably, yes – you are. Have faith that things will get better. Ultimately, it’s about what’s right for you.”
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A timely Substack essay challenging outdated age-based limits for HRT and advocating for a personalized approach to hormone health.

Hormones regulate so many of the systems in your body. At times, it seems unclear exactly what each of them accomplishes, or why certain levels of particular hormones are floating around. This conversation comes up, especially around perimenopause, and even post-menopause, when specific hormone therapies can be utilized as treatments for bothersome menopause-related symptoms like hot flashes, low energy, and low libido. Estrogen is the most common hormone used in hormone replacement therapy, also known as menopausal replacement therapy, but what about testosterone? Yes, we’re talking about that hormone, the one that’s typically known as the “male” hormone. That’s right — testosterone is found in women’s bodies (at one-tenth of the amount in men’s bodies, but still) and any people born as female. Ovaries make testosterone and technically produce it at even higher levels than estrogen. And during menopause, when the ovaries slow down in their functioning, estrogen levels lower, as do testosterone levels in the body. Just like estrogen, testosterone can be safely used as a hormone replacement therapy during menopause. Still, not many people know that, because it’s not well-studied or officially FDA-approved for women. Keep on reading for everything you didn’t know about testosterone in women, testosterone replacement therapy, and how to know if it could be the right treatment for you.