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Monday 8:30am - 5:30pm Tuesday 8:30am - 5:30pm Wednesday 8:30am - 5:30pm Thursday 8:30am - 5:30pm Friday 8:30am - 4:30pm

Peri & Pause, 1876 N Broad Street, Fuquay-Varina, NC (2025)

12/22/2025

🎄 12 Days of Menopause: Day 11 🎄

Today we’re shining a light on bone health in perimenopause and menopause—because bone loss doesn’t announce itself. It just quietly happens while we’re busy managing hot flashes, sleep issues, mood shifts, and everything else midlife throws at us. 🙃

Here’s what the evidence shows, in real-world terms:

Bone loss accelerates during late perimenopause and the early postmenopausal years, when estrogen levels decline.

Research shows women can lose ~1–2% of bone density per year during this transition, with the most rapid loss occurring around the final menstrual period.

Cumulatively, up to ~20% of lifetime bone loss can occur in the years surrounding menopause—often before osteoporosis is ever diagnosed.

Now the important hormone piece 👇
🩺 Systemic estrogen (including estradiol) is FDA-approved for the prevention of postmenopausal osteoporosis.
Estrogen plays a direct role in maintaining bone remodeling balance, and when estrogen declines, bone breakdown outpaces bone formation.

Bone health is not just about avoiding fractures later - it’s about preserving strength, stability, and independence for decades to come.

What helps support bones during this transition:

Weight-bearing and resistance exercise (yes, bones need stress to stay strong)

Adequate protein, calcium, and vitamin D

Early conversations about bone density, risk factors, and prevention strategies

Understanding how menopause physiology - not aging alone - drives bone changes

🎄 Ms. Elf’s takeaway today:
You can’t “feel” bone loss ... but you can do something about it early.

Educational only, not medical advice.
If you’re in perimenopause or menopause and wondering how to protect your bones long-term, this is exactly the kind of proactive, evidence-based conversation we love having with our patients. 💗

12/21/2025

🎄 12 Days of Menopause: Day 10 🌲

Ms. Elf had a plan.
Ms. Elf sat down.
That was it. 😴

Fatigue during perimenopause and menopause isn’t just “being tired.” It’s heavy, unmotivated, brain-foggy exhaustion...and it’s VERY real.

Here’s why it happens (science, but short):

🧠 Estrogen & brain energy
Estrogen helps the brain use glucose efficiently. When estrogen fluctuates, the brain has to work harder to get fuel → hello fatigue and brain fog.

😴 Sleep disruption
Night sweats, early waking, and lighter sleep mean you sleep… but don’t feel rested.

🔥 Stress load
Chronic stress + midlife demands drain energy fast.

What actually helps:
✔ Regular meals with protein
✔ Gentle movement (walking, strength training)
✔ Prioritizing sleep (even when imperfect)
✔ Addressing hormone health when appropriate

🎁 Day 10 takeaway:
You’re not lazy. You’re hormonally tired - and your body is asking for support.

Ms. Elf will now be taking a very intentional nap. 🛋️ Probably won't help.

Educational only, not medical advice. Persistent, worsening, or concerning fatigue should be evaluated - not everything is menopause. Peri & Pause is here to help.

12/20/2025

🎄 12 Days of Menopause: Day 9🎄
Ms. Elf is moving a little slow today… 🧑‍🎄🦴

Why?
She stayed up way too late watching that Alabama game last night, woke up stiff, creaky, and announced:
👉 “My joints hurt worse than usual, and I wasn't even on the receiving end of that football!"

Sound familiar? 😅

💡 Here’s the science (made simple):
Orthopedic expert Dr. Vonda Wright calls this cluster of symptoms the Musculoskeletal Syndrome of Menopause — it’s basically what happens when estrogen drops and affects bones, muscles, tendons, ligaments, and joints all at once. This can show up as: joint stiffness/aches, muscle weakness, faster loss of bone density, and even things like frozen shoulder or worsening arthritis — and it affects most people in this life stage.

So that “I feel 87 today” isn’t just in your head - it’s a very real body system response as hormones shift! 📉🦵

✨ Things that actually help (real life, not fluff):
• Strength training (yes, even light weights)
• Daily mobility & walking
• Sleep when you can
• Talking with a clinician who gets menopause

👉 One more thing:
If your joint pain is persistent, worsening, limited to one joint, or red/swollen, we want you to have this evaluated. It’s not always just hormones, and proper evaluation helps guide the right care.

💗 At Peri & Pause, we help you figure out what part of your pain is hormonal, what isn’t, and what steps make the biggest difference - so you don’t feel like you’re in this alone.

✨ Educational only. Not medical advice. Talk with your provider about symptoms or concerns. ✨

12/19/2025

🎄12 Days of Menopause: Day 8 🎄
Mood swings, irritability… and “Who is this person?” rage

Mr. Elf is getting snapped at one minute, ignored the next… and then everything is suddenly fine. 🎭
If that feels familiar, you’re not alone.

You snap over something tiny.
You feel a wave of anger out of nowhere.
You don’t recognize your own reactions - and that can be deeply unsettling.

For many women in perimenopause, mood swings and rage are some of the most disturbing symptoms, especially if you’ve never struggled with mood issues before.

😤 What this can look like
• Sudden irritability or anger
• Feeling overstimulated or emotionally raw
• Tearful one moment, furious the next
• Little tolerance for noise, people, or chaos

😤 Why this happens (the science)
Estrogen directly influences serotonin, dopamine, GABA, and cortisol regulation. During perimenopause, rapid hormone fluctuations - not just low levels - affect emotional regulation and stress response. Add disrupted sleep and midlife demands, and the nervous system becomes more reactive.

This is not a personality flaw.
It’s neurobiology.

😤 Why it can feel scary
Women often say, “I’m not an angry person - so why do I feel like this?”
These symptoms are real, common, and treatable - and they do not mean you’re “losing control” or becoming someone else.

✨ A little humor, because it helps:
If you suddenly need silence, sunlight, snacks, and zero questions - your hormones may be in charge today.

📌 Important note:
This post is for educational purposes only, not medical advice. While hormonal changes explain many midlife mood symptoms, not everything is menopause. At Peri & Pause, we offer thorough, individualized assessments to help you understand what’s happening and get the support you deserve.

💗 You are not broken. You are not alone. And we’re here to help.

12/18/2025

🎄12 Days of Menopause: Day 7 🎄
Brain fog & word-finding struggles

📝 Why does Ms. Elf have sticky notes everywhere?
Because brain fog hits different in perimenopause.

Forgetting why you walked into a room.
Losing a word mid-sentence.
Feeling mentally “offline.”

For many women in perimenopause and menopause, this isn’t just stress - it’s a real, hormone-related brain change.

🧠 How it shows up
• Word-finding difficulty
• Slower recall and focus
• Trouble multitasking
• Often worse with poor sleep or before a period

🧠 Why it happens
Estrogen supports brain energy use, neurotransmitters, and blood flow. During perimenopause, estrogen fluctuates, temporarily affecting how efficiently the brain processes information. Research shows functional changes, not structural damage.

🧠 Why it can feel scary
If you have a family history of dementia, these symptoms can be very anxiety-provoking. The evidence-based reassurance: menopause-related cognitive changes are common, often temporary, and do not follow dementia patterns. Anxiety and sleep disruption can make them worse.

✨ You are not losing your mind - your brain is adapting.

📌 Important note:
This post is for educational purposes only and not medical advice. While hormones explain many midlife symptoms, not everything is menopause. At Peri & Pause, we provide thoughtful, thorough assessments to help our patients understand what’s happening and navigate these changes with confidence.

💗 Midlife women’s care as it should be.

12/17/2025

🎄12 Days of Menopause: Day 6 🎄🎄
Low Libido (aka: “I love you… but don’t touch me.”) 😅

“I love you, but don’t touch me.”
“I don’t feel like it right now (or ever?).”
“I want to want but I don't want.”

If any of those sound familiar, you’re not broken and you’re definitely not alone.

Libido changes are very common in perimenopause, and they’re rarely about lack of love or attraction. They’re about biology, brain chemistry, and life load colliding all at once.

Here’s what’s actually going on:

Hormones are shifting.
Estrogen supports blood flow, tissue health, and comfort. Testosterone (yes, women have it too) plays a role in desire, motivation, and responsiveness. During perimenopause, fluctuations - and eventual declines - in these hormones can reduce spontaneous desire and make arousal harder to access.

There is evidence for testosterone in women.
High-quality research shows that physiologic testosterone therapy can improve desire, arousal, and satisfaction in women with clinically significant low libido, particularly in midlife and postmenopausal women. This isn’t about making testosterone higher than its ever been in women - it’s about restoring levels to a normal female range when appropriate. Testosterone is one of the most evidence-supported treatments for low desire in women.

Your brain is tired.
Libido starts in the brain. Chronic stress, poor sleep, anxiety, and mental overload directly suppress desire. If your nervous system is stuck in survival mode, s*x drops wayyy down the priority list. 🧠

Biology is no longer reproduction-focused.
From an evolutionary standpoint, once reproduction is no longer the goal, the body doesn’t automatically prioritize libido. That doesn’t mean intimacy is over...it often just needs more intention and support.

Long-term relationships shift desire patterns.
In midlife, many partnerships are decades old. Novelty is lower, routines are heavy, and connection can get buried under logistics. This isn’t failure - it’s a cue for attention, not blame.

Physical discomfort matters.
Vaginal dryness, pain, pelvic floor tension, and recurrent UTIs can quietly shut desire down. If intimacy hurts, your brain will protect you by lowering interest. 🚫

Midlife obligations are heavy.
Careers, kids, aging parents, and emotional labor leave many women depleted. Desire doesn’t thrive when exhaustion is running the show.

Important perspective:
Hormone therapy - including testosterone - is not about forcing desire. When appropriately prescribed and monitored, it can support the biological pieces of libido, but it works best alongside attention to sleep, stress, relationship health, and physical comfort.

Bottom line:
Low libido in perimenopause is common, multifactorial, and deeply human. Understanding the why allows for compassionate, evidence-based care - without shame, pressure, or dismissal. 💗

12/16/2025

We are so excited and incredibly honored to celebrate our Raleigh ribbon cutting with the Raleigh Chamber! ✂️✨

Expanding into a second location is a huge milestone for us, and it means so much to be able to bring thoughtful, evidence-based midlife women’s care to the Raleigh community while continuing to care for ALL women virtually across North Carolina.

Thank you to the Raleigh Chamber for the warm welcome and to our patients and community who continue to trust us with their care. This next chapter feels super special, and we’re just getting started 💗

12/16/2025

🎄 12 Days of Menopause: Day 5 🎄
Insomnia (or: “Why am I exhausted but wide awake?”) 😵‍💫

If sleep suddenly became elusive sometime in your late 30s, this can actually be one of the earliest signs that hormones are starting to shift.

The usual culprit? Progesterone. 🌙

Progesterone has a calming, GABA-supporting effect on the brain. It helps with falling asleep and staying asleep. During perimenopause, progesterone is often the first hormone to decline or fluctuate, sometimes years before periods change much. Translation: your brain loses some of its natural “off switch.” 🔌

And then there’s the rest of the midlife sleep sabotage:

Estrogen fluctuations → night sweats and temperature changes 🔥❄️

Cortisol shifts (stress + poor sleep = a vicious cycle)

Blood sugar dips → 2–4 a.m. wake-ups 🍪

Racing thoughts that came out of nowhere (“Why am I replaying 2009?”) 🧠

Life load: work, kids, aging parents, and a brain that never fully powers down

Research shows that sleep disturbance is one of the most common and distressing symptoms of the menopause transition, often showing up years before anyone mentions the word “menopause.”

So if you’re:

Falling asleep but waking at 2–3 a.m.

Tossing and turning despite being exhausted

Feeling wired but tired ⚡

Suddenly best friends with melatonin, Unisom, podcasts, or doom scrolling 📱

…it’s not because you “can’t shut your brain off.”
It’s because your hormones changed the rules.

Important note:
Hormone therapy is not a sleep medication, but when appropriately prescribed for the right person, addressing hormonal drivers (especially progesterone) can significantly improve sleep quality as part of an overall care plan.

Bottom line:
Perimenopause insomnia is common, real, and often one of the earliest clues that your body is entering a new hormonal phase. You’re not broken...your chemistry just shifted. 💗

12/15/2025

🎄 12 Days of Menopause: Day 4🎄

Perimenopause Weight Gain + Cravings (aka: “Why am I thinking about Ben & Jerry's Half Baked at 9:17 pm?!”) 🍟😅

If you’ve hit your 40s and suddenly feel like your body got a new operating system without your permission… you’re not imagining it.

Here’s what’s going on “under the hood”:

1) Your hormones are doing the cha-cha.
Estrogen and progesterone can fluctuate like crazy in perimenopause, and those shifts can mess with appetite signals, cravings, sleep, and stress response (HELLO, cortisol). When sleep is trash, cravings get loud.

2) The scale can lie. LIE I tell ya!
During the menopause transition, research shows fat mass tends to increase and lean mass can decrease, especially around the midsection - even when total weight doesn’t change much. So you may feel “softer” or notice your clothes fit differently despite doing “all the right things.”

3) “But I’m eating healthier and working out more?!”
Yes… and also: metabolism + body composition can shift during this transition, which means the usual tricks don’t always work the way they used to. (Rude. We agree.)

What about hormone therapy?

Let’s keep it real and evidence-based:

✅ Hormone therapy is NOT a weight-loss medication.
But for the right patient, it may help support overall health and may help blunt the typical increase in abdominal fat / central fat shift seen across the transition - especially when used appropriately and individualized.

It’s best thought of as: symptom + quality-of-life support (sleep, hot flashes, mood, joint aches for some) and health support (like bone protection in appropriate candidates) - not an “Wegovy for menopause.”

The takeaway:

If your body is changing during perimenopause, it’s not a character flaw or a WILL POWER issue. It’s biology.
And you deserve care that treats you like a whole person—not a before-and-after photo. 💗

*xercisemoreisalie

12/14/2025

🎄 12 Days of Menopause: Day 3 🎄

Today, Ms. Elf is holding something she never expected to need… a tube of vaginal estrogen.
Her face says it all: “Is this really happening?” 😅

As estrogen levels drop, the tissues in the vaginal and urinary area can become thinner, drier, and more sensitive. This very common set of changes is called genitourinary syndrome of menopause (GSM).

Women may notice:
• Dryness or irritation
• Discomfort with certain “activities” (you know what we’re talking about 👀)
• Increased urinary urgency or frequency
• More frequent urinary tract infections (UTIs)

Why this matters (beyond comfort) 👇
• UTIs are one of the most common infections in midlife and older women
• Recurrent UTIs can sometimes lead to serious infections requiring hospitalization and sometimes death if these result in urosepsis
• Estrogen helps keep tissues healthy and acts like a protective barrier

The good news?
💙 This is very treatable
💙 Low-dose vaginal estrogen works locally
💙 It supports comfort, confidence, and urinary health - not just “activity”
💓 Breast cancer patients and survivors can use this SAFELY

Ms. Elf is learning that menopause isn’t just hot flashes and mood changes - it affects everyday life in quiet ways women are often told to ignore.

More menopause truths coming tomorrow… ✨

12/13/2025

🎄 12 Days of Menopause: Day 2 🎄

🥶 When hot flashes get so bad… even the freezer feels like a reasonable option. Ms. Elf clearly agrees. 😅

Hot flashes and night sweats aren’t just uncomfortable - research shows they can be a signal from your body, not just a temperature issue.

Here’s the simple takeaway 👇
• Frequent or severe hot flashes are linked to higher future heart and blood vessel risk
• They’re associated with insulin resistance, cholesterol changes, and blood pressure shifts
• Women with early or ongoing symptoms have been shown to have higher rates of cardiovascular problems later on

This doesn’t mean hot flashes cause heart disease - but they may be an early warning sign that shouldn’t be ignored. 💔

If you’re having persistent hot flashes or night sweats whether you're 38 or 58, you deserve care that looks at both how you feel now and your long-term health. We’re here to help - with evidence-based care, not ice baths. 😉

💙 More menopause truths coming tomorrow…

12/13/2025

🎄 12 Days of Menopause: Day 1 🎄
Our holiday guest, Ms. Elf, has arrived - and this morning we found her curled up next to a book titled “Ms. Claus Has Menopause.” 📖✨ (Great read BTW!)

She looks a little worried… and honestly, she has good reason to pause. See what I did there? 🤭 Lately she’s been noticing:

✨ Waking up at 2–3 a.m. like it’s cookie-baking hour
✨ Mood swings that could rival the reindeer on a windy night
✨ Night sweats (and not from tending the fire)
✨ Brain fog thicker than a December snowstorm
✨ Achy joints from more than just wrapping presents
✨ Low energy and low motivation
✨ Vaginal dryness she was not expecting at the North Pole

So she’s wondering…
“Is this menopause? And what am I supposed to do about it?”

Today marks the start of her journey to understand what’s happening inside her body - and how to get the help she deserves.

Follow along with us as Ms. Elf uncovers the real story behind midlife hormones… and finds her way toward support, clarity, and feeling like herself again. ❤️✨

Peri & Pause

12/22/2025

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Monday	8:30am - 5:30pm
Tuesday	8:30am - 5:30pm
Wednesday	8:30am - 5:30pm
Thursday	8:30am - 5:30pm
Friday	8:30am - 4:30pm