Perimenopause: An Evidence-Based Guide to Making Sense of Key Symptoms, Comparing Hormonal and Nonhormonal Care, and Choosing Safer Next Steps for ... Heart Health (The Practical Evidence Series)

Sleep, mood, periods, concentration: when several things change at once, which question comes first? (based on 104 scientific studies)

Fragmented advice can leave you unsure what is connected, what may have another cause, and which options deserve attention. A change that feels familiar to someone else may raise a different question in your own circumstances.

Drawing on 104 scientific studies, this evidence-based guide helps you sort symptoms, compare care, and prepare a focused next step. It offers a way to understand the transition without treating every symptom as proof of the same cause or expecting one treatment choice to answer every concern.

Make sense of the transition

• Understand hot flashes and night sweats, and explore sleep support beyond generic sleep hygiene, including cognitive behavioral therapy for insomnia.
• Put memory and concentration problems in context, including their overlap with disrupted rest and mood.
• Compare estrogen therapy risks and benefits alongside nonhormonal options, with questions about timing, personal history, and monitoring.
• Prepare for discussions about heavy periods and contraception options without assuming every change is hormonal, and learn which patterns the book flags for clinical evaluation.
• Find language for vaginal dryness and sexual concerns, and understand routes for urinary and pelvic symptoms.
• Evaluate supplement safety, including soy isoflavones and black cohosh, without treating natural branding as proof.

Begin with four orientation chapters, then turn to the issue that matters now. Option comparisons and appointment prompts help you organize questions; chapters on weight, exercise, bone, and heart health extend the discussion beyond immediate symptoms. The six-part structure makes it easier to focus on a pressing concern while seeing how it fits into a wider picture.

The guide explains uncertainty without taking sides for or against hormones. It supports informed conversations without promising diagnosis, guaranteed relief, or one program for everyone.

Choose Perimenopause to approach your next care conversation with clearer priorities and realistic expectations.

Table of Contents

Introduction
Part I Understanding the Transition
Chapter 1 Recognizing Perimenopause and Making Sense of Changing Symptoms
Chapter 2 Protecting Sleep When Symptoms and Hormonal Change Collide
Chapter 3 Navigating Mood Changes, Anxiety, and Depression
Chapter 4 Understanding Memory, Focus, and Brain Fog
Part II Managing the Symptoms That Disrupt Daily Life
Chapter 5 Understanding Hot Flashes and Choosing a Starting Strategy
Chapter 6 Comparing Nonhormonal Medicines and Newer Treatments for Hot Flashes
Chapter 7 Using Behavioral and Mind-Body Approaches Without Overpromising
Chapter 8 Assessing Acupuncture Without Ignoring Sham-Controlled Findings
Part III Comparing Medical Care and Reproductive Decisions
Chapter 9 Weighing Hormone Therapy Benefits, Risks, and Timing
Chapter 10 Managing Heavy Bleeding and Contraception During the Transition
Part IV Protecting Sexual, Urinary, and Pelvic Health
Chapter 11 Relieving Vaginal, Urinary, Pelvic Floor, and Sexual Symptoms
Part V Supporting Strength, Metabolism, and Long-Term Health
Chapter 12 Protecting Bone, Joint, and Muscle Health
Chapter 13 Managing Weight, Diet, and Metabolic Change Without Blame
Chapter 14 Supporting Heart Health Before Risks Become Harder to Reverse
Chapter 15 Using Exercise as a Practical Whole-Body Tool
Part VI Evaluating Supplements and Complementary Claims
Chapter 16 Evaluating Soy, Black Cohosh, and Supplement Claims
Conclusion
Bibliography