- I feel like I should be generally happier than what I am.

I feel like my mood should be better.

I, you know, all of those things, so I did start, I think this whole thing kind of probably started with me listening to my clients, me going to my provider, and then me, kind of in my own tuition, going I need more information.

- [Stefanie] In her late 30s nurse practitioner and small business owner, Chelsea House, found herself not feeling like herself anymore.

- They're telling me they have new anxiety or their skin's dry, or they just don't feel like themselves, and I'm like gathering this information thinking like, wow, these are all these really common themes in these women showing up, and then that kinda like led me into my own personal symptoms, being 38 years-old and thinking, wow, I don't really feel like myself either, and I have this new anxiety I never had.

My sleep kind of stinks, you know?

So kind of connecting with my clients in that way and then realizing that like maybe this is menopause, perimenopause, maybe my hormones are changing.

- [Stefanie] Chelsea was also experiencing a range of symptoms and went from brushing them off to taking action.

- I did go to my primary care doctor, and I wouldn't say that I was unhappy by any means because it was kind of new to me as well, I should eat better.

And I said, should sleep more and I should work out more.

So I was like, maybe I'll just like do those things and I'll feel better.

I'll feel more like myself.

And so I did those things, had a great conversation with my provider, but then it was kind of my own internal like intuition to dig deeper, to go okay, yeah, I'm doing these things, but I feel like I should feel better than I feel.

I feel like I should be sleeping better than I sleep.

- [Stefanie] While she followed her doctor's advice, Chelsea still wasn't finding the kind of relief or answers that she was hoping for.

Her search led her to the symptoms of perimenopause, something often considered for older women, but she quickly learned that age is irrelevant.

- We usually talk about like reproductive age and then perimenopause, and there's some overlap between things too, perimenopause and then menopause and honestly, I don't even really give ages because people go through it at different times, different symptoms for different people.

- [Stefanie] The National Institutes of Health categorizes menopause into three separate stages.

First stage perimenopause, which can begin an estimated eight to 10 years before menopause.

This is a time when ovaries produce less and less estrogen.

Second stage menopause, the day you've gone an entire year without a menstrual period.

Third stage, post menopause, the day after you've missed your period for a full calendar year.

Women remain in this stage for the remainder of life.

- Most of the time when I'm talking with a patient, we're talking about that individual's experience, whether we call it perimenopause or we call it age-related changes.

For me, it doesn't make a whole big difference what we name it, but we're addressing it.

- Perimenopause and menopause symptoms are not just hot flashes, night sweats, like it's not just that.

It can be ringing in your ears, changing in taste, anxiety, dry skin, like it's a wealth of symptoms.

- Symptoms are not the same for every woman during this aging transition.

For years, starter conversations about menopause often began with missed periods, but there's so much more to it.

Take a look at this list of symptoms, which includes things like weight gain, frequent UTIs, mood swings among many other issues.

For the generations of women, now, postmenopausal, the list of symptoms isn't a surprise, but what might be surprising is how more women are now talking about it and finding support and relief.

Another major milestone, the FDA's recent decision to remove the black box safety warning from hormone treatment options.

It had been in place since 2002 due to a study that might have overstated some risks.

- When WHI trial came out and everybody kind of said, whoa, we're not gonna use estrogen or progesterone anymore.

Women suffered.

Menopause Society recommends these low dose estrogen therapies, and I say estrogen, but if people have a uterus, then you have to also balance that with progesterone.

- We do need to know more.

We do need to talk more.

This is an issue.

We are doing harm by not providing or giving this as an option.

I think a lot of people don't realize that with every single thing that we put in or on our body, there's a risk, but there's also a risk of not.

Estrogen affects everything.

We know as women that our ovaries peter out as we age and they stop producing hormones and you go through menopause, that's usually stop having menstrual periods.

You have being able to carry a baby, and that's all due to the decrease in estrogens or lack thereof, and so it can affect, I mean, our brains brain fog, memory issues, they're relating it to some dementia in women.

And so just being aware and having that open conversation with a provider who is really aware of the risk and the understanding of how it works.

- [Stefanie] It can't be stressed enough.

The symptoms and treatment of menopause are different for every single woman, but at the heart of it all is the impact that hormones like estrogen, testosterone, and progesterone have on mental, physical, and sexual health.

As more women and doctors are talking about menopause, online platforms are also a huge part in the conversation.

- I think we're definitely talking about menopause and hormones and women's health in general, way more than we have because the minute you say one of those things, just like you said, we all start talking.

- I think it has more to do with quality of life, living healthier longer, but we as doctors also need to be better about that.

I think in my training years ago, it was more on, like, if somebody's sick, how do they make them better?

Specifically, in perimenopause and menopause, I think that the shift needs to be more on quality of life.