Third in a series about Genitourinary Syndrome of Menopause In Part 1 of this series, we covered what genitourinary syndrome of menopause (GSM) is and why it tends to get worse over time. In Part 2, we looked at vaginal estrogen, the most well-evidenced treatment, and why systemic HRT alone often isn't enough. This time, we're covering two pieces that often get left out of the conversation entirely: pelvic floor physical therapy and non-hormonal options for those who can't or

In Part 1 of this series, we covered what Genitourinary Syndrome of Menopause (GSM) is, how common it is, and why it tends to get worse over time rather than resolve on its own. This time, we're looking at what the evidence actually shows about treatment, starting with the most well-studied option: vaginal estrogen. vaginal estrogen Vaginal estrogen is a low-dose estrogen applied directly to the vaginal tissue, as a cream, tablet, insert, or ring, rather than taken as a pill

Are you in perimenopause or menopause? Have you noticed vaginal dryness/discomfort, more frequent UTIs, pain during sex or unexpected leaks when you run, jump, laugh or sneeze? There's a name for what you're experiencing: Genitourinary Syndrome of Menopause, or GSM. Most women have never heard the term. tI remains one of the most underdiscussed parts of the menopause transition, despite affecting the majority of postmenopausal women. What GSM actually is GSM is the medical

Online coaching makes it convenient. Studies show its effective. I get this question a lot: what does a perimenopause coach actually do, and why would I need one? Let me start with what I'm not. I don't diagnose. I don't prescribe. I don't treat. If you're looking for a medical opinion, I'm not it. I work alongside doctors, who do diagnose and prescribe. I am is your relentless advocate for getting the best perimenopause care possible, and feeling like yourself again. Her

1️⃣ HRT is safe for most women and is the first-line treatment for peri/menopause symptoms (NICE NG23, British Menopause Society). 2️⃣ Breast cancer risk associated with HRT has not been linked to increased breast cancer deaths — in fact, women diagnosed with breast cancer while on HRT have shown lower mortality and recurrence than those not on it (NICE NG23 evidence review). 3️⃣ A family history of breast cancer does not automatically rule out HRT — it's about individualized

by Kristyn Zalota | Menopauser | Perimenopause Coaching, Munich, Germany So you are in your late 30s to 50s and you're not feeing at all like yourself. One minute you were cruising along, balancing home, career, health habits and a great social life. And then, out of nowhere, you feel like crap all the time. Welcome to perimenopause. This symptom list for perimenopause is staggeringly long. Because oestrogen and progesterone receptors exist throughout your entire body — in

I heard the words "I'm so glad you're doing this" many times on a recent Saturday at the IamExpat Fair in Berlin. Over the course of the day, 40 to 50 women stopped by to talk about perimenopause. Not just briefly, but really talk about it. They shared their struggles, their confusion, and their search for trustworthy information. Many expressed how different the German healthcare system feels compared to what they grew up with. The absence of the paper gown was mentioned - w

It's what we see when we look in the mirror: changes to our hair and skin. You're a woman in your early-to-mid 40s. Your moisturiser suddenly feels like it's doing nothing. You're finding more hair in the drain. You've noticed eye bags or developed a bit of a turkey neck. And something is happening to your vagina. According to a growing body of peer-reviewed research, what you're experiencing may be the dermatological effects of perimenopause. Why Hormones Matter So Much fo

40 to 50% of women in perimenopause suffer from sleep disturbances You set your alarm for 7am. But at 3am you're wide awake, heart racing, staring at the ceiling. An hour later you finally drift off - just in time for the alarm to go off. You drag yourself through the day exhausted, and yet the next night, the same thing happens again. If this sounds familiar, you are not alone. And no, it is not in your head. It is your hormones and there is a clear biological explanation f

Nobody told me. Not my mom, not my doctor, a single friend who'd already been through it. I never even heard the word: perimenopause. While there is alot more conversation about it today, it's happening among women in their 40s who are in the thick of it. But what would happen if we actually prepared for this life cataclysm. Because not to scare you, but it's big. The good news is there are things you can do to prepare. Here are 7 for starters: Know Your Body 1.Become an E

The EU must create a workplace policy on perimenopause. The case for EU-level workplace policy on perimenopause is not speculative. The evidence base is robust, the economic argument is clear, and crucially the solutions already exist. A handful of forward-thinking employers have shown what’s possible. The question is no longer whether this can be done. It’s why it isn’t required of everyone. Companies Leading the Way In 2019, Channel 4 became the first UK media organisation

Why is a high-performing woman in her forties having a hard time focusing? Why does she feel exhausted in meetings? Why is she second-guessing decisions she would have made without hesitation a year ago? The answer might be perimenopause. And the silence around it is costing women their careers. Workplaces should provide accomodation and support to women in perimenopause. What Perimenopause Actually Does at Work Research consistently shows that the cognitive and psychological

Across Europe, retirement ages are rising. By 2070, the average statutory retirement age is projected to reach 67. This a shift will require millions of women to remain in the workforce well into their sixties. Labour force participation among women aged 55–64 is already at 59%, and is expected to climb a further ten percentage points in the decades ahead. (European Commission Ageing Report, 2024; Eurostat, 2024) But here’s what nobody in the policy conversation is saying ou

every woman's experience of perimenopause is unique Kristyn "takes the time to really understand your personality and life circumstances in order to find the most effective and tailored solutions for you..." Steffi There is no shortage of information about perimenopause symptoms online. What is in short supply is personalised, evidence-based guidance that helps you make sense of your experience and someone to walk alongside you as you put it into practice. That's where worki

It's not an appointment with your doctor. It's not random information from the internet. It's a plan built around you, your symptoms and your goals. If you've landed here, you're probably somewhere in that exhausting in-between: you know something is off. Your sleep, your mood, your weight, your energy but you're not getting clear answers. Maybe your doctor ran blood tests and said everything looks "normal." Maybe you've been told you're too young. Maybe you've been Googlin

You wake up at 3 a.m. drenched in sweat. Again. Your jeans that fit perfectly six months ago no longer button. You snap at your partner over something tiny and then spend the rest of the day wondering who you've become. You've Googled everything from HRT menopause to bioidentical hormones to supplements for menopause, and you're drowning in contradictory information. If any of this sounds familiar, you are not alone and you are not broken. You are likely in perimenopause, th

From Alzheimer's research to the controversy over HRT as a preventative therapy, Part III completes the HRT picture and gives you the tools to take to your next doctor's appointment. Your choice about HRT in perimenopause can impact your health for decades. In Parts I and II of this series, we examined how a flawed 2002 study caused women to lose faith in and access to HRT, and why the specific fears around breast cancer and heart disease do not hold up under scrutiny. In t

The WHI study claimed HRT raised breast cancer risk by 26%. What it didn't say is that this finding was not statistically significant and that the evidence on heart disease and bone health points firmly in HRT's favour. Of all the fears that keep women away from HRT, the fear of breast cancer is the most powerful. And of all the statistics cited to justify that fear, the most influential comes from the WHI study's claim that women taking combined hormone therapy had a 26% i

For decades, a 2002 headline stopped women and their doctors in their tracks. Here's what that headline got wrong and why it matters so much now. Imagine a treatment that relieves debilitating hot flushes, improves sleep, reduces joint pain, alleviates vaginal dryness, and supports your cardiovascular and bone health. Then imagine being told it will give you cancer. That was the experience of millions of women in the summer of 2002, when the Women's Health Initiative (WHI)

Perimenopause can begin up to 10 years before your final period. [1]. Yet, many women don't know that and won't hear that from their doctors. Perimenopause symptoms that are easy to blame on busy modern life: the anxiety that came out of nowhere, the sleep that stopped working, the brain fog you blamed on juggling to many things at once. Often, women get misdiagnosed with anxiety, depression, or thyroid issues because doctors recieve very little training on perimenopause in