Hi Friend!
At the beginning of this year, I asked women to complete a short social media survey to find out what information and education I could provide that would be most helpful.
The responses were eye-opening—but more than that, they were motivating.
65% of responses said perimenopause and/or menopause.
Every response reinforced something I believe deeply: women want to understand their bodies better and they aren’t sure where to find information they can trust.
My mission is to help change what women’s healthcare looks and feels like in Oklahoma. To create a space, whether in the clinic or online, where education is accessible, conversations are honest, and care is truly collaborative.
Because healthcare works best when it’s a partnership.
I don’t want to make decisions for you.
I want to make them with you, by empowering you with knowledge.
If you are my patient, I don’t ever want you to preface a conversation with “this may be TMI…” There is no such thing as TMI with your health.
Yes, these topics are personal. And vulnerability can feel hard. But your body tells a story—and every detail matters. Like a puzzle, I can’t see the full picture if pieces are missing. Trust and honesty go both ways. And in this space, they are always met with respect.
Clinic visits are invaluable—but I want my social presence to be intentional and purposeful and where medical information feels human, relatable, and actionable.
Back to that social media survey — let’s get to the #1 topic of interest.
IS IT PERIMENOPAUSE?
Perimenopause is the phase of life when your body is transitioning toward menopause. It most commonly begins in your 40s (although, there are some menopause practitioners who believe there is evidence that it may start even earlier), and it’s marked by fluctuating estrogen levels that can affect nearly every system in your body.
During this time, you may notice:
- Changes in your menstrual cycle
- Hot flashes or night sweats
- Fatigue or sleep disruption
- Mood shifts or brain fog
- Vaginal dryness or discomfort
After you’ve gone 12 consecutive months without a period, you’ve officially reached menopause. A key word there is consecutive.
Sometimes the body likes to keep things interesting, though. I’ve had patients go almost a year without a period, have one, and then have to restart the proverbial menopause countdown clock. Our bodies are complex, intelligent, and wonderfully unique.
And that’s an important point.
Your perimenopause journey will not look exactly like your mother’s. Or your sister’s. Or your best friend’s.
There is no “standard” experience—only your experience.
Biology is beautifully individual. Every system in your body is interconnected, influenced by genetics, lifestyle, stress, environment, and life history. It’s why personalized care should not be part of your experience; it should be THE experience. It’s why listening matters. And it’s why no symptom should be dismissed simply because someone else isn’t experiencing it.
Perimenopause care isn’t just about knowing the science. It’s about applying the science to you.
COMMON SIGNS OF PERIMENOPAUSE
I know I just said, in several different ways, that perimenopause is highly individualized. Because it is. But there are some basic biological realities of this transition that most women will experience during this time. Some of the more common experiences include:
Irregular Periods
Fluctuating estrogen and progesterone can cause periods to become longer, shorter, heavier, lighter, closer together, or farther apart.
Hot Flashes and Night Sweats
Shifts in estrogen can affect the brain’s temperature control center, leading to sudden waves of heat, flushing, and sweating.
Mood Changes and Sleep Disruption
Hormones interact closely with brain chemicals like serotonin. As levels change, you may notice anxiety, irritability, low mood, headaches, or difficulty sleeping.
Libido and Intimacy Comfort Changes
Lower estrogen can contribute to vaginal dryness, tightness, or discomfort, which may naturally decrease desire. Stress, fatigue, and life transitions often add to this.
Cholesterol and Cardiovascular Changes
As estrogen declines, cholesterol patterns may shift, making proactive screening and personalized care especially important.
the LESSER-KNOWN faces of perimenopause
As estrogen and progesterone fluctuate, they influence the nervous system, brain chemistry, connective tissue, temperature regulation, and even how our senses interpret the world. Because of that, perimenopause can bring symptoms many women would never think to link to hormones—including:
- Brief “electric shock” sensations
- Joint or muscle pain
- Burning mouth syndrome
- Dizziness or lightheadedness
- Changes in body odor or scent perception
These symptoms may send women down long, frustrating paths—neurology referrals, autoimmune workups, dental visits, cardiac tests—only to be told everything is “normal,” or worse, that it’s anxiety.
But these experiences are not imagined. They are not random. They are frequently the result of real, measurable hormonal shifts affecting real physiological systems.
Estrogen plays a critical role in nerve signaling, pain perception, collagen production, blood vessel tone, and sensory processing. When levels become erratic, the body can express that disruption in surprising ways. The problem isn’t that women are “too sensitive.” The problem is that these connections are rarely taught, rarely discussed, and too often dismissed.
These symptoms are real. They are biological. And they deserve to be named, validated, and openly discussed—so women can seek informed care instead of silently questioning their bodies.
WHEN PERI BECOMES MENOPAUSE.
Menopause is not something that suddenly “happens” overnight—it’s a milestone your body reaches.
Clinically, menopause is defined as the point when you’ve gone 12 consecutive months without a menstrual period. After those twelve months, perimenopause ends, and you are considered postmenopausal.
While the clinical definition is neat, the experience rarely is.
I believe the way we think about this season of life is so important.
Menopause is not the end of something. It’s not a final curtain call. It is not one last hurrah.
It is the beginning of a new physiological chapter — one that deserves just as much attention, care, and personalization as every stage that came before it.
Your ovaries have officially retired from releasing eggs, and estrogen and progesterone settle into their new, lower baseline. That shift can influence nearly every system in the body—from the brain to the bones to the heart to the skin.
And for many women, this is when symptoms either continue, evolve, or newly appear.
COMMON MENOPAUSE SYMPTOMS.
Some women feel relief once their cycles stop. Others notice new changes. Both are “normal” and, a lot like we discussed earlier, will vary from woman to woman. Common menopause symptoms can include:
Hot Flashes and Night Sweats
These may persist or intensify. Lower estrogen affects the brain’s internal thermostat, making it more sensitive to temperature shifts.
Sleep Disturbance
Difficulty falling or staying asleep is extremely common and may occur even without night sweats.
Mood Changes, Anxiety, or Low Motivation
Estrogen influences serotonin and dopamine. Its decline can affect emotional regulation, resilience, and focus.
Vaginal Dryness, Irritation, or Pain with Intimacy
Lower estrogen thins vaginal tissue and reduces natural lubrication, increasing the chance of discomfort, infections, and urinary symptoms.
Libido Changes
Desire, arousal, and orgasm can shift. A fulfilling sex life does not expire; it may just look a little bit different—and options for support are available.
Weight Redistribution and Metabolic Shifts
Many women notice increased abdominal fat, insulin resistance, and changes in muscle mass, even without changing eating or exercise habits.
Brain Fog or Memory Concerns
Difficulty concentrating and word-finding problems are commonly reported and hormonally influenced.
Joint Pain and Stiffness
Lower estrogen increases inflammation and affects connective tissue health.
Long-term health after menopause.
Menopause is not only about hot flashes, sleep disruption, or mood changes. It marks a profound biological transition—one that reshapes a woman’s long-term health trajectory.
Estrogen is not just a reproductive hormone. It plays a protective role in nearly every major system in the body. As levels decline, the effects extend far beyond the menstrual cycle, influencing how bones remodel, how blood vessels function, how tissues maintain strength and elasticity, and how the brain and bladder communicate.
Because of this, menopause represents a shift in long-term health priorities like:
Bone Health
In the first years after menopause, women can lose bone density at an accelerated rate. This silent loss increases the risk of osteopenia and osteoporosis—conditions that often go undetected until a fracture occurs.
Heart and Vascular Health
Cardiovascular disease becomes the leading cause of death in women after menopause. Changes in estrogen influence cholesterol patterns, blood vessel elasticity, inflammation, and insulin sensitivity.
Bladder and Vaginal Health
Estrogen deficiency affects the tissues of the urinary and genital tract, contributing to dryness, irritation, painful intercourse, recurrent urinary tract infections, urgency, and incontinence. These are not inevitable “nuisances.” They are medical changes, and they are treatable.
These are not inconveniences to endure. They are biological realities that deserve proactive care. Too many women are told, “This is just menopause,” as though that should end the conversation.
I believe menopause should open it.
This phase of life deserves intentional, evidence-based care — care focused on symptom relief, disease prevention, vitality, and quality of life.
Options may include:
- Hormone therapy when appropriate
- Non-hormonal prescriptions
- Vaginal and/or urinary therapies
- Nutrition, movement, and lifestyle guidance
- Evidence-based supplements
- Integrative strategies
There is no universal protocol—because there is no universal woman.
Your care should reflect your health history, your risk factors, your symptoms, your goals, and your lived experience.
THIS SEASON BELONGS TO YOU.
Perimenopause and menopause are not something to just “get through.” They are something to be supported through.
This chapter of life should be informed.
It should be powerful.
It should be deeply connected to your long-term health.
You deserve to understand what is happening in your body.
You deserve options.
You deserve to be heard. Really heard.
And you deserve a provider with specialized training to walk with you through it.
I’m one of only thirteen physicians in Oklahoma certified by The Menopause Society1. That’s not something I share to brag or draw lines between providers, but to shine a light on how valuable specialized menopause training is—and how challenging it still is for women to find doctors who have it.
My goal is to normalize these conversations.
To remove shame from discussion.
To replace confusion with clarity.
To help you feel confident, informed, and supported in every healthcare decision you make.
Because:
It is your body.
Your health.
Your life.
I’m simply honored to be part of it.
If any of this resonates, I invite you to call our office at 405-701-6717 to schedule a visit. We would be honored to walk with you through this transition.
And please share this blog. You never know who it may help!
With Love,
Dr. Ronni Farris
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