Women's Wellness

Understanding Perimenopause and Menopause

Perimenopause and menopause are often talked about as single moments in time, but they are actually long biological transitions that can affect the body for years.

Perimenopause is the phase leading up to menopause when hormone levels, particularly estrogen and progesterone, begin to fluctuate. This phase commonly begins in the 40s but can start earlier. During perimenopause, ovulation becomes less consistent, which is why menstrual cycles may change in length, flow, or regularity.

Common symptoms of perimenopause may include:

• Hot flashes or night sweats
• Changes in sleep quality
• Mood changes or increased anxiety
• Difficulty concentrating or memory changes
• Weight or body composition changes

Menopause is defined medically as 12 consecutive months without a menstrual period and marks the end of reproductive years. While hormone levels tend to stabilize after menopause, symptoms can persist for some women.

These transitions are normal, but they are not always simple. Symptoms vary widely, and the same symptoms can also be linked to other health conditions. That’s why education and evaluation matter. Understanding what is happening in the body is the first step in determining whether lifestyle strategies, medical treatments, or further evaluation may be helpful.

What I Explain to Patients When We Talk About Menopause

By Shalin Arnett, DO

One of the most important conversations I have with patients is about what menopause actually is and what it is not. Many symptoms attributed to menopause, such as fatigue, mood changes, or weight gain, can have multiple causes. My role is to help patients understand which symptoms may be related to hormonal changes and which may need further evaluation. This distinction matters because it guides treatment decisions.

When we talk about perimenopause and menopause, we often focus on three key areas:

• How symptoms are affecting daily life, sleep, work, and relationships
• Medical conditions, medications, and family history that influence care options
• What matters most to the patient right now

Treatment is not one‑size‑fits‑all. Some women feel well with education and reassurance alone. Others benefit from targeted interventions such as hormone therapy or non‑hormonal options. Mental health support can also be an important part of care, especially during times of hormonal fluctuation.

As a Menopause Society Certified Practitioner, I focus on evidence‑based guidance and shared decision‑making. The goal is not to “treat menopause,” but to support a woman’s health and quality of life during and after this transition.

About the Provider

Shalin Arnett, DO is a board-certified OB/GYN at Riverview Health who provides comprehensive care for women across all stages of life. Her clinical interests include low- and high-risk pregnancies, infertility, annual gynecological care, abnormal periods, menopause management, birth control, STD screening, abnormal Pap smears, and BRCA screening. Dr. Arnett is also credentialed as a Menopause Society Certified Practitioner (MSCP).

Patient Story

Uterine fibroids are common and can cause heavy periods, pelvic pain, and other symptoms that affect daily life. For some women, symptoms persist for years before effective treatment is found.

In this short video, a Riverview Health patient shares her experience living with fibroids for more than a decade and how working with her provider led to a hysterectomy that finally relieved her symptoms.