Perimenopause is the natural transition leading into menopause, marked by erratic fluctuations in estrogen and progesterone. These unpredictable shifts can trigger emotional, cognitive, and physical changes – often years before menopause officially begins. We spoke with Megan Spence, PsyD, PMH-C, a licensed clinical psychologist, about the whole-body experience of perimenopause, including mood and memory changes, the structural and social factors that place some groups at higher risk, available hormonal and non-hormonal treatments, lifestyle strategies that may help, and when – and how – to ask for support. Your symptoms matter, and you deserve informed, compassionate care.

Credits
Host: Neha Pathak, MD, FACP, DipABLM
Guest: Megan Spence, PsyD, PMH-C
Producer/Editor: Lauren Summers
Show Notes: Lauren Summers

<a href="https://www.webmd.com/menopause/guide-chapter-perimenopause-overview" data-testid="linkable-text">Perimenopause</a> is the natural transition leading into menopause, marked by erratic fluctuations in estrogen and progesterone. These unpredictable shifts can trigger&nbsp;<a href="https://www.webmd.com/menopause/emotional-roller-coaster" data-testid="linkable-text">emotional</a>, cognitive, and physical changes &ndash; often years before menopause officially begins. We spoke with <a href="https://www.psychologytoday.com/us/therapists/megan-spence-alameda-ca/869278" data-testid="linkable-text">Megan Spence, PsyD, PMH-C</a>, a licensed clinical psychologist, about the whole-body experience of perimenopause, including mood and memory changes, the structural and social factors that place some groups at higher risk, available hormonal and non-hormonal treatments, lifestyle strategies that may help, and when &ndash; and how &ndash; to ask for support. Your symptoms matter, and you deserve informed, compassionate care.
Credits
<ul>
<li aria-level="1">Host: Neha Pathak, MD, FACP, DipABLM</li>
<li aria-level="1">Guest: Megan Spence, PsyD, PMH-C</li>
<li aria-level="1">Producer/Editor: Lauren Summers</li>
<li aria-level="1">Show Notes: Lauren Summers</li>
</ul>

WebMD Chief Physician Editor Neha Pathak, MD, and Chief Medical Officer, John Whyte, MD, MPH, explore fascinating stories to find the unexpected things that help us understand our health.

Health Discovered

Perimenopause: Understanding the Emotional, Cognitive, and Physical Changes

Joint pain is often brushed off as a normal part of aging – but pain that interferes with your daily life doesn’t have to be something you simply live with. In this episode, we talk with Una Makris, MD, MSc, a clinical rheumatologist, about the common joint conditions affecting older adults and what actually helps. From movement and weight management to nutrition and physical therapy, she shares practical, evidence-based strategies to reduce pain and protect your joints. Learn how small, sustainable lifestyle changes can support mobility, independence, and quality of life at every age.

Credits
Host: Neha Pathak, MD, FACP, DipABLM
Producer/Editor: Lauren Summers
Show Notes: Lauren Summers
Guest: Una Makris, MD, MSc

<a href="https://www.webmd.com/pain-management/joint-pain" data-testid="linkable-text">Joint pain</a> is often brushed off as a normal part of aging &ndash; but pain that interferes with your daily life doesn&rsquo;t have to be something you simply live with. In this episode, we talk with <a href="https://breakthroughs.utsouthwestern.edu/women/stories/makris-una.html" data-testid="linkable-text">Una Makris, MD, MSc</a>, a clinical rheumatologist, about the common joint conditions affecting older adults and what actually helps. From movement and weight management to nutrition and physical therapy, she shares practical, evidence-based strategies to reduce pain and protect your joints. Learn how small, sustainable <a href="https://www.webmd.com/arthritis/caring-your-joints" data-testid="linkable-text">lifestyle changes</a> can support mobility, independence, and quality of life at every age.
Credits
<ul>
<li aria-level="1">Host: Neha Pathak, MD, FACP, DipABLM</li>
<li aria-level="1">Producer/Editor: Lauren Summers</li>
<li aria-level="1">Show Notes: Lauren Summers</li>
<li>Guest: Una Makris, MD, MSc</li>
</ul>

Joint Pain as We Age: Prevention, Treatment, and Daily Care

In part two of our menopause series, we unpack common myths and misinformation about perimenopause, menopause, and hormone replacement therapy. Many women are treated in fragments – this episode brings the conversation back into the exam room with practical, patient-centered guidance. We continue our conversation with Sharon Malone, MD, board-certified OB-GYN and chief medical advisor for Alloy Women’s Health, on how perimenopause is diagnosed clinically (often without definitive lab tests), which symptoms should raise red flags, and why HRT is never a one-size-fits-all yes-or-no decision.

Credits
Host: Neha Pathak, MD, FACP, DipABLM
Producer/Editor: Lauren Summers
Show Notes: Lauren Summers
Guest: Sharon Malone, MD

In part two of our menopause series, we unpack common myths and misinformation about <a href="https://www.webmd.com/menopause/guide-perimenopause" data-testid="linkable-text">perimenopause</a>, <a href="https://www.webmd.com/menopause/menopause-basics" data-testid="linkable-text">menopause</a>, and <a href="https://www.webmd.com/healthy-aging/what-to-know-about-hrt" data-testid="linkable-text">hormone replacement therapy</a>. Many women are treated in fragments &ndash; this episode brings the conversation back into the exam room with practical, patient-centered guidance. We continue our conversation with <a href="https://www.drsharonmalone.com/" data-testid="linkable-text">Sharon Malone, MD</a>, board-certified OB-GYN and chief medical advisor for Alloy Women&rsquo;s Health, on how perimenopause is diagnosed clinically (often without definitive lab tests), which symptoms should raise red flags, and why HRT is never a one-size-fits-all yes-or-no decision.
Credits
<ul>
<li aria-level="1">Host: Neha Pathak, MD, FACP, DipABLM</li>
<li aria-level="1">Producer/Editor: Lauren Summers</li>
<li aria-level="1">Show Notes: Lauren Summers</li>
<li>Guest: Sharon Malone, MD</li>
</ul>

Menopause and Hormone Therapy Explained (Part 2): Myths, Diagnosis, and Who Should Consider HRT

In 2025, the U.S. FDA removed the “black box” warnings from menopausal hormone therapy products – but what does that actually mean for patients? For decades, many women have navigated perimenopause and menopause with limited information, few effective options, and little validation of their symptoms. In part one of this two-part series, we speak with Sharon Malone, MD, board-certified OB-GYN and chief medical advisor for Alloy Women’s Health, about what happens during the menopausal transition, why symptoms can feel chaotic and unpredictable, and how misinterpretations of past research have shaped – and often restricted – women’s care.

Credits

Host: Neha Pathak, MD, FACP, DipABLM
Guest: Sharon Malone, MD
Producer/Editor: Lauren Summers
Show Notes: Lauren Summers

In 2025, the U.S. FDA removed the &ldquo;black box&rdquo; warnings from menopausal <a href="https://www.webmd.com/healthy-aging/what-to-know-about-hrt" data-testid="linkable-text">hormone therapy products</a> &ndash; but what does that actually mean for patients? For decades, many women have navigated <a href="https://www.webmd.com/menopause/guide-perimenopause" data-testid="linkable-text">perimenopause</a> and <a href="https://www.webmd.com/menopause/menopause-basics" data-testid="linkable-text">menopause</a> with limited information, few effective options, and little validation of their symptoms. In part one of this two-part series, we speak with <a href="https://www.drsharonmalone.com/" data-testid="linkable-text">Sharon Malone, MD</a>, board-certified OB-GYN and chief medical advisor for Alloy Women&rsquo;s Health, about what happens during the menopausal transition, why symptoms can feel chaotic and unpredictable, and how misinterpretations of past research have shaped &ndash; and often restricted &ndash; women&rsquo;s care.
Credits
<ul>
<li>
<ul>
<li aria-level="1">Host: Neha Pathak, MD, FACP, DipABLM</li>
<li aria-level="1">Guest: Sharon Malone, MD</li>
<li aria-level="1">Producer/Editor: Lauren Summers</li>
<li aria-level="1">Show Notes: Lauren Summers</li>
</ul>
</li>
</ul>

Perimenopause: Understanding the Emotional, Cognitive, and Physical Changes

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