You Asked, We Answered: Navigating Perimenopause and Menopause (Part Two)

Managing Perimenopause and Menopause: Symptoms, Lifestyle Tips & Support at Work 

By Oumeet Ravi, BSC., BSC.N, MSC.N, Primary Care Nurse Practitioner

Every month, Kii Health offers monthly Ask an Expert webinars to its clients. During our recent session on perimenopause and menopause, we received many thoughtful questions, so many that we couldn’t answer them all during the live webinar. To continue the conversation, we’ve compiled them into a two-part Q&A blog series.

You can find part one here, which focused on general questions about perimenopause/menopause, the option of hormone replacement therapy, and how to advocate for your health. In part two, we’re diving into the day-to-day realities, from managing symptoms like hot flashes, sleep disruptions, and weight changes, to finding support for your mental health and navigating conversations at work.

As always, please note that this is general information based on my clinical experience and does not substitute for more personalized information specific to your situation. For specific health conditions and how they relate to perimenopause/menopause, it’s always best to talk to your healthcare practitioner. They can help tailor advice to your personal health, symptoms, and risk factors.

MANAGING SYMPTOMS

You’ve talked about heavier and lighter periods. What about periods that go on for weeks? Is this typical of perimenopause?

It is always best to consult a healthcare professional to make sure there is no underlying issue causing the ongoing bleeding. Periods that last for weeks are not uncommon during perimenopause because hormone levels become irregular and can cause the lining of the uterus to build up more than usual. This can lead to long, unpredictable, or very heavy bleeding. However, if your bleeding goes on for more than two weeks, is so heavy you soak through pads every 1-2 hours, or if you feel dizzy or weak, you should see your healthcare provider. They may want to check for other causes such as fibroids, polyps, or problems with clotting.

Are there triggers for hot flashes, or do they just happen?

Hot flashes can happen on their own because of hormone changes, but they also often have triggers that make them more likely or more intense. Common triggers include hot drinks, spicy foods, alcohol, caffeine, stress, and warm environments. Each person is different, so it can help to keep track of when yours happen to see if there’s a pattern.

Regarding excessive sweating, is there anything that can be done? I have been shying away from exercise because I hate all the sweat.

Yes, there are things you can try.

• Dress in lightweight, breathable fabrics like cotton or moisture-wicking workout clothes.
• Use stronger antiperspirants (even on areas like under the breasts or thighs, if safe).
• Stay hydrated and avoid caffeine or spicy foods, which can trigger more sweating.
• Exercise in a cooler environment, like early morning, indoors with a fan, or swimming.

If it’s severe and really limiting your life, there are medical options like prescription antiperspirants, medications that reduce sweating, or even Botox in certain sweat glands. It’s still very important to move your body—maybe start gently and find activities that don’t make you overheat as much.

Why is it so hard to lose weight post menopause?

After menopause, it’s harder to lose weight mainly because of hormone changes, slower metabolism, and loss of muscle mass. Lower estrogen levels can change how your body stores fat, more often around the belly. Muscle naturally decreases with age, and muscle burns more calories than fat, so your metabolism slows down. Many also experience more stress or poorer sleep, which can raise hunger hormones and lead to weight gain. It doesn’t mean weight loss is impossible — just that it often takes more time, smaller portions, more activity, and strength exercises to build muscle back up.

It seems impossible for me to lose weight. I don’t know what to do.

To lose weight during menopause:

• Eat smaller portions and more whole foods (e.g., vegetables, fruits, lean proteins, whole grains).
• Move more. Aim for daily activities like brisk walking, plus some muscle-strengthening exercises.
• Cut back on sugar, refined carbs, and alcohol.
• Get enough sleep and manage stress, which can affect weight.

It may be slower than before, but small, steady changes work. There are also medications that can be used temporarily to support weight loss, but not everyone qualifies, and they can have many side effects. It’s best to discuss this with your primary care provider.

What kind of help is available for immigrants who are away from their support system and away from family? Where can they seek this assistance to deal with depression and mood swings related to perimenopause?

Here are some supportive options for immigrants experiencing perimenopause-related mood changes or depression:

• Peer & community support groups: Immigrant women’s programs and community groups can help reduce isolation and offer emotional support through group activities or peer discussions.
• Menopause-specific medical care: Many women’s health clinics and primary care providers now offer support for perimenopause, including help with mood swings and depression.

Practical next steps:

• Look for immigrant support organizations or women’s community centers near you — social connection is powerful.
• Talk to your family doctor or nurse practitioner about mood changes during perimenopause so they can suggest treatments or refer you.
• Ask about mental health services that offer culturally sensitive or language-accessible care.

Do people report having higher blood pressure as a symptom?

High blood pressure readings must be evaluated by your healthcare provider to ensure your health is okay. Please consult in person, as it requires a physical exam.

Would brown spotting count as a period, seeing as I haven’t had a period in 2 years?

It would be best to consult a healthcare provider as symptoms need to be properly assessed.

I’ve heard that inflammation is a cause of hot flashes.  What are some remedies for reducing inflammation in the body?

Some research indeed suggests inflammation might play a role in hot flashes, though it’s not the only cause — hormone changes are still the main driver. To help reduce inflammation in the body, you can try:

• Eating more anti-inflammatory foods: fruits, vegetables, whole grains, nuts, fatty fish (like salmon).
• Reducing processed foods, sugar, and trans fats, which can promote inflammation.
• Staying active — regular exercise helps lower inflammatory markers.
• Getting enough sleep and managing stress, since stress hormones can worsen inflammation.
• Limiting alcohol and quitting smoking, which are both linked to more inflammation.

These steps are good for your overall health, too, and may indirectly help with hot flashes.Do you know which sleep cycle is most affected during perimenopause/menopause?

During perimenopause and menopause, both deep sleep and REM sleep can be affected. Many women get less deep sleep (slow-wave sleep), which is the most physically restorative stage. This is why you might wake up feeling less refreshed. REM sleep, which is important for memory and mood, can also become lighter or more broken up. Hot flashes at night, more frequent awakenings, and hormone changes (like lower estrogen and progesterone) disrupt normal sleep cycles. So, it’s usually a bit of both — less deep sleep and more fragmented REM sleep — that lead to feeling more tired.

What dietary recommendations are supportive for perimenopause?

Eat more fruits, vegetables, and whole grains to help with weight, cholesterol, and overall health. Include foods rich in calcium and vitamin D (e.g., milk, yogurt, leafy greens, fortified drinks) to protect your bones. Choose lean proteins (e.g., chicken, fish, legumes) and healthy fats (e.g., olive oil, nuts). Limit processed foods, sugary snacks, and excess alcohol. Stay well hydrated and try to cut back on caffeine if it worsens hot flashes.

MANAGING PERIMENOPAUSE/MENOPAUSE IN THE WORKPLACE

What can you tell your employer to support you when menopause is not an illness/disability, and there is no obligation to provide accommodation?

Even though menopause is not an illness or a disability, you can still have an open conversation with your employer. You might say something like, “I’m going through menopause, and sometimes experience hot flashes, fatigue, or trouble concentrating. It’s not a medical disability, but small adjustments like a fan at my desk, flexible breaks, or working near natural light would really help me stay comfortable and productive.” Most employers appreciate being informed so they can support you, even if they aren’t legally obligated to provide formal accommodations.

Can you tell us more about what Kii Health can do for women? What is the process when someone calls in with questions?

We’re excited to share that we will soon be launching a virtual women’s health offering for all Kii platform users, with curated content and trusted information for many key stages of life, including menopause. This new content will be included in your EFAP at no additional cost as a complement to the existing support you’re receiving. Stay tuned for more updates coming soon!

In the meantime, please use your EAP as you usually would, and one of our Kii Health Navigators will be happy to guide you in the right direction, based on your individual needs.

Whether you’re navigating perimenopause/menopause yourself or looking to support someone who is, I hope these practical tips and insights can help you feel more prepared, supported, and understood. However, if you find yourself struggling, don’t hesitate to reach out. Kii Health offers a range of supports that can help you navigate this stage of life.