Breaking the Silence on Perimenopause for Women’s Health
Key Takeaways
In this TEDxSanDiego talk, Dr. Manna Semby addresses the often-taboo subject of perimenopause, highlighting how silence surrounding this natural transition leads millions of women to suffer and even leave their careers. Drawing from her own experience of extreme burnout that forced her to quit a job, she explains the biological shifts occurring during this time and calls for systemic changes in education, healthcare, and workplace support to empower women in midlife.
Understanding Perimenopause and Its Impact
- Perimenopause is the transition leading up to menopause that can begin up to ten years before a woman’s final period.
- The average age of menopause is fifty-one, defined by twelve consecutive months without a period.
- Hormonal fluctuations during this transition affect nearly every organ system, including the brain, bones, heart, and mental health.
- Rapid bone loss often begins during perimenopause rather than in old age, increasing the long-term risk of osteoporosis.
- Research indicates a significant decline in brain energy during this time, which is linked to common symptoms like brain fog and difficulty concentrating.
The Challenges of Silence and Misinformation
- A 2002 study by the Women’s Health Initiative led to widespread fear of hormone therapies based on conclusions that were later found to be largely incorrect.
- The resulting medical misinformation has left an entire generation of doctors without adequate training on how to care for women in perimenopause.
- Societal taboos prevent women from discussing their symptoms, leading to isolation and confusion for both women and their partners.
- Currently, there is a severe shortage of certified practitioners, with only one specialist for every thirteen thousand five hundred women in need.
Normalizing the Conversation
- Dr. Semby emphasizes the need to break the silence and treat perimenopause with the same level of public awareness and openness as other previously taboo health topics.
- Education should extend beyond women to include men, fostering empathy and allowing them to be part of the solution.
- Bringing perimenopause education into schools, communities, and workplaces is essential for preparing future generations.
- Individuals are encouraged to share what they have learned to create a ripple effect of awareness and empowerment.
Supporting Women in the Workplace
- Many women reach the peak of their professional experience and leadership at the same time they encounter perimenopausal symptoms.
- The lack of support causes roughly ten percent of women to consider leaving their jobs, resulting in a loss of leadership and innovation for companies.
- Addressing perimenopause as a workplace challenge is a matter of equity, retention, and economic productivity.
- Implementing real solutions and support systems in professional environments can prevent burnout and allow women to continue thriving in their careers.
Key Video Highlights
What exactly is perimenopause and when does it start?
[02:48] Menopause is defined as going 12 consecutive months without a period, with the average age being 51. Perimenopause is the transition leading up to this point and can begin up to 10 years earlier, marked by wild hormone fluctuations that affect the brain, bones, heart, and emotional health.
How does perimenopause affect bone health and osteoporosis risk?
[03:35] Rapid bone loss actually begins during perimenopause rather than old age. Once a woman goes three months without a period during this transition, she begins to experience the fast bone loss that eventually leads to osteoporosis, making early monitoring critical.
What causes “brain fog” and cognitive changes during this transition?
[04:18] Brain imaging shows that women can experience up to a 30% decline in brain energy during perimenopause. The brain undergoes significant remodeling, changing its regional connectivity and chemistry, which directly correlates with symptoms like brain fog, mood shifts, and difficulty concentrating.
Why is there so much confusion regarding hormone therapy?
[05:55] A 2002 study by the Women’s Health Initiative (WHI) incorrectly suggested that hormone therapy was harmful for most women. Although the WHI has since walked back nearly all of those findings, the resulting misinformation left a generation of doctors untrained in menopause care, creating a barrier for women seeking help today.
How does perimenopause impact women in the professional workplace?
[08:41] Many women at the peak of their careers consider leaving the workforce due to manageable symptoms. Reports indicate that 10% of women actually do quit because of perimenopause, leading to a loss of leadership and productivity that highlights the need for better workplace support and awareness.
Citations Mentioned
About the Expert
Name: Dr. Manna Semby, ND, MSCP, IFMCP
Affiliation: Founder of Aruna Personalized Medicine and Center for Cognitive Resilience
Profile: arunamed.com
Professional Standing: Dr. Manna Semby is a Naturopathic and Functional Medicine doctor specializing in perimenopause, menopause, and dementia prevention. She is a Menopause Society Certified Practitioner (MSCP) and holds certifications in the ReCODE 2.0 protocol for reversing cognitive decline. As a former finance professional, she now focuses on helping women optimize brain, hormone, and metabolic health to maintain leadership and vitality during midlife transitions.
Full Video Transcript
# It’s time to break the silence on perimenopause
#https://www.youtube.com/watch/qa8dl6uhBlE
00:00:00.930 [Music]
00:00:08.310 [Applause]
00:00:21.359 there is something we don’t talk
00:00:23.760 about and because we don’t talk about
00:00:26.160 this thing millions of women suffer in
00:00:30.720 silence the silence robs them of
00:00:34.000 strength resilience and
00:00:37.079 careers per
00:00:41.320 menopause back in October of 2020 I
00:00:44.960 started a new job in
00:00:47.800 Irvine I worked at this Clinic as a
00:00:50.120 functional medicine doctor and I loved
00:00:52.480 it I would see multiple patience every
00:00:54.840 day and derive a lot of satisfaction
00:00:57.079 from my
00:00:58.280 work but little by little in a few
00:01:00.760 months I started to feel a drag on my
00:01:03.680 energy I started to feel tired rundown
00:01:10.280 exhausted fatigue was overtaking my life
00:01:14.040 my work was affected my children were
00:01:16.439 affected I knew something was wrong but
00:01:19.360 I didn’t know
00:01:21.000 what I knew I needed help but I didn’t
00:01:24.320 know where to
00:01:27.119 begin in a few months by May of 2021 my
00:01:31.799 burnout had become so extreme I had to
00:01:34.280 quit my job I am an ex-corporate
00:01:37.079 executive turned functional medicine
00:01:39.479 doctor and I’m a menopause Society
00:01:42.280 certified
00:01:44.399 practitioner I’m an advocate for
00:01:46.520 menopause at work and I help midlife
00:01:49.920 women navigate per menopause and
00:01:56.000 menopause per menopause
00:02:00.479 just saying the word or perhaps hearing
00:02:03.880 it can make some of us
00:02:06.960 squirm it has been taboo
00:02:10.400 private and yet this word signifies a
00:02:14.000 stage that every woman has gone through
00:02:18.040 is going through or will go
00:02:21.239 through but because of our reluctance to
00:02:23.879 talk about it many women do not know
00:02:27.000 what to expect how to prepare and how to
00:02:30.440 get the help they
00:02:31.640 need just like
00:02:37.760 me so what is per
00:02:40.760 menopause the average age of menopause
00:02:44.680 is
00:02:46.800 51 a woman is said to be in menopause
00:02:49.720 when she goes 12 consecutive months
00:02:52.000 without a
00:02:53.720 period per menopause is the transition
00:02:57.239 leading up to menopause and can begin up
00:03:00.000 to 10 years
00:03:01.720 before during this time a woman’s
00:03:04.760 hormones will fluctuate wildly leading
00:03:08.200 to symptoms in almost every organ system
00:03:10.920 in the
00:03:11.760 body brain bones heart Sexual Health
00:03:16.840 mental emotional health you name
00:03:21.400 it let me share a few findings with you
00:03:24.840 from the swan study the study of women’s
00:03:27.120 health Across the Nation Dr Lisa con’s
00:03:30.280 work and my own
00:03:33.080 experience one when a woman goes 3
00:03:37.159 months without her period She begins to
00:03:39.720 experience fast bone
00:03:41.920 loss now we think osteoporosis is a
00:03:44.959 disease of old age but the fast bone
00:03:48.200 loss that leads to
00:03:50.080 osteoporosis begins in
00:03:54.439 perimenopause
00:03:57.640 two 50% of women with frequent hot
00:04:01.040 flashes will experience them for 7 years
00:04:04.840 or
00:04:06.439 more to me a hot flash felt like a 5 to
00:04:11.519 6 Dee increase in body temperature in
00:04:14.879 less than three
00:04:17.160 seconds multiple times day after
00:04:22.360 day
00:04:24.280 three pet scans show that women can
00:04:27.520 experience an up to 30% decline in brain
00:04:30.800 energy during this time the brain is
00:04:34.320 actually remodeling with changes in
00:04:37.080 Regional connectivity and
00:04:41.320 chemistry these changes are correlated
00:04:43.680 with changes in mood sleep and
00:04:46.360 cognition so when you hear a woman talk
00:04:48.800 about brain fog or difficulty
00:04:51.800 concentrating these symptoms are likely
00:04:54.320 related to the brain remodeling taking
00:04:58.639 place
00:05:00.400 four 50% of women have trouble sleeping
00:05:04.240 through the night night after night
00:05:07.680 leading to fatigue depression
00:05:12.240 anxiety
00:05:14.280 five sexual dysfunction increases the
00:05:18.360 most in the two years leading to
00:05:24.479 menopause these symptoms are just the
00:05:27.160 tip of the iceberg
00:05:30.199 the whole list is much
00:05:32.759 longer it’s not like we don’t know how
00:05:35.280 to help women we don’t as as if we don’t
00:05:38.479 know how to help women navigate per
00:05:40.440 menopause and menopause we do we do have
00:05:43.800 effective ways to help women through
00:05:46.000 this
00:05:46.840 transition but there is one additional
00:05:49.360 confounding
00:05:51.440 factor in 2002 the Women’s Health
00:05:54.919 Initiative published their findings on a
00:05:58.360 study on the the use of hormones for
00:06:01.520 menopausal
00:06:02.919 symptoms the results were published with
00:06:05.400 great
00:06:06.720 Fanfare they announced that hormones are
00:06:09.720 mostly harmful for most
00:06:13.039 women and here’s the
00:06:15.759 problem those conclusions were mostly
00:06:19.599 incorrect in the 20 plus years since
00:06:22.599 then the Whi has walked back almost
00:06:26.120 every finding that they said that they
00:06:28.479 announced in 2002 do but the damage has
00:06:31.639 been
00:06:33.000 done a whole generation of doctors has
00:06:36.120 not been taught about how to care for
00:06:38.680 women undergoing per menopause and
00:06:42.199 menopause so women go through this huge
00:06:46.160 seismic hormonal shift in
00:06:48.479 midlife and we’ve been conditioned to
00:06:50.759 stay silent which is compounded by this
00:06:56.120 misinformation so what should we do
00:07:00.599 I have three
00:07:02.919 suggestions first normalize the
00:07:06.720 conversation I keep coming back to this
00:07:09.199 the silence around per menopause is its
00:07:11.720 biggest challenge women do suffer in
00:07:14.960 isolation unsure of what’s happening to
00:07:17.280 them men watching their Partners or
00:07:20.680 colleagues
00:07:21.840 struggle feel confused and
00:07:25.800 Powerless we have broken tabos before
00:07:29.639 remember when breast cancer was
00:07:31.400 whispered
00:07:32.560 about today the NFL wears Pink Shoes in
00:07:36.720 October for breast cancer
00:07:39.400 awareness per menopause needs the same
00:07:44.560 attention
00:07:46.319 second educate
00:07:49.039 everyone certainly we should educate
00:07:51.360 women so they know how to advocate for
00:07:54.039 themselves it is time to bring men into
00:07:56.960 the conversation so there can be true
00:07:59.479 empathy and understanding and they can
00:08:01.520 be part of the
00:08:04.360 solution currently there is one menop
00:08:07.879 Society certified practitioner for
00:08:10.800 13,500 women that need
00:08:13.479 help Not Enough by a long
00:08:17.639 shot it is time to educate our doctors
00:08:21.199 and healthc Care practitioners so they
00:08:23.680 can provide
00:08:25.080 individualized evidence-based therapies
00:08:27.400 to women it is time to bring education
00:08:30.720 into schools communities and
00:08:34.120 workplaces
00:08:36.000 third support midlife women in the
00:08:39.679 workplace today women are leading
00:08:42.399 Industries companies and shaping the
00:08:44.720 future and yet at midlife when they are
00:08:48.800 at the peak of their experience the
00:08:50.839 leadership and capability too many of
00:08:53.720 them consider leaving because of
00:08:56.680 symptoms that are entirely manageable
00:08:59.440 with the right
00:09:00.600 support in fact according to a deoy
00:09:04.279 women at work 2024 report 10% of them
00:09:08.760 actually
00:09:10.600 do when women leave companies lose
00:09:14.480 leadership Innovation and
00:09:17.279 investment when women stay without the
00:09:20.399 help they need billions can be lost in
00:09:25.160 productivity this is not just a women’s
00:09:27.560 issue it’s an issue of of equity
00:09:30.760 retention and bottom
00:09:33.360 line it is time for companies to
00:09:36.560 recognize perim menopause as the
00:09:38.760 workplace challenge it is and Implement
00:09:42.160 real solutions there is a lot that we
00:09:45.000 can do
00:09:48.680 there so I’ll admit until very recently
00:09:53.959 I hesitated to speak on this topic
00:09:57.680 publicly but the more I I talk about it
00:10:00.519 the more I feel its time has
00:10:03.760 come had someone talked to me about per
00:10:06.360 menopause earlier I could have been
00:10:09.480 prepared I could have avoided
00:10:12.040 burnout I could have avoided quitting my
00:10:17.079 job so it is time for a
00:10:20.839 change it is time to change how our
00:10:24.000 society addresses per
00:10:27.040 menopause and change
00:10:29.760 change requires that we speak up that we
00:10:33.440 challenge the silence that we turn
00:10:35.800 knowledge into
00:10:38.519 action so will you help me turn
00:10:42.320 knowledge into
00:10:44.399 action will you will you speak to at
00:10:48.320 least one other person this week about
00:10:51.800 something you’ve learned here today
00:11:03.519 will you help create a ripple effect of
00:11:05.880 awareness that can bring empowerment and
00:11:09.360 help change women’s lives because if you
00:11:12.440 do we will finally break the silence on
00:11:15.720 per menopause thank you
00:11:30.480 w
This curated content is for educational purposes only and does not constitute medical advice.
Please review our Editorial Standards to see how we verify and source clinical information.