Inspired by the incredible work of Dr. Mary Claire Haver, MD, and grounded in the tools that have transformed my own life as a cancer survivor 💛🎀
Ladies, we have to talk. 🌸
For too long, women have been told that perimenopause is just “hot flashes and moodiness.” That it’s a season to “get through.” That we should “tough it out.”
That is not the truth. 🚫
Perimenopause and menopause are one of the biggest hormonal and physiological transitions a woman’s body will ever go through. It affects your brain, your heart, your bones, your metabolism, your immune system, your skin, your mood, your sleep, and yes, your voice.
And it starts earlier than most of us think. In our mid-30s to early 40s. And it can last 7 to 10 years.
The good news? We finally have real data, brilliant doctors like Dr. Mary Claire Haver leading the way, and tools that actually work. Whether you can take hormone replacement therapy or not (I can’t, more on that in a minute), there are so many powerful ways to feel like yourself again. ✨
Let’s break this all down. Simply. With Compassion. And with the science to back it up. 💛
💛 A Personal Note First
I want to start with my story because it shapes everything I share here.
After my cancer diagnosis, I sat in a dark place for almost a year. Grief. Fear. Silence. Then I made a decision. I studied Nutrition, Nutrigenomics, Genetics, Epigenetics, Holistic Wellness, and Reiki. I became a Wellness Expert. I founded Claridad, an elevated beauty and wellness ritual brand. I built a wellness practice for women.
But here’s the piece that’s most relevant to today’s conversation: as a cancer survivor, I am not a candidate for hormone replacement therapy because of my cancer type. So everything you’re going to read here about non-HRT options is not theoretical for me. It’s what I live, every single day.
If you’re a survivor like me, or if HRT isn’t right for you for any reason, this blog was written with you especially in mind. You have SO many options. And they work. 💛
🌸 First: What Perimenopause Actually Is
Dr. Mary Claire Haver, board-certified OB-GYN and one of the most trusted voices in menopause medicine, calls perimenopause the “hormonal zone of chaos.” 🌀
Her framework:
- Perimenopause begins in your mid-30s to early 40s and lasts 7 to 10 years
- Estrogen and progesterone don’t just drop, they fluctuate wildly, creating that “wired but tired” exhaustion
- A “normal” FSH blood test does NOT rule out perimenopause (this one is critical)
- Diagnosis is based on your age, your symptoms, and your history, not one blood test
- Estrogen affects nearly every organ in your body, so symptoms show up everywhere
Translation: if a doctor tells you “your labs are fine, this isn’t perimenopause,” they may be missing everything. 🚫
🚨 It’s WAY More Than Hot Flashes: The Symptoms Most Women Don’t Know About
Based on Dr. Haver’s clinical work and current research, here are the symptoms women in perimenopause and menopause experience, most of which get missed or dismissed by doctors:
🧠 Brain & Mood
- Brain fog
- Difficulty concentrating
- Word-finding difficulties
- Loss of executive function
- Anxiety (even in women who never had anxiety before)
- Depression
- Mood swings
- Irritability and rage
- Panic attacks
- Loss of confidence
- Feeling like you don’t recognize yourself anymore
💤 Sleep
- Trouble falling asleep
- Waking at 2 or 3 AM and not being able to go back to sleep
- Night sweats
- Restless legs
- Chronic exhaustion even after sleep
🌸 Reproductive & Sexual Health
- Irregular periods (lighter, heavier, closer together, farther apart)
- Vaginal dryness
- Painful intercourse
- Reduced libido
- Recurrent UTIs
- Urinary urgency and incontinence
- Pelvic floor changes
💪 Body & Metabolism
- Unexplained weight gain (especially belly fat)
- Loss of muscle mass
- Slower metabolism
- Insulin resistance
- Blood sugar fluctuations
- Fatty liver
- Sugar and carb cravings
❤️ Cardiovascular
- Heart palpitations
- Elevated blood pressure
- Rising cholesterol (LDL and ApoB climb)
- Increased cardiovascular risk
🦴 Musculoskeletal
- Joint pain and stiffness (especially in the morning)
- Frozen shoulder
- Muscle aches
- Loss of bone density
- Accelerated osteoporosis risk
- Back pain
💇♀️ Skin, Hair & Nails
- Hair thinning (widening part, less volume)
- Dry, itchy skin
- Skin thinning
- Acne (yes, in your 30s’ 40s)
- Melasma and hormonal pigmentation
- Brittle nails
- Loss of collagen
🌡️ Vasomotor (the ones people know about)
- Hot flashes
- Night sweats
- Flushing
- Heat intolerance
👁️ Sensory & Nervous System
- Tinnitus (ringing in the ears)
- Dizziness
- Dry eyes
- Blurry vision
- Migraines and worsening headaches
- Burning tongue or altered taste
- Body odor changes
- Electric-shock sensations
- Tingling in hands and feet
🍽️ Digestive
- Bloating (especially after meals)
- New food sensitivities
- Reflux and heartburn
- Constipation or IBS-like symptoms
- Gum recession and dental changes
🛡️ Immune
- Increased inflammation
- Autoimmune flares
- Getting sick more often
- Longer recovery times
If you’re reading this and feeling seen, you’re not crazy. You’re not broken. Your body is going through a real, biological, hormonal transition. And you deserve real care. 💛
🧪 The Labs Every Woman Needs (Dr. Mary Claire Haver’s Full Panel)
This is the panel Dr. Haver runs on every menopausal patient she sees. Print this. Take it to your doctor. If they refuse, find one who will.
1. Advanced Lipid Panel ❤️
- LDL cholesterol: Optimal: <70 to 100 mg/dL
- HDL cholesterol: Optimal: >60 mg/dL
- Triglycerides: Optimal: <100 mg/dL
- Non-HDL cholesterol: Optimal: <100 mg/dL
- ApoB (apolipoprotein B): Optimal: <80 to 90 mg/dL. This is Dr. Haver’s most important marker, more accurate than LDL alone.
- Lp(a) (lipoprotein little a): Optimal: <30 mg/dL. Check at baseline and again after menopause (levels rise in women)
2. Blood Sugar and Insulin 🍬
- Fasting glucose: Optimal: 70 to 90 mg/dL
- Hemoglobin A1c: Optimal: <5.4%
- Fasting insulin: Optimal: <7 to 10 µIU/mL
- HOMA-IR: Optimal: <1.5
3. Bone Health 🦴
- DEXA scan: Baseline in perimenopause, not at 65
- 25-OH Vitamin D: Optimal: 60 to 100 ng/mL
- Calcium
- PTH (if vitamin D is low)
4. Thyroid 🦋
- TSH: Optimal: 0.4 to 2.5 mIU/L
- Free T4 and Free T3: Mid to upper half of range
- TPO antibodies: Optimal: <35 IU/mL
- Thyroglobulin antibodies: Optimal: <1.0 IU/mL
5. Iron and Ferritin 🩸
- Ferritin: Optimal: 50 to 100+ ng/mL (for hair regrowth target above 70)
- Hemoglobin, iron saturation, TIBC if ferritin is low
6. B12, Folate & Methylation 🧬
- Vitamin B12: Optimal: >500 pg/mL
- Folate: Optimal: >7 ng/mL
- Homocysteine: Optimal: <9 µmol/L
7. Inflammation 🔥
- hs-CRP (high-sensitivity C-reactive protein): Optimal: <1 mg/L
8. Hormones (Situational, Not Routine)
- Estradiol, FSH, total and free testosterone, DHEA-S. Ask for these if you’re not menstruating, are under 45 and want to confirm early menopause, or are evaluating low libido.
Plus Two Basics
- CBC (complete blood count)
- CMP (comprehensive metabolic panel)
Print this list. Bring it to your annual visit. If your doctor refuses to run it, find a menopause-informed provider (I’ll share my favorite in a minute). 💛
💊 Let’s Talk About HRT (Hormone Replacement Therapy)
For decades, women were told HRT was dangerous. That fear came from the 2002 Women’s Health Initiative (WHI) study, which was later reanalyzed and largely reversed in a 2013 JAMA paper by Manson et al.
The current evidence: for symptomatic women who are within 10 years of menopause and without contraindications, the benefits of HRT often outweigh the risks. It can reduce hot flashes, protect bones, protect the brain, protect the heart, improve sleep, improve mood, restore libido, and dramatically improve quality of life.
But here’s the honest truth: HRT is not for every woman.
Contraindications include:
- Certain types of breast cancer (mine, for example) 🎀
- Estrogen-sensitive cancers
- Active blood clots or history of clotting disorders
- Untreated hypertension
- Active liver disease
If HRT is right for you, please explore it with a knowledgeable provider (again, MIDI is my recommendation, and I’ll share why below).
If HRT is NOT right for you (like me), keep reading. There is SO much more we can do. 💛
🌿 If You’re Not a Candidate for HRT: What I Do Instead
Here is my exact protocol as a cancer survivor navigating this transition without HRT. It is not medical advice. It’s my personal roadmap, and it works. 💛
1. Genetic + Epigenetic Testing 🧬
Because I can’t lean on HRT, I lean on understanding my body deeper than most women do. I did a full genetic test to understand my unique DNA, then I layered an epigenetic test on top to see how my lifestyle is currently expressing (or suppressing) certain genes. Based on those results, I built a personalized protocol for supplementation, food, and lifestyle. This is exactly the work I now do for other women in my practice.
2. Annual Lab Testing 📊
I run Dr. Haver’s full panel (above) every single year. I look for what’s deficient. I supplement to correct it. Then I retest to make sure it’s working.
3. Nervous System Nourishment 🧘♀️
This is my foundation. When my nervous system is calm, everything else works.
- PEMF therapy (pulsed electromagnetic field, for cellular regeneration and nervous system support)
- Daily meditation and breathwork
- Reiki (as a reiki practitioner myself, I use this regularly)
- Adaptogenic supplements (ashwagandha, reishi, magnesium)
- Vagus nerve exercises (I have a free ebook on this if you want it)
4. Strength Training + Heavy Lifting 💪
Muscle is the longevity organ. Especially without estrogen’s protection, my job is to build and protect muscle aggressively.
- Compound lifts (squats, deadlifts, rows, presses, lunges)
- 3 to 4 sessions per week
- Progressive overload (lift heavier over time)
- Walking daily for recovery
5. Hydration + Electrolytes 💧
Every single day. Half my body weight in ounces of water, plus clean electrolytes (no artificial dyes or sweeteners).
6. Sleep, Protected Like My Life Depends on It 😴
This is my #1 priority. My nighttime ritual is more important than my morning ritual. Cool, dark room. Screens off an hour before bed. Magnesium. Slow wind-down. 7 to 9 hours. Non-negotiable.
7. Biohacking Tools I Love 🔴
These are the tools I’ve added over the years that have made a real difference:
- 🧖♀️ Sauna (cardiovascular health, detox, longevity)
- 🔴 Red light therapy (mitochondrial support, skin, hair, cellular repair)
- 📳 Vibration plate (bone density, circulation)
- ⚛️ Quantum Upgrade + Capsule Necklaces (I feel a real energetic difference)
- 🧬 Peptides (I cycle these carefully and track results to ensure they’re doing what I intend)
8. Nutrition That Doubles Down 🥗
This is where I put on my Nutrition Expert hat. Here’s what I prioritize:
Protein (foundational for muscle preservation)
- Aim for 1 gram per pound of body weight
- 20 to 40g per meal
- Grass-fed meats, wild fish, pastured eggs, Greek yogurt, cottage cheese
Fiber (foundational for hormone metabolism)
- Aim for 30+ grams a day
- Chia, flax, oats, beans, berries
Cruciferous Vegetables (support healthy estrogen metabolism)
- Broccoli, cauliflower, brussels sprouts, kale, cabbage (microgreens)
- Daily
Anti-Inflammatory Fats
- Wild salmon, sardines, avocado, extra virgin olive oil, walnuts
Complex Carbs (yes, women in perimenopause NEED carbs for thyroid + hormones)
- Sweet potatoes, quinoa, oats, root vegetables
Fermented Foods (gut health = hormone metabolism)
- Kimchi, sauerkraut, kefir, unsweetened yogurt
Foods to Reduce 🚫
- Alcohol (worsens hot flashes, sleep, and hormones)
- Ultra-processed foods
- Excess sugar and refined carbs
- Seed oils (soybean, canola, corn)
👩⚕️ The Right Doctor Changes Everything: My Recommendation
Here’s the truth. Most OB/GYNs did not receive training in menopause during residency. Dr. Haver has said this openly about her own training. It is not their fault, but it means we, as women, have to advocate for the care we deserve.
That’s why I’m so passionate about telling you about MIDI Health. 💛
MIDI Health is a virtual telehealth platform staffed by OB/GYNs, nurse practitioners, and clinicians who are specifically trained in perimenopause and menopause. They are up to date on the latest research, science, biohacking, and supplementation. Most importantly? You feel seen. You feel heard. You feel like your symptoms matter.
What I love about MIDI:
- ✅ They take insurance
- ✅ 100% virtual (see them from anywhere)
- ✅ Can prescribe HRT if you’re a candidate
- ✅ Can prescribe oral minoxidil, vaginal estrogen, and many other tools
- ✅ Can order the full lab panel we just discussed
- ✅ Just launched their own supplement line specifically for this stage
Where to find them: MIDI Health (joinmidi.com)
My VIP discount code for their supplement line: clarita10
They are a game-changer. Add them to your medical team. 💛
🧠 Doubling Down on Your Brain
Perimenopause hits your brain HARD. Estrogen is deeply neuroprotective, and its decline is why so many women experience brain fog, memory issues, and even increased dementia risk over time. Here’s what I do:
- Omega-3 fatty acids daily (wild salmon or clean fish oil)
- Creatine (5g daily, supports muscle AND brain)
- B vitamins, especially B12
- Sleep (glymphatic clearing happens at night)
- Movement (raises BDNF, brain-protective protein)
- Learning new things (language, instrument, new skill)
- Cold exposure (in moderation for women)
- Sauna (linked to reduced dementia risk in research)
- Managing stress (chronic cortisol is toxic to the brain)
💛 Doubling Down on Your Nervous System
If your body isn’t grounded, calm, and safe, nothing else works. This is your foundation.
- Daily breathwork (cyclic sighing has RCT-backed benefit for stress reduction, per Stanford’s Balban et al. 2023 study in Cell Reports Medicine)
- Meditation
- Time in nature
- Boundaries as a health practice
- Vagus nerve exercises
- Reiki, somatic work, or trauma-informed therapy
- Slower mornings, protected weekends
- Community and co-regulation
✨ A Simple Weekly Rhythm to Start
If everything above feels like a lot, here is the simple version to start with this week:
- Every day: hydrate, protein at every meal, walk, magnesium at night, 7 to 9 hours of sleep
- 3 to 4 times a week: strength train
- Once this month: book your labs (bring Dr. Haver’s list)
- Once this month: book an appointment with a menopause-informed provider (MIDI is my recommendation)
- Ongoing: breathwork or meditation daily, even 5 minutes
That’s it. Build from there. 💛
💛 Let’s Work Together
If you feel called to go deeper, I have three ways we can work together:
1. 🧬 Genetic Testing Package A personalized deep dive into your unique DNA + a custom protocol built for your body. This is the exact process I did for myself after my cancer diagnosis.
2. ✨ Genetic + Epigenetic Wellness Package The full experience. Genetic testing + epigenetic testing + a personalized wellness roadmap based on both your DNA AND how your lifestyle is currently expressing your genes. This is the most comprehensive option.
3. 📞 60-Minute Virtual One-on-One Consultation Sit down with me, share your story, and let’s build a plan tailored to you. Perfect if you’re just starting or want personalized guidance without going all-in.
👉 Book your package or consultation here
Or send me a DM or email if you have questions. I read every message. 📩💛
🎀 A Final Word
If you’re reading this and you’re a cancer survivor like me, please hear this. Your journey is beautiful. Your body is not broken. And you have SO many tools available to you, even without HRT.
If you’re not a survivor but you’re in this stage and struggling, please know: you are not crazy. You are not lazy. You are not “just aging.” Your body is going through a massive hormonal transition, and it deserves real care from real experts.
Whether that’s Dr. Mary Claire Haver’s work, MIDI Health, my practice, or a combination of everything, please find people who see you.
You deserve to thrive in this next chapter. Not just survive it. 💛✨
Save this. Share it with your sister, your best friend, your mom. Every woman deserves this information. 👯♀️🌸
Progress, not perfection. Always. ✨
Xo,
Clarita Escalante, Wellness Expert & Founder of Claridad
Disclaimer ⚠️
This article is for educational and informational purposes only and is not intended as medical advice. The information shared here is not a substitute for consultation with a licensed healthcare provider. Always consult your physician, OB/GYN, or qualified healthcare provider before starting or stopping any medication (including HRT), supplement, lab testing, or lifestyle protocol, particularly if you are pregnant, breastfeeding, taking medications, have a history of cancer or clotting disorders, or have any underlying health conditions. Genetic and epigenetic testing results should be interpreted with a qualified provider. References to Dr. Mary Claire Haver’s clinical work are based on her publicly available writings, book “The New Perimenopause,” and public podcast interviews; her inclusion is educational and not a paid endorsement. References to MIDI Health include a discount code for the author’s audience; this is a personal recommendation, not medical advice. Individual results vary.