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As women enter their 40s and 50s, they may experience a range of new health changes — such as shifting hormones, hot flashes, night sweats, pelvic discomfort, and heavy periods — that may go unaddressed. We spoke with three of our women’s health experts to shed light on what’s normal, what’s not, and when to seek help.
1. Perimenopause: It’s not just hot flashes
In the years leading up to menopause, known as perimenopause, hormonal shifts can trigger a wide range of symptoms, such as vaginal dryness, heart palpitations, sleep issues, mood swings, brain fog, anxiety, or irregular cycles. They can start sometimes years before periods stop and are often mistaken for stress or aging.
“Many women are surprised to learn that perimenopause can begin as early as their mid-30s,” says Dr. Jason Kanos, Chairman of Obstetrics and Gynecology at Holy Name. He emphasizes that support and treatment options are available for anyone going through it.
“You don’t have to wait until menopause to talk to your provider,” he says. “Lifestyle changes like exercise, weight loss, and meditation should help the symptoms. Other options include hormone replacement therapy, birth control pills, and mood adjustment medications.”
Some symptoms, however, may cover up underlying medical conditions. It’s important to discuss any new changes with your doctor.
2. Fibroids: Common, Treatable, and Often Overlooked
Uterine fibroids are non-cancerous growths in the uterus. They are extremely common, but many women may not be aware they have them.
“By age 50, up to 70% of women will develop fibroids,” says Dr. Eric Liberman, Director of Minimally Invasive Gynecologic Surgery at Holy Name. “Of these women, approximately 25 percent experience fibroid-related symptoms, such as heavy menstrual bleeding (leading to anemia), pelvic pain or pressure, bloating, increased urinary frequency, constipation, and pain with intercourse.”
While fibroids are benign, they can significantly affect quality of life and may even impact fertility and pregnancy. Thankfully, there are many treatment options, such as medications, uterine fibroid embolization (UFE), and minimally invasive surgery. “It's important women are aware of fibroids and the associated symptoms so they may be their own advocates,” Dr. Liberman says.
3. Pelvic Floor Health: Why It Matters at Midlife
Whether due to childbirth, aging, or hormonal changes, pelvic floor weakness is common — and treatable.
“Pelvic floor disorders, like urinary incontinence or pelvic organ prolapse, are caused by weakening or damage to muscles and tissues that support different organs in the pelvis, such as the uterus, vagina, bladder, and rectum,” says Dr. Diana Hearn, OB/GYN and urogynecologist. “They affect nearly 1 in 3 women, but we often don’t talk about them, which leads to unnecessary suffering.”
There are many ways to treat pelvic floor disorders, including without surgery. “There are excellent physical therapy options and non-invasive treatments that can restore function and confidence,” Dr. Hearn explains.
Take Charge of Your Health
If you’re experiencing changes related to perimenopause, fibroids, or pelvic floor function, don’t wait. Start the conversation with your OB/GYN or primary care provider at Holy Name.
