Navigating Perimenopause & Menopause: The Symptoms You Need to Know (And How We Can Help)

If you're a woman in your 40s or 50s experiencing changes you can't quite explain—brain fog that makes you forget why you walked into a room, joint pain that appeared seemingly overnight, or intimate discomfort you're too embarrassed to discuss—you're not alone. Over 50% of women experience moderate to severe symptoms during the menopausal transition, yet many suffer in silence, unaware that these changes are connected to fluctuating (up & down) hormone levels.

As the owner of Kairos Float & Wellness Studio and someone with a PhD in Physiology, I'm committed to providing evidence-based information about women's health. This isn't just spa talk—it's science-backed wellness designed to support you through one of life's most significant transitions.

Understanding the Menopausal Transition

Perimenopause is the transition period leading to menopause, typically beginning in your 40s (though it can start earlier). During this phase, estrogen and progesterone levels fluctuate wildly before eventually declining. This hormonal rollercoaster can last anywhere from a few years to over a decade.

Menopause is officially reached when you haven't had a menstrual period for 12 consecutive months. The average age is 51, but the range is wide—anywhere from the mid-40s to late 50s. What follows is the postmenopausal phase, where symptoms may continue or new concerns emerge.

The Symptoms Everyone Talks About

Let's start with the well-known culprits:

• Hot flashes and night sweats affect approximately 75% of menopausal women. These sudden feelings of intense heat, accompanied by flushing, rapid heartbeat, and perspiration, can disrupt sleep and daily activities.

• Sleep disturbances plague many women during this transition, whether from night sweats, anxiety, or changes in sleep architecture itself.

• Mood changes including anxiety, irritability, mood swings, and depression are common as hormones that regulate neurotransmitters fluctuate.

• Brain fog—that frustrating inability to concentrate, remember names, or find the right word—affects approximately 62% of women in midlife. Research confirms these cognitive changes are real, not imagined, as the brain adapts to lower estrogen levels.

• Joint pain and muscle aches impact over 50% of perimenopausal and menopausal women. Estrogen plays a protective role in joints, and its decline can lead to inflammation, decreased muscle mass, and reduced joint support.

The Symptoms No One Warns You About

Here's where things get real—and where many women feel isolated because these symptoms are rarely discussed openly.

Genitourinary Syndrome of Menopause (GSM)

Formerly called vaginal atrophy or vulvovaginal atrophy, GSM affects 40-90% of postmenopausal women, yet only about 4-7% seek treatment. The decline in estrogen causes profound changes throughout the genitourinary system:

Vaginal and vulvar changes:

• Vaginal dryness, burning, and irritation

• Thinning of vaginal tissues, making them more fragile

• Loss of vaginal elasticity and natural lubrication

• Painful intercourse (dyspareunia)

• Loss of fat from the outer labia

• Changes in vaginal pH, increasing infection risk

Clitoral changes (yes, this happens):

• Clitoral atrophy—the thinning, shrinking, and loss of sensitivity of the clitoris

• Retraction or shrinking of the clitoral hood

• Reduced blood flow to clitoral tissues

• Decreased sensitivity and arousal

• Changes in appearance, with the clitoral hood potentially overgrowing or retracting

• Reduced ability to achieve orgasm or experience sexual pleasure

These changes occur because the clitoris contains numerous estrogen receptors. When estrogen levels drop, the clitoris loses size, thickness, and vascular support. The surrounding structures—including the labia—may thin or fuse, further impacting sexual function.

Urinary changes:

• Increased urinary frequency and urgency

• Recurrent urinary tract infections

• Urinary incontinence (affects up to 50% of postmenopausal women)

• Burning with urination

• Bladder weakness

GSM doesn't resolve on its own and typically worsens without treatment. The good news? It's highly treatable.

Other Lesser-Known Symptoms

• Skin changes including increased dryness, itchiness, altered sensation, and accelerated aging as collagen production decreases by up to 30% in the first five years after menopause.

• Changes in body odor, taste, and smell that can be disconcerting and rarely discussed.

• Dental and oral health issues including sensitive teeth, painful gums, and dry mouth.

• Tinnitus (ringing in the ears) and dizziness.

• Electric shock sensations or "formication"—the feeling of something crawling on your skin.

• Weight redistribution with a shift from pear-shaped to apple-shaped body composition, particularly around the midsection.

• Hair loss and thinning happens to about half of women during perimenopause and menopause. You might notice:

  • Your hair getting thinner all over your head

  • Your part looking wider

  • More hair coming out when you brush or wash it

  • Hair feeling dryer and more brittle

  • Hair growing more slowly

  • Some women lose hair near their temples or on top of their head

  
  

  Here's what's happening: When estrogen drops, it affects the collagen layer in your skin where hair roots live. As this layer gets thinner, the "home" for your hair follicle shrinks. Also, when estrogen drops a lot but testosterone only drops a little, you end up with more testosterone compared to estrogen. This makes hair follicles get smaller—the same thing that causes baldness in men. Weirdly, while your scalp hair thins out, some women notice more hair growing on their upper lip or chin because of this hormone shift.

  
  

  Your scalp also makes less natural oil, which is why your hair feels so dry. The way hair grows also changes, with more hair follicles "resting" at the same time, so you lose more hair all at once.

Understanding Hormone Replacement Therapy (HRT)

The landscape of HRT has evolved significantly, especially with recent FDA guidance removing black box warnings and emphasizing the benefits for women who start therapy within 10 years of menopause onset or before age 60.

HRT for Women WITH a Uterus: Combined Therapy

Women who have an intact uterus require estrogen plus progesterone (or a progestin) therapy. Here's why both hormones are essential:

• Estrogen addresses the majority of menopausal symptoms—hot flashes, night sweats, vaginal dryness, bone loss, and brain fog. It's the primary therapeutic hormone.

• Progesterone or progestin is added specifically to protect the uterine lining. Estrogen alone stimulates endometrial growth, which can lead to endometrial hyperplasia and increase cancer risk. Progesterone counteracts this by thinning and protecting the uterine lining.

  
  

  There's an important distinction between bioidentical progesterone and synthetic progestins. Research suggests that bioidentical progesterone may have a more favorable risk profile, particularly regarding breast cancer risk, compared to synthetic progestins.

  
  

Delivery methods include:

• Oral tablets (estrogen + progesterone/progestin)

• Transdermal patches combining both hormones

• Separate estrogen patches/creams with oral progesterone

• IUD (intrauterine device) that releases progestin locally while taking systemic estrogen

HRT for Women WITHOUT a Uterus: Estrogen-Only Therapy

Women who have had a hysterectomy (uterus removed) typically receive estrogen-only therapy (ET). Since there's no uterine lining to protect, progesterone is generally unnecessary—and evidence suggests that estrogen alone actually carries a lower breast cancer risk than combined therapy.

Important exception: Some healthcare providers may recommend adding progesterone even after hysterectomy for its additional benefits:

• Neuroprotective effects on the brain and nervous system

• Support for neurotransmitters that regulate mood, sleep, and appetite

• Potential protection against certain cancers

• Improved sleep quality (progesterone is often taken at night)

• Support for bone health

This decision should be individualized based on your symptoms, health history, and goals.

Forms of HRT: Systemic vs. Local

Systemic HRT (oral, transdermal patches, vaginal rings) delivers hormones throughout the body via the bloodstream, addressing symptoms like hot flashes, mood changes, and bone health.

Local (low-dose) vaginal estrogen is applied directly to vaginal tissues as creams, tablets, or rings. This provides targeted relief for GSM symptoms with minimal systemic absorption, making it appropriate even for women who cannot take systemic hormones.

The Benefits of Starting Early

Research shows that women who initiate HRT within 10 years of menopause onset may experience:

• Up to 50% reduction in cardiovascular disease risk

• 35% reduction in Alzheimer's disease risk

• 50-60% reduction in bone fractures

• Reduction in all-cause mortality

Timing matters. Starting HRT more than 10 years after menopause or after age 60 may not provide the same protective benefits and could carry different risks.

How Kairos Services Support Menopausal Physiology

At Kairos Float & Wellness Studio, we offer evidence-based therapies that directly address the physiological changes occurring during perimenopause and menopause. Our services aren't just relaxation—they're scientifically validated interventions.

Flotation Therapy: Cortisol Reduction & Stress Management

The float tank experience creates a unique environment where external sensory input is eliminated, allowing your nervous system to deeply rest. For women navigating perimenopause, this matters significantly:

Cortisol regulation: Floating has been shown to reduce cortisol levels—the primary stress hormone. During menopause, cortisol levels are often elevated, which can amplify menopausal symptoms including hot flashes, mood instability, and weight gain. By lowering cortisol, floating helps break this cycle.

Hormonal balance: Elevated cortisol interferes with estrogen and progesterone function. When you're chronically stressed, your body prioritizes cortisol production over sex hormones. Flotation therapy helps reset this balance by activating the parasympathetic nervous system ("rest and digest" mode) and decreasing sympathetic activation ("fight or flight").

Magnesium absorption: Float tanks contain approximately 1,500 pounds of Epsom salt (magnesium sulfate), creating a supersaturated solution. Magnesium is absorbed transdermally during your session and has been shown to:

• Regulate high blood pressure

• Prevent osteoporosis (a key concern post-menopause)

• Provide relief from PMS and menopausal symptoms

• Support bone and teeth health

• Reduce inflammation and muscle tension

• Improve sleep quality

Sleep improvement: Many women report that 90 minutes in the float tank feels like 6-8 hours of restorative sleep. Given that sleep disturbances affect the majority of perimenopausal women—and poor sleep exacerbates every other symptom—this effect alone is transformative.

Pain relief: The weightless environment removes gravitational pressure from joints and muscles, providing relief from the joint pain and stiffness that plague over 50% of menopausal women. The magnesium absorption further reduces inflammation and promotes healing.

Mental clarity: The reduction in external stimuli and stress hormones often leads to improved focus, reduced brain fog, and enhanced mental well-being. The float environment induces theta brain waves associated with deep relaxation and creativity.

Immune function: By suppressing stress hormones that weaken the immune system, floating enhances immune function and supports the body's natural healing processes.

Infrared/RED Light Sauna: Cellular Support & Symptom Relief

While it might seem counterintuitive to recommend heat therapy for women experiencing hot flashes, research consistently demonstrates significant benefits:

Hot flash reduction: Studies show that infrared sauna therapy used 2-4 times weekly can significantly reduce the frequency and severity of hot flashes and night sweats. One small study documented an 87% reduction in hot flashes after 6 weeks of consistent use (3 sessions weekly for 35 minutes).

The mechanism appears to involve:

• Enhanced production of heat shock proteins that regulate body temperature homeostasis

• Stabilization of the autonomic nervous system

• Training the body's temperature regulation system through controlled heat exposure

• Potential increases in estrogen levels (observed in animal studies)

Improved sleep: The warming effect of infrared therapy shifts your body into parasympathetic mode, preparing you for rest. By reducing stress and regulating body temperature, it addresses two primary causes of sleep disturbances during menopause.

Pain and inflammation relief: Infrared light penetrates deeper into tissues than traditional sauna heat, reducing inflammation and easing the joint pain and muscle aches common during this transition.

Skin health and collagen restoration: This is particularly crucial for menopausal women, as collagen production drops by 30% in the first five years after menopause. Infrared therapy stimulates fibroblast activity in the dermis, triggering increased production of both collagen and elastin—the proteins responsible for skin firmness, elasticity, and youthful appearance.

Research published in the Yonsei Medical Journal demonstrated remarkable results: participants using far-infrared therapy for 20 minutes daily, five times per week, experienced 50-75% improvement in skin texture, wrinkles, and overall skin quality over six months. Biopsies confirmed significant increases in dermal collagen and elastin content. The infrared light creates a gentle thermal effect in the dermis that stimulates new collagen growth without damaging the epidermis—a non-ablative remodeling technique.

Detoxification: Deep sweating helps eliminate toxins and metabolic waste products, reducing the burden on your liver and supporting overall hormone balance.

Mood and stress support: Like floating, sauna use activates the parasympathetic nervous system, reduces cortisol, and promotes the release of endorphins. This creates a calmer stress response and improved emotional resilience.

Cardiovascular and bone health: Regular sauna use supports long-term cardiovascular health and may help prevent the increased heart disease risk that emerges post-menopause.

The Collagen Support Protocol: Low-Temperature Infrared Therapy

At Kairos, we've developed a specialized 20-minute Collagen Support session using low-temperature infrared at just 95°F. This gentler approach is specifically designed for skin health and collagen stimulation, making it ideal for women with sensitive skin, those new to sauna therapy, or anyone primarily focused on anti-aging benefits.

Why low temperature works:

Unlike traditional saunas that operate at 150-200°F or standard infrared sessions at 110-140°F, low-temperature infrared therapy at 95°F provides deep tissue penetration without overwhelming heat stress. This approach:

• Allows for comfortable, extended sessions where infrared light can penetrate to the dermal layers

• Reduces risk of skin irritation or excessive dryness

• Maintains gentle stimulation of fibroblasts for sustained collagen production

• Creates a pleasant skin temperature elevation (around 90-95°F at the skin surface) that triggers collagen synthesis without thermal damage

• Is well-tolerated by those who find traditional sauna heat uncomfortable or triggering for hot flashes

• Enables the body to remain in a relaxed, parasympathetic state throughout the session

The science behind it:

Research shows that even modest elevations in skin temperature (to around 90-95°F) from far-infrared exposure can stimulate collagen and elastin production. The key is consistent, gentle heat that reaches the deeper skin layers where fibroblasts reside. These fibroblast cells absorb the infrared light energy and respond by increasing production of the structural proteins your skin needs.

A landmark study published in the Journal of Cosmetic and Laser Therapy found that infrared exposure stimulated significant improvements in skin appearance after just three months of regular use. The therapeutic effect comes from the infrared wavelengths themselves—particularly far-infrared (FIR) and near-infrared (NIR) combined—not from extreme heat.

Who benefits most from the Collagen Support Protocol:

• Women in perimenopause or menopause experiencing accelerated skin aging

• Those with sensitive skin who find higher heat uncomfortable

• Anyone seeking anti-aging benefits without invasive procedures

• Women who want to maintain skin health as estrogen levels decline

• Those combining multiple wellness modalities (excellent pairing with float therapy)

This 20-minute protocol offers a targeted, science-backed approach to one of the most visible effects of menopause: changes in skin quality and appearance.

Cold Plunge & Contrast Therapy: Inflammation & Hormonal Regulation

While less researched specifically for menopause, cold exposure therapy offers complementary benefits:

Inflammation reduction: Cold therapy powerfully reduces systemic inflammation, which increases during the menopausal transition and contributes to joint pain, brain fog, and cardiovascular risk.

Hormonal optimization: Cold exposure stimulates the production of norepinephrine and may support overall endocrine function.

Improved resilience: Regular cold exposure trains your stress response system, making you more resilient to the hormonal fluctuations of perimenopause.

Enhanced recovery: For active women, cold plunge aids muscle recovery and reduces exercise-related soreness, supporting your ability to maintain bone-protective strength training.

Contrast therapy (alternating between infrared sauna and cold plunge) provides the combined benefits of both modalities while enhancing circulation and lymphatic drainage.

Halotherapy: Respiratory & Immune Support

While not specifically studied for menopausal symptoms, halotherapy (salt therapy) offers:

Respiratory support: Improved breathing can enhance your exercise tolerance and sleep quality.

Immune function: The antimicrobial properties of salt support immune health during a time when your body is adjusting to hormonal changes.

Stress reduction: The calming environment and negative ions may contribute to overall stress management.

A Holistic Approach: Combining Therapies

The beauty of Kairos's offerings is that these therapies work synergistically. A thoughtful approach might include:

• 2-3 float sessions weekly for deep stress reduction, magnesium absorption, and sleep support, reduce to 1-2x monthly for maintenance after the first month

• 2-4 infrared sauna sessions weekly for hot flash reduction, pain relief, and skin health

• 1-2 cold plunge or contrast therapy sessions weekly for inflammation management and hormonal support

• Regular halotherapy as desired for respiratory and immune benefits

This multi-modal approach addresses the complex, interconnected nature of menopausal symptoms. You're not just treating one symptom—you're supporting your entire physiology during a major transition.

The Bottom Line

Perimenopause and menopause represent a significant neuroendocrine transition, not a disease. While symptoms can be challenging, they're also highly treatable through a combination of medical interventions (like HRT when appropriate) and evidence-based wellness therapies.

You don't have to suffer in silence. Whether you're experiencing classic symptoms like hot flashes or lesser-known changes like clitoral atrophy and brain fog, understanding what's happening in your body empowers you to seek appropriate support.

At Kairos Float & Wellness Studio, we're committed to meeting you where you are with science-backed therapies that support your physiology during this transition. Because when science meets wellness, transformation happens.

Ready to experience the difference?

Book your first session at Kairos Float & Wellness Studio and discover how evidence-based wellness can transform your menopausal experience.

As always, discuss significant symptoms and treatment options with your healthcare provider. The information provided here is educational and should not replace personalized medical advice.

Scientific References

Genitourinary Syndrome of Menopause & Lesser-Known Symptoms

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2. Bachmann G. Urogenital ageing: an old problem newly recognized. Maturitas. 1995;22(Suppl):S1-S5.

3. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause. 2013;20(9):888-904. doi:10.1097/GME.0b013e3182a122c2

4. Kingsberg SA, Wysocki S, Magnus L, Krychman ML. Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey. J Sex Med. 2013;10(7):1790-1799.

5. Shifren JL. Genitourinary syndrome of menopause. Clin Obstet Gynecol. 2018;61(3):508-516.

Perimenopause & Menopause Symptoms

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Hormone Replacement Therapy

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13. Hodis HN, Mack WJ, Henderson VW, et al. Vascular effects of early versus late postmenopausal treatment with estradiol. N Engl J Med. 2016;374(13):1221-1231.

14. Salpeter SR, Walsh JM, Greyber E, Salpeter EE. Brief report: Coronary heart disease events associated with hormone therapy in younger and older women. A meta-analysis. J Gen Intern Med. 2006;21(4):363-366.

Flotation Therapy & Stress Reduction

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20. Suedfeld P, Metcalfe J, Bluck S. Enhancement of scientific creativity by flotation REST (Restricted Environmental Stimulation Technique). J Environ Psychol. 1987;7(3):219-231.

Infrared Sauna & Menopause

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24. Oosterveld FG, Rasker JJ, Floors M, et al. Infrared sauna in patients with rheumatoid arthritis and ankylosing spondylitis. Clin Rheumatol. 2009;28(1):29-34.

Infrared Therapy & Collagen Production

25. Lee JH, Roh MR, Lee KH, et al. Effects of infrared radiation on skin photo-aging and pigmentation. Yonsei Med J. 2006;47(4):485-490. doi:10.3349/ymj.2006.47.4.485

26. Schroeder P, Pohl C, Calles C, et al. Cellular response to infrared radiation involves retrograde mitochondrial signaling. Free Radic Biol Med. 2007;43(1):128-135.

27. Barolet D, Roberge CJ, Auger FA, et al. Regulation of skin collagen metabolism in vitro using a pulsed 660 nm LED light source: clinical correlation with a single-blinded study. J Invest Dermatol. 2009;129(12):2751-2759.

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Magnesium & Women's Health

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33. Facchinetti F, Borella P, Sances G, et al. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol. 1991;78(2):177-181.

Cortisol & Menopausal Health

34. Woods NF, Mitchell ES, Smith-DiJulio K. Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women's Health Study. Menopause. 2009;16(4):708-718.

35. Lovallo WR, Whitsett TL, al'Absi M, et al. Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels. Psychosom Med. 2005;67(5):734-739.

As always, discuss significant symptoms and treatment options with your healthcare provider. The information provided here is educational and should not replace personalized medical advice.