The Fatigue Fixer29 Okt 2025

39. The One Where Perimenopause Isn’t Always to Blame

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If you’ve ever wondered, “Is this perimenopause—or something else?”, this episode will help you get clarity, feel empowered, and take the right next steps for your health.

Dr. Sarah Vadeboncoeur shares key takeaways from the Canadian Menopause Society conference, where over 600 practitioners gathered to improve menopause care.

She explores the growing trend of blaming every midlife symptom on perimenopause—and why this isn’t always accurate. From her own surprising realization about being in denial of her symptoms to real-life patient stories, Sarah highlights the importance of accurate diagnosis, cycle tracking, and ruling out other health conditions before attributing everything to hormones.

Learn how to distinguish between true perimenopause, the late reproductive stage, and other midlife factors like stress, sleep deprivation, and common conditions such as thyroid issues or iron deficiency. Plus, Sarah dives into the latest research on hormone replacement therapy (HRT) and how to advocate for comprehensive, menopause-literate care.

What You’ll Learn

Conference Insights – Hopeful updates in menopause care from experts across Canada and the U.S.
Perimenopause vs. Everything Else – Why symptom lists with 100+ items cause confusion and overwhelm.
Personal Story – Even menopause experts (like Sarah!) can miss or deny their own symptoms.
Key Hormonal Stages –
- Late reproductive stage: often mistaken for early perimenopause.
- Early perimenopause: high estrogen, low progesterone, big swings.
- Late perimenopause: low estrogen, classic symptoms peak.
The Sleep Factor – How poor sleep mimics or worsens perimenopause symptoms—and why it must be addressed first.
Testing & Assessment – The 13 lab tests every woman over 40 should request before assuming symptoms are hormonal.
Real Patient Story – A case where symptoms blamed on menopause turned out to be an H. pylori infection.
HRT Facts – What hormone replacement therapy can and can’t treat.

Key Takeaways

Don’t automatically blame perimenopause—get properly assessed and rule out other causes.
Track your cycle: a change of more than 7 days in cycle length is a defining sign of perimenopause.
Prioritize sleep health—69% of midlife women report sleep issues that can mimic or amplify symptoms.
Ask for comprehensive lab work including thyroid, iron, blood sugar, and more.
Seek menopause-literate practitioners who can guide you with expertise and empathy.

Resources & Links

Canadian Menopause Society
The Menopause Society (North America)
The Missing Piece (free lab guide): 13 Must-Have Lab Tests For More Energy & Feeling Like Yourself Again In Your 40’s

Dr. Sarah Vadeboncoeur is a Naturopathic Doctor, mom, and fatigue fixer who’s on a mission to help women fix their fatigue and get the health care they deserve. You can find her talking about all things fatigue on Instagram and learn more about her services at drsarahv.ca.

The Fatigue Fixer is produced by Story Studio Network.

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