It’s Not You. It’s Perimenopause.

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That's H-I-Y-A-H-E-A-L-T-H.com. Perry Menopause is when the signals coming from the brain don't work on the ovaries anymore, like they used to. The ovaries go out kicking and screaming, you know, all the processes you had put in place, that you could manage the life you built, start failing.

If you find yourself with new anxiety, new depression, snapping at your kids, not sleeping, you're really on the struggle bus. 10,000 women are not lying or exaggerating. There's a lot of data out there, but no one was pulling it out of the academic journals and bringing it to the light.

Most women can tell you what menopause is. Flashes, the endopperiods, the sort of cultural punchline, but ask a room full of 40-year-olds about paramenopause, and you'll get something very different. You tend to hear, I thought I was using my mind. I thought I was just stressed.

My doctor said I was too young. I didn't recognize myself. Paramenopause is the long runway before menopause. And for a lot of women, it's the season when things just start to feel off. Sleep shifts, patience, bins, emotions get louder and focus gets very slippery.

And you're parenting during this time. And often, you have a kid who's going through their own hormonal shift in puberty. There is so much going on in your house. It feels like two nervous systems colliding, and there's a lot of chaos. For a very long time, this stage was fairly talked about.

Women just thought it was in their head, or they weren't feeling like themselves, but now women are comparing notes in real time. And they're naming what's happening. They're asking better questions, and they are demanding better care. Dr. Mary Claire Hayver has been a major force in that shift.

I was lucky enough to meet her a couple of years ago at a conference, and I'm so impressed by all of her work. She's a board certified OBGYN, educator, and researcher who has spent years translating the science of menopause and paramenopause into language women can actually use.

Her new book, The New Paramenopause, is part of the larger effort to rewrite the narrative around midlife, not as a decline, but as a transition. Today, we're going to be breaking down what paramenopause is. I promise you, you are going to connect so many dots.

You're going to understand your body better. It might even lead to you asking different questions of your own doctor,

which is such a powerful shift.

I'm Dr. Becky, and this is Good Inside.

“Women, females, are born with our entire eggs supply, okay?”

Men make their stuff fresh in the testicles every day. Our ovaries are born with the eggs. We are prepared, and that's all you care. We don't make any more, it's like brain cells, right? And as we age, we start losing eggs, and we ovulate,

we lose about 1,000 or so each month as well. So by the time we're born, we have about one to two million eggs, right? So by the time we're 30, we're down to 10% of our eggs supply, and then by the time we're 40, we're down to 3%, just to give you an idea of the scale, okay? When you are pre-menopausal, menopause is not entered the chat in any form,

and you are having regular monthly periods, and that's about 80% of us. We have the signals coming from the brain, telling the ovaries to ovulate each month. So all of this starts in the brain, not the ovaries. So we have these hormones coming from the brain, stimulating hormones. That say, hey, our estrogen level dropped normally after ovulation, right?

We need estrogen again, so it starts pumping out these signals to the ovaries. Oh, here we go, let's make more estrogen. We'll ovulate, then we'll make progesterone.

“The whole thing starts every month over and over again, roughly every 28 days, okay?”

That looks like an EKG. It is this Ebon flow that is very predictable for a healthy woman.

and we can, and it just, is this gorgeous curve.

Perry menopause is when the signals coming from the brain don't work on the ovaries anymore, like they used to. So the brain starts freaking out. What's going on? Where's my estrogen?

“Then it starts pounding the ovary with higher and higher levels of that stimulating hormone, okay?”

So this Perry menopause transition, where you went from normal, regular, Ebon flow predictable to now if I take spaghetti and throw it at the wall, the curves look, my hands are waving all around for those listening. The curves are everywhere. And so we can see much higher estrogen levels than we ever had, like as high as they were in pregnancy.

We can see them plummet and then tank for three or four months, then pop back up. So we call it the zone of chaos, and it can take seven to ten years to get through it. And you can be having absolutely regular periods with hormonal chaos in the background. So this starts well before your cycles become irregular. We start seeing the mental health seven to ten years we get this.

Yes, on the changes. Now, everything gets worse as we get closer to the end. And then menopause is, you're out of eggs. So average age of menopause, right, in the US is 51. Now that's for people who look like us Caucasian.

Then, but normal is still 46 to 55, okay, for the end of your periods forever. All right, that's under the normal curve. Back that up, that's seven to ten years we were talking about. So when I have a 44 year old coming in, who's like, I'm having regular periods, but I'm at a control. Wait, it's almost statistically impossible for her not to be in Perry, menopause.

But what you're also saying is in your late 30s, it's common pause. Yes, come, and there's some patients, you know, now we have more women of a 40, having babies than under 20, right, this is new. And so I can't tell you how many patients go right from postpartum, straight into Perry, menopause.

When you first learn about menopause, when did the word Perry, menopause come across, your desk across your ears? Let's just start there before we get into all the things I know you're going to teach us. So I remember my mother mentioning it, kind of, and it was just this very vague notion, and she would go into her dark room and just say, it's menopause and disappear for hours at a time.

So I just understood it to be a bad thing. I didn't really understand what was happening to her.

And she never sat me down and said, you know, this was my menopause experience, nothing.

So now if I go to medical school, you know, go to undergrad and then go to med school.

“And you know, it was mentioned, I think we had six one hour lectures, we didn't have like a”

menopause clinic or any like specific focused, like taking care of women after reproduction and that didn't exist. Interesting. And in in medical school was Perry menopause, even was it mentioned? Was that a thing? So I don't remember learning that word.

And I can remember mention it being mentioned. And in my mind, it was like the, I thought it was this gentle decline of a variant function until the ovaries just kind of stopped putting out. And it was just, I learned how to pronounce it. I didn't learn anything about the endocrinology of it.

What actually was happening on a day-to-day basis, you know, how chaotic the hormones were in this like phase, all the organisms that could be affected, nothing, nothing, nothing. It was her periods will become irregular. She may start having a few hot flashes and then she'll go into full menopause. The end.

“How did your knowledge go from that very, you know, rudimentary understanding to where you are now?”

At what point were you like, hold on a second.

So I, the internet talking to people, you know, like the one-on-one interactions I was having with my patients was making me think, right, but that's still very limited. Women were coming to me for obstetrics, for gynecology, for surgery, for, you know, birth control, for all these things and menopause was just kind of mentioned. Now, if I had a patient who was absolutely desperate with hot flashes and it was just severely

life disrupting, we would have a conversation, but these were really, really limited. But it wasn't until I got active on social and started talking about it. And it was like the world's biggest water cooler, right, every woman was like, oh my God, me, oh my God, what I'm still having periods, but I'm having all of these symptoms. So that's when I started saying, wait a minute, 10,000 women are not lying or exaggerating.

These are all, you know, it took me being in a much bigger room to really see the pattern starting to emerge. Then I started looking retrospectively at the data and finding there's a lot of data out there,

And I think that's what I was able to do is like, wait a minute, we have science here.

Actually, it's not a general decline. It, the ovaries go out kicking and screaming, you know, the brain isn't complete chaos through this transition until things kind of quiet down in the post-metopause face. Okay, so in that perimenopause phase, I know I hear from a lot of women. I hear from a lot of moms. I hear from a lot of friends.

I don't feel like myself. I just don't feel like myself.

“Okay, can you unpack that? And yeah, what's going on there?”

We have a paper. So presented at the Metapause Society meeting last year, the woman who wrote the paper and it was published in

20, 24. They actually, it's called IDFLM. I don't feel like myself.

And they quantify it. They gave it a scale, a scoring system. And they interviewed thousands and thousands of women and what that actually meant. And it's usually some form of cognitive issue, like brain fog, right? Plus loss of resilience, like things that used to not bother you. Things that you could handle. This life you built for yourself,

you could manage the ups and blows and the ups and downs. But all of a sudden, all the processes you had put in place, that you could manage the life you built, start failing. So seeing that paper made me realize I had to write this book, you know, for those of us, you know, I'm well past transition.

I'm very much post mental puzzle. But for Mary Claire, 10 years ago, who had nothing. That was navigating this blind and yelling at my kids and talking, you know, considering divorce and, you know, leaving my job, which actually was a good thing in the long run.

“You know, like all of these things that I'm like, what's wrong with me?”

I'm not myself. So it's quantifiable and loss of resilience, brain fog, and the emotional changes that are coming. So our neuro receptors. So our neuro receptors change and the neurotransmitters. So serotonin dopamine, neuropronephrane, all of them are affected by these hormone levels. It's a back and forth indecrinesystem. So our neuroindecrinesystem goes through a massive

up people and then it kind of calms down in postmenopause. So the most symptomatic you are with sleep disruption. I don't feel like myself, anxiety and depression, brain fog is in parry menopause, not postmenopause. Okay. I just want to double click on something you said because something I see from kids and from girls, especially in definitely from a lot of the moms I talk to is just when they're struggling with something, the interpretation of this must be my fault or

something is wrong with me is so common versus I'm noticing something, what's going on? What might I need? Who can I talk to about this? It's very different and I'm just wondering, when you see that pattern, is that one of the reasons this hasn't been talked about? Like this, we stay quiet. Like we think something's wrong with us. We've been socialized to think this, versus hey, go talk to a doctor about this. Your body is changing in major ways. Nothing's wrong

with you. So two problems, yes, we're socialized to like limit our interaction with the world, limit our, you know, don't make any one feel uncomfortable, don't admit, you know, it's some kind of failure if you're struggling and you need help. And no one was taught parry menopause and not taught it well. And so we have and it's not, you know, there are not great individual doctors, but most

doctors go into this for the right reason, but if you were never taught, if you were never taught

to connect the dots, if you were taught, systemically we were taught women tend to somaticize psychological symptoms. So she's coming in with hot flashes, sleep disruption, brain fog and all you know how to tell her is, you're stressed out. This is just your age. You know, there's nothing we can do. And not taught that this could have a hormonal component. We are really failing women

“overall. It's getting better. And I think the social media push and women waking up and lots of”

great books coming out right now, mine included, you know, of women educating themselves and clinicians getting educated outside of this system on this. But I think what you're saying is you're saying at the medical system level, even for very well-intentioned doctors, if you're not informed about something, if you haven't been taught about something, then you don't actually know how to show up. And so this narrative, some version, you didn't say this, but like it's kind of in her head or

yeah, it's all in her head. That's in her head. That's in her head. And right book to by Elizabeth Coleman, Dr. Elizabeth Coleman, it's all in her head. On how the medical system was built to fail women in this way. And so for the woman listening to this, thinking, maybe this whole, I don't feel like myself, like maybe this is more than just, I don't know, a new personality stage, you know? What do you, yeah, what do you say to her? Like what are

what are some next steps? How do you talk to yourself where we go next? So if you find yourself

day-to-day. And all of a sudden you find yourself with new anxiety, new depression, snapping at your

kids, not sleeping, are just feeling this like overall sense of, this isn't me, okay? You're losing satisfaction. You know, we call it anodonia, which is loss of joy. You're not depressed, maybe, but you just aren't finding joy in the same things. Take a deep breath. Look at your external stressors. Has anything changed? Those are the common things, right? But if it hasn't,

“you need to find a menovaw's educated clinician to begin having this conversation. Because”

guess what? Stabilizing your hormones through this transition is showing to have be more affected than starting you want an antidepressant or anti-xiety med. I feel like that's something that's gone in and out of medical trends. Is that accurate? Like hormone hormone replacement? Can you educate us a little bit? Yeah, so a great question. So when you have a patient, and they did this study in Australia, and this is for mental health, who has new onset anxiety or depression, starting those

patients on menopause hormone therapy dosing. So, estradiol, the exact equivalent of which are overuse to make, plus or minus a progestin, they do a lot better. And we are seeing this clinically, those of us who are doing menopause medicine are seeing this clinically. Is it a fad? You know,

the more science we learn, the pendulum really swung. The first pendulum swung because there was

this get your wife back book that was written, and it was really like how to keep your wife sexual, right? And estrogen was touted as this miracle hormone so that your wife would want to have sex with you. Okay, and it was written by a male physician, basically, for husbands. It was crazy viral. It was the achiest, skankiest book you've ever read in your life, and all these husbands are pushing their wives to get on estrogen. So then lots and lots of people are in estrogen. Well, it turns out

they feel better. Their bones are stronger. They have less heart disease. They die less, you know, they live longer, all these benefits, and they don't necessarily want to have more sex with their husbands. But they're seeing benefits. Then the women's health initiative came out. Basically, to study does a woman on hormone therapy, is she really going to have less heart attacks? Is it really cardiovascular protective or is it just an artifact because healthy or wealthier women

who have better socioeconomic stuff go on HRT and this is just because they're healthier from

baseline. Okay, the best gold star $1 billion study. Again, didn't look at the nuanced

data. The results did not reach statistical significance and said, oh my god, they should call up cause of press conference, which went viral before viral, that estrogen causes heart attacks and estrogen causes breast cancer and none of that turned out to be true. But that messaging was really

“hard. Once that genie got out of the bottle, it was really hard to shake it. I remember hearing it.”

I remember being scared of hormone therapy. I remember like, oh, we only use it if she's severe and we just for the lowest amount for the shortest time possible. Like, this isn't we could hurt her with this and exactly the opposite is true. Every medication Becky has risk benefits, you know, every single medication we prescribe to patients. And you know, this, this is just a tool in the toolkit. But now that we understand the nuances behind that and how safe the medication actually

is and how it can be beneficial, the pendulum is swinging. Now, as of 2023, only 4% of women were on FDA approved HRT. So it's not like the cats out of the back, you know, and we're all these women. Now we're seeing shortages and patches like the demand is up. And we think that's a good thing because women have options and they're talking to certified practitioners who know what they're doing. They're making decisions for themselves. Like, how is it that is women? We're told you can't have

something. You don't tell a man. You can't have testosterone or you can't have this medication. You can't have that. You lay out the risk benefits, you know, and you let him make a decision. You can throw your opinion in there. But it's not my decision to tell a woman what to do with her own body. It is my job to explain to her risk benefits. I can add in my two cents. And she makes a decision for herself.

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you're going to love this show. It's the same good inside principles and method, just applied to all the challenges in the teen and tween years. Search for The In-Between Years from good inside and click follow or subscribe now. What are some of the things for someone listening? You would tell them, look out for this, and if any of the stuff's happening in your life, you're not their doctor, but yeah, bring up

HRT with your doctor. What's the method you think they should look for? So if you start noticing, so we'll kind of go top to bottom. Great. Mental health change

is, so we'll start with the brain, right? So you are having increasing anxiety or depression, right?

If you are having sleep disruptions, okay, either difficulty falling asleep or waking up at 3am, you've done all the sleep hygiene stuff, you know, did all the checkpoints out of the room, yep, you're doing all the things, and you are still consistently, I mean, sleep, insomnia is now a risk factor for cardiovascular disease, like not having good quality sleep is a risk factor for so many diseases, obesity, heart disease, diabetes, or everything.

So it is so, so, so, so important, okay, that we get on top of this. Skin, it's legion, so you can have dry skin, oily skin, acne, itchy ears. I mean, it's a combination of the nerves and the skin can become inflamed, so people can feel ants crawling on them, it's called formication. All of a sudden you're having dry skin way out of the ordinary for you. I mean, my acne cleared up, so that was a plus for me, hair changes, so hair loss in areas

you want to keep it or hair gain and hair, this you don't want to have it, the chin and mustache. You can see asthma affected, so if you're noticing that your asthma is worse or you're struggling,

“you need to get evaluated for that sleep apnea becomes a problem, gastrointestinal changes,”

the gut microbiome changes to that of a man's. So that affects everything, how we absorb nutrients, how we absorb drugs, the brain gut connection is everything, the musculoskeletal system, joint pain, back pain. We think in our little world that in the orthopedic surgeons who do this work, that a lot of fibromyalgia is actually menopause related. Wow, because estrogen is an anti-inflammatory hormone and the general urinary system. So drive a giant, loud loss of lubrication,

libido tanks, you love your partner, like you used to want to have sex all the time, and now you can't, you know, seem to summon the will, that is a huge, huge problem. I mean, I think one of the things you're saying is, I mean, I hear these symptoms, I'm thinking that is almost everything, we could experience, but I think the reason that makes sense is all of these changes are happening in the context of this massive life stage that has huge hormonal changes. So of course,

that has to be evaluated as potentially a primary cause of a sudden change in your mental health through your physical health. And instead of assuming, oh, this is weird, this is something I just had to put up with, this is my fault, this is in my head, just say, hold on, I'm in this life stage, this might be permanent a puzzle. Let me talk to a doctor where I could at least raise that,

“and that can be taken seriously, and really looking at, looked into, that's what's not been”

happening by and large, but and that is why I fight so hard, why I do all the things I do on social media is in an effort to educate and raise awareness so that women don't suffer unnecessarily. The point of it is we're suffering and not having any help. Another thing I want to ask you about, okay, is, is it some cruel joke that a lot of us go through parimenopause at the exact time, our kid is going through puberty? Like, there's a lot of hormonal changes. I feel like happening,

I feel like that happening at once is a lot in the whole, it's like having triplets, you know,

the whole house is hormonal, your, your, and aging parents, you know, yes. On top of that, a lot of women are parenting their parents. Yeah, paint me a picture. Yeah, like what do you see? What do you hear about all the time with all those factors? So, you know, you're really on the struggle bus, like your resilience, your ability, you know, first of all, you're having brain fog. So, the parts of the brain responsible for memory aren't getting as much glucose, basically, in this transition. And

great scans done by Lisa Masconey, who wrote the Metapause Brain. I'm really looking at, like, glucose utilization and uptake and how that, those parts of our brain are really struggling to fire. And so, here you are, you know, trying to, you've got a kid who's going through their own hormonal up people with, you know, and testing boundaries and all the thing. Plus, a lot of us who are in our career

are at really crucial points in our career. It's like a perfect storm. So, what we do in our clinic,

I'm just trying to give them their resilience back. I can't fix that they have teenagers or, you know, give them a skill set to deal with aging parents, but I have resources, right? We have books, you know, good inside. We have podcasts. We have ways to help them cope. What I'm trying to give them back is if this is hormonal really related, we can try to give you back some resilience.

“First of all, you need to sleep. We've got to have restful sleep. Nothing's going to work well, okay?”

And if the hot flushes are waking you up or a progesterone loss is waking you up, we can fix that. Double down on sleep for a little bit with me because it's, it's also something it's interesting. I say this a lot to parents of teens and it's one of the reasons why sleep hygiene phones out of the room. I just think, you know, whatever a kid's going through if they are so sleep deprived, it's hard to even assess exactly what it is until sleep is a little, you know, has it better

rhythm? Are you saying the same thing is true for any of us going through parameda paws? Absolutely. Like, these have disrupted our sleep, you know, in these phones, these things are personal. I'm holding up my cell phone. I just got the brick app because I had to turn it, you know, figure out a way to like take it away from myself. So my menopause friend group, we call ourselves the menopausey. I've all gotten bricks. So, you know, when you work on social media as you do too,

you find yourself falling into the trap a little more. You're saying also there might be real hormonal changes also. Yeah. Yeah. That no matter what you do with your phone, you're still having disrupted sleep, right? Yeah. So the biggest, the two biggest complaints that we see in clinic in this population is difficulty falling asleep. So that's usually racing thoughts. They can't turn their brain off. And so that responds really well to CBT, cognitive behavioral therapy,

retraining your brain. And then, you know, how to sleep medicine specialist on the middle of the night of wake inings. If something's waking you up, a kid, a hot flash, whatever, you know, we can work on that. But if you are spontaneously waking up at 2 to 3 in the morning, we have to retrain

“you. It becomes a but a learned behavior. And so no sleeping pill is going to fix that, right?”

There's no medication, no supplement that really fixes that. That is really, you have

trained your brain to wake up at 3. Try to do box breathing, meditation, first it. That's not working

get up. Your bed is for intimacy and for sleep. I want to ask you a little bit about women advocating for themselves with doctors. Like, what gets in their way? Where are you seeing patients even of yours, maybe? Be successful or how you've done that even as a patient with other doctors? I love to learn from you there. So, you know, if your doctor's not trained and they really have to step outside of their training, most of them now to be qualified to be able to

talk to menopause, you know, with you. So, you really need to find someone who's menopause society certified. That's a separate certification that we do outside in. And in any clinician, we have nurse practitioners, internal medicine cardiologists, like, this is a certification you seek outside of your residency. So, that's like one tip. We have a resource on our website where people do testimonials. We have thousands in there from my followers who, like,

just talk about their doctors and we organize them by city and state. That's another resource.

“So, but, you know, ask your friends. Did you have anybody that was helpful to you that talked to you?”

You don't have to pay millions of dollars. I think the medical system is broken in a lot of ways. These 10, 15 minute visits, you know, really being constrained and only being able to address one problem at a time and it just, you know, the medical system is not set up to serve women in menopause, but there's some great telemedicine options. Now, you know, these companies are

So, I'm taking insurance. So, you have the resources are getting better. Right now is not reasonable for you to be able to walk into your great OBGYN, your wonderful internist, you know, and expect that they will have enough knowledge. I mean, they're busy, they're being overworked themselves. All the administrative burden, you know, medical systems can broken on both sides. And so, for them to, like, have had the time and the inclination to go seek outside training to be

able to do this is, you know, really, we can't expect that of people. And so, okay, a couple of questions for you just to like, make it into just a back and forth. So,

“a woman listening if she's thinking, can I ask my doctor, are you, are you certified? How is that?”

Call her? Yeah, don't. Don't make the appointment. Don't pay the copay until you know.

And call her head, do they have special certification and menopause? Yes or no? Second question,

because I think this is something I know. A lot of my friends talk about, like, do I have to pre-cop with my doctor? I don't want to pre-cop with my doctor, like so. So, we're so worried about our doctor's feelings and not, not technical yet concerned about ourselves. Okay, so yeah, can you get permission for that to break up? But quite often no. So, like, our patients, we just do menopause care. We do a lot of preventative medicine. We do a lot of

building a runway for the next 30 years around risk of heart disease and obesity and diabetes and stuff. So, but if she needs a biopsy, if she needs a pap smear, we're sitting her back to her regular doctor and letting, you know, my clinic doesn't accept insurance because I spend an hour with my patients and insurance won't pay for that. So, so our patient is it's feet for service. Like I'm a doctor in the 1940s. And so, but, you know, she needs a biopsy or got into

collogic care. I love for her to go back to her got into college. Now, I've done that job. I know how to counsel her, what to expect. But, you know, I'm going to let her use her insurance to go back if she has it for that or help her find a resource. Yeah, and I just want

“to give permission for anyone listening. You know, I think there's a larger pattern for a lot of”

us. We can be so oriented to taking care of everyone else. Sometimes, to the exclusion of taking care of ourselves, this can be in small ways. I take care of my kids so much that I haven't talked to my friend on a phone or I haven't taken a walk around the block. They're just permission to say, I'm allowed to look to someone else. I'm allowed to prioritize my own needs here. I can do that. What would you tell the Mary Claire who went through medical school? I know you started that

way. What would you tell her? What would you form her about? What questions would you demand? She asked her for training. My daughter's a medical school, so I think about this a lot. And she's very menopause aware and likes to text me whenever they talk about it. It's getting better, definitely better than when I was there. But what I tell, you know, I was 26 when I started

“medical. And eat some food, get your sleep, staying up another three hours for the test is not”

going to make a difference. And the long run, take care of yourself, get therapy. These are the conversations I'm having now. You know, God, if I could have gotten those habits, nailed down younger, I just would have set myself for so much more success than I would have. Like putting

might not being embarrassed or ashamed to put myself first, demanding an equal partnership in my

marriage. But really, it's, you know, once we put out the fire of menopause, I'm having the same conversation over and over again. Let's get therapy, lower your stress. You're, you know, what it, how cool is your bedroom? Are you sleeping? How's your intimacy? Do you need, you know, is this a relationship that's serving you? You know, do you want to stay with this person for the next 30 years? All of that stuff. Oh, God, and choose your partner wisely. Oh, yes.

And maybe I'll kind of end on this one for the mother listening now, who feels foggy and unlike herself and more reactive than usual. What do you want to tell her? It's okay. It's okay. You know, take a deep breath, love yourself. Let's go find you a partner in health care, who's going to listen to you and help you figure this out. It might not be perimenopause. It might be that you have low iron stores. You could have an autoimmune disease. You could have an inflammatory disorder,

but you deserve to feel amazing. Users deserve to wake up and ready to take on the world. And if

that's not consistent in you, then you deserve a partner in care is going to help you figure this out. There's so many nuggets from that conversation that will stick with me, but to me, the theme that's loudest is this tendency so many of us have, or something shifts in our life. All of a sudden we're a lot more reactive. We're not sleeping. Our body feels off. And it's just so easy to tell ourselves,

happening in our body, as we respond to the story we tell ourselves about what's happening to our

body. And to me, what's loud from this conversation is that we can tell ourselves a new story. Hey, I might be in a really important and powerful hormonal shift. This might be perimenopause,

“and I can go talk to my doctor about it. That's what I'm going to be left with. Let's end the”

way we always do. Place your feet on the ground. Place the hand on your heart. And let's remind

ourselves, even as we struggle on the outside, we remain good inside. I'll see you soon.

“One thing I see over and over with parents is just how much we're carrying. The data backs”

this up. Most parents spend nearly every waking hour focused on someone else. So if you feel exhausted,

stretch thin or like your brain never really shuts off, that makes complete sense. I've seen

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“And do you know that you can find activities, camps, and daycare on care.com, too?”

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