February 2023

In this VETgirl online veterinary continuing education blog, Dr. Justine Lee, DACVECC, DABT talks about something most people don’t talk about EVER in veterinary medicine. Perimenopause and menopause. Yup. Keep reading. Because we’re a field of 70-90% women, and you need to know this!

By Dr. Justine Lee, DACVECC, DABT
Director of Medicine / CEO, VETgirl

Perimenopause and What You Need to Know

Well, sh*tttttttttt.

(Said in the fashion of Bunk, from The Wire)…

I never thought I’d be writing about infertility and why you should stop and have kids now, which was a very heartfelt, honest, vulnerable VETgirl blog for me to write about 6 years ago.

Well, while I’m at it, I might as well tell you about perimenopause and menopause (that’ll be a future blog in about 12 months), because you know what? This sh*t needs to be discussed!

Recently, I went to visit my dear old veterinary friends, and one of their life hacks of life was this amazing fan that goes around your neck to help with menopause

And with that, she jinxed me.

Call it psychosomatic, but within < 1 week, I officially became perimenopausal with severe hot flashes and the need for a neck fan. So, what the heck is perimenopause? As we all know, ‘peri’ refers to “around”… which means the dream is over and menopause is right around the corner. This officially means that my infertility is officially become the capital “I” as the end of my reproductive years are officially over.

Why am I talking about it? Because when I graduated from veterinary school in 1997, my Cornell class was about 65% female. And now? Graduating classes are almost 90-100% female… so it’s an important topic. Perimenopause can occur at various ages – but in general, can occur as early as the mid- to late-30’s to the 40’s. And just in case you don’t remember from your theriogenology class (granted, it was a different species), perimenopause is when the levels of estrogen fluctuate tremendously.

Clinical signs of perimenopause include:

  • Various length and heaviness of menstrual cycles*
  • Hotter-than-hell hot flashes (for someone who is normally cold)
  • Vaginal and bladder problems (decreased elasticity and lubrication, predisposing us to urogenital infections along with decreased tissue tone and secondary urinary incontinence)
  • Irregularities in sleep
  • Night sweats (hot flashes + no sleep, Yeah!)
  • Mood swings
  • Irritability
  • Higher risks of depression
  • Lack of sex drive

* If it’s > 7 days in the length of your menstrual cycle, you’re in early perimenopause, while if it’s > 60 days between cycles, you’re in late perimenopause.

dragon woman

Add to that, the other physiological changes like decreased bone density, increasing your risk of osteoporoisis and changes in cholestrol (your “good” cholesterol goes down while your “bad” LDL cholesterol goes up).

I mean, can it get worse?

Once you’ve gone through 12 consecutive months without a menstrual period, you’ve officially reached menopause, and the perimenopause period is over.

Man, I’m already stressed in life or in the veterinary clinic or in family life and now I’ve got all that above PLUS sleep deprivation?

Why am I telling you this?

I’m truly telling you this because before you know it, you’re in your 30’s with decreased infertility and then, before you know it again, you’re almost 50 and approaching these crazy hormonal changes that make you think that you’re becoming more bitchy and crabby and monstrous and then you find out, it’s just your body talking to you.


Plus, it’s another reminder for some more empathy, please. It’s a good reminder that we individually all have a lot going on.

Most importantly, how we feel in our bodies and minds directly impacts how we show up to our veterinary clients, patients, and colleagues at work, as well as our capacity to keep all of the plates spinning. Women’s issues, including menopause and perimenopause support, are workplace issues!

It’s not a club I want to join. But I’m here in the end of my PM stage, and looking for some sympathetic sisters. You can find the Top 5 Things That Helped Me with Menopause.

What are you hacks on how you managed PM or menopause?

JLEE signature

Addendum added February 7, 2023.

Well, wow. See, this is an important topic to be made transparent! Look what posted two days ago on New York Times Magazine?

Photo by Marta Blue for New York Times Magazine


  1. I’m a 46 yr old and quickly applauding as I read this…can I just add that CALM (its a magnesium supplement) has helped me immensely, with the sleep, irritability, brain fog…and maybe I’m not so sweaty…and I haven’t actually taken out my husband.

  2. I’ve been reading a wonderful/ educational/ hilariously tongue in cheek book called “What the Fresh Hell is This? Perimenopause, Menopause, Other Indignities, and You” by Heather Corinna. Highly recommend!

  3. For any athletes in this age group read Stacy Sims The Next Level. Great advice on how to exercise and nutritional needs

  4. I’m very sad to report that decreasing my red wine intake has helped a lot with both the severity and frequency of hot flashes.

  5. I recently turned the big 50. On my special day a good friend of mine was kind enough to take me to “Menopause – The Musical.” For any woman going through “The Change” I would strongly recommend it. Nothing like laughing along with other women going through this same stage of life.

  6. If you have perimenopause or menopause and <60 yo and no contraindications SERIOUSLY consider hormone replacement therapy. There is really no reason to suffer symptoms, and you may have symptoms and think it's just me – and it isn't.

  7. I feel terrible for all the women in my life (who were older than me) that I teased about their hot flashes!! Peri-menopause is no joke I now realize!!! And it has made a significant impact on my quality of life–and my husband would say on his, too! (To be fair, it has!) Thanks for touching on this, Justine! I’ll be glad when I make it to the next hormonal stage (I think).

  8. Peri has been rough for me, and looong (8-ish years); I went almost 7 months and just cycled again, still waiting for the 12 month mark to hopefully get off the hormone rollercoaster. I even took 3 months off from work at one point because it compounded my burnout. Happy to say things are improving- HRT has been a huge help for me, as has more outside time spent decompressing.

  9. Thank you for bringing this subject to light! The struggle is real, and having others to lean on going through the same thing is so substantial! There have been moments when I have worried that I have early onset Alzheimer’s, that’s how bad my brain fog and memory have been at times. Knowing it is all just part of the process is such a relief. A friend just recently recommended these podcasts: The Menopause Manifesto, HITPLAYNOTPAUSE. I have taken the natural root with the help of a naturopath due to a family history of breast cancer to help with balancing hormones. It has worked wonders.

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