Top Women’s Health Issues Part 2: Peri-menopause, Depression, and Sleep

If you are approaching 40, in your 40s or early 50s: heed my advice. Peri-menopause is real, can be painful physically and emotionally and there are simple and dignified steps you can take to improve your well-being. I’ve been there.

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Every one of us will, or has, gone through it. Some endured and “muscled” through it. Some didn’t seem phased. Some are in it now. Naturally, too, some of us deny we are “in it.” Why? Because we are afraid to talk openly about anything “down there?” Or perhaps it is a first sign of aging?

Whatever the reason, it is time for a discussion of not only relief yet also how peri-menopause can lead to serious emotional and physical health issues if left unaddressed.

Peri-menopause is the transition leading to menopause – when we stop having our cycle for one complete year.  And those menopausal symptoms like hot flashes, sweats, and disturbed sleep can last up to 10 – even 15 – years or more. It is nothing shy of a roller coaster ride. It can start in your mid-30s yet is more typically associated with the changes in the late 40s.

Symptoms include, yet are not exclusive of the following. Any of these sound familiar?

  • • Insomnia
  • • Sleeplessness
  • • Sudden panic attacks
  • • Depression
  • • Chronic anxiety
  • • Moodiness

We are aware of the body changing (that hard to lose belly fat)/life changing, and much more discussed, phase of womanhood called menopause. Yet simply waiting for your period to be over for a year can seem – and really be – the longest year(s) in your life! I should know. I started my peri-menopause journey at 35.



The symptoms for peri-menopause can come so much earlier than that erratic cycle. It is silent yet can be emotionally draining for many reasons. During peri-menopause your hormones swing immensely and can lead to any of the symptoms above. Your levels of progesterone typically decline, while estrogen levels remain stable or even increase.

Sadly, antidepressants seem to be the first remedy offered by the medical community when a woman finally raises her struggles of sleeplessness, moodiness, hot flashes, and sweats, with her doctor. And those antidepressants come with side effects like loss of interest in sex, inability to have an orgasm, and weight gain (belly fat on top of belly fat).

Three of the more common symptoms for peri-menopause are anxiety, depression, and headache. This is largely due to the fact that your hormones are not being produced in a consistent way anymore. They are too high, then too low, and then too high again. Simply put, the brain is mad and confused. It used to be a consistent and predictable monthly cycle, even around the same time of the month.

During peri-menopause our cycle tends to be more like a roller coaster ride at Kings Dominion: heavy some months, lighter during others, on schedule or erratic, and really everything between. The only thing about them that’s predictable is that they are well… unpredictable.

Fluctuation of hormones can cause the following:

  • • Breast swelling and tenderness
  • • Mood swings
  • • “Fuzzy thinking”
  • • Irritability
  • • Trouble sleeping
  • • Bloating and water retention
  • • PMS
  • • Weight gain
  • • Loss of sex drive
  • • Decreased sexual response
  • • Decreased sensitivity in your erogenous zones
  • • Decreased sense of well-being, energy, and ambition
  • • Depression
  • • Loss of or thinning pubic hair
  • • Hot flashes
  • • Night sweats
  • • Vaginal dryness
  • • Decreased energy and ambition
  • • Dizziness
  • • Headaches
  • • Mental confusion
  • • Urinary incontinence
  • • Recurrent urinary tract infections
  • • Increased susceptibility to vaginal infections

Another cause of frustration, illness and lack of wellness can be directly related to your sleep. When we sleep, our body not only restores, yet our brain carries out vital functions that, when left interrupted or undone, are dangerous to your health.



Sleep is essential for maintaining a healthy immune system, body temperature, blood pressure, and yes, a “fit” body. Without consistent and adequate sleep, we aren’t able to recover well from injury or stressful events.

Quality sleep also likely reduces a person’s likeliness of developing dementia and quality sleep actually causes a beautiful “cleanse” of the toxins in your brain.

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  • The latest from Adrien
Adrien founded Fitness on the Run in 2004 out of her home after a successful career in policy and public affairs communications. After spending 15 years developing her own personal definition of wellness and watching thousands struggle with theirs, in January 2019 Adrien founded Alexandria Wellness, the home for the Concierge Wellness Program and Corporate Wellness with Adrien Cotton. Over the course of 15 years, “FOR” was home to more than 2,000 clients, 30 instructors, and hundreds of inspirational success stories. Adrien is now, more-than-ever, passionate about helping women view their fitness as a journey, not a quick fix. Adrien’s recipe for success herself has evolved from a rigid training plan of sweaty and heart pumping workouts to some days getting in her 10,000 steps, consciously breathing, her 7.5 hours of sleep, and her beloved 5-Minute Flow. Adrien believes the most important ingredient is making small changes for big results, even if it’s one new habit formed each month. Still passionate about fitness, Adrien’s clients appreciate her ability to make sessions seriously challenging without a “beat down,” a healthy mix of strength and metabolic (cardio) work and ultimately helping her clients gain real strength in mind and body. She believes we all benefit from being curious about our bodies and that change, or improvement, is within reach despite what your “inner voice” or others may tell you. Adrien is bubbling with excitement to help women learn the importance of a comprehensive approach to wellness, weight loss, and contentedness with yourself, and that every person has the right to feel good about themselves. Most days, you can find her helping clients with their wellness, listening to success stories, and bragging about her twin 13-year-old children and “fittest man in Alexandria” Bill Cotton. Adrien prides herself on her practice of mindfulness, meditation, and putting it all into perspective.

Alexandria Wellness offers achievable answers for anyone who is tired of chasing fitness and health without a clear plan, someone who has struggled and is not satisfied with their fitness and wellness or someone who is open to maximized healthful longevity and fitness along with healthful weight loss. Adrien and her team offer help with food guidance, body acceptance, sleep and stress issues, and insist you have fun along the way.

Schedule your free 30 minute consult here!

Alexandria Wellness
215 North Payne Street
Alexandria, VA 22314



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