April 19, 2026

Perimenopause Q&A: Symptoms, HRT, Misdiagnosis, Vaginal Health and Pelvic Floor

Perimenopause Q&A: Symptoms, HRT, Misdiagnosis, Vaginal Health and Pelvic Floor
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If you have ever been handed antidepressants when what you actually needed was a hormone check, this episode is the conversation you should have had in that doctor's office.


This is Part 2 of the live Q&A event hosted by Dr Shaun Watts where a panel of experts answered the questions about perimenopause that women are rarely given time to ask. If you have not listened to Part 1 yet, head back first. It covers the basics, mental health, sexual health, pelvic health, GLP-1s, and the ADHD overlap.


This episode picks up with the room-wide questions that got the most honest answers of the afternoon.


What is covered in this episode:

• The truth about the "5-year HRT rule" (and the 10-year one): where it came from and why it is completely outdated

• Perimenopause misdiagnosis: why depression and anxiety are the most commonly missed diagnoses, and how to push back

• Thyroid dysfunction and B12 deficiency: the two conditions that mimic almost every perimenopause symptom and are frequently missed

• A head-to-toe walkthrough of 42+ perimenopause symptoms, from hair thinning and tinnitus to joint pain, rage, and insomnia

• Vaginal hormones explained: what they are, who they are for, and why every woman can benefit

• The monthly vulva check: a simple shower routine that could help you catch changes early and advocate for yourself


If this episode made you feel seen, send it to one woman in your life who needs to hear it. She might not have the words for what she is going through yet, but this might help her find them. And if you found it useful, leave a review so more women can find the show.


For more resources:

Prof. Heather Irvine-Rundle:https://www.instagram.com/heatherirvine/

Gina Jeffreys: https://www.instagram.com/gina_jeffreys/

Dr Shauna Watts: https://www.instagram.com/dr.shaunawatts/

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Follow Dr Shauna and the podcast on social:

Podcast Website: ⁠www.allaboutyoupod.com⁠.

Instagram: https://www.instagram.com/allaboutyou_withdrshaunawatts https://www.instagram.com/drshaunawattsgp

LinkedIn: https://www.linkedin.com/in/shauna-watts-a903a5247


Disclaimer: This podcast and any information, advice, opinions or statements within it do not constitute medical, health care or other professional advice. Information is provided for educational and entertainment purposes only.


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Chapters

2:40 - What are vaginal hormones and who should use them?5:11 - Perimenopause misdiagnosis: when symptoms are mistaken for depression

6:47 - Thyroid and B12 deficiency: symptoms that mimic perimenopause

8:00 - The 5-year HRT rule debunked: how long should you actually take HRT?

13:28 - Bioidentical vs body identical HRT: what is the actual difference?

17:43 - 42+ perimenopause symptoms from head to toe

23:30 - The vagus nerve and nervous system regulation in perimenopause

30:59 - Plant-based diet and menopause: can 30 plants a week reduce symptoms?

34:33 - Monthly vulva check: how to know your baseline and advocate for yourself


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