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If night sweats, poor sleep, and brain fog are giving you pause, you’re not alone. The conversation around perimenopause and menopause is taking center stage. Ask women who have already been through “the change,” and they will tell you this: it’s about time.

If you’re looking for insight, tips, or simply some validation, keep reading. Ellen Brunetti, FNP-C, is a board-certified family nurse practitioner at Highland Medical and Clarkstown Medical Associates. She holds a certification in menopause health and shares how women can identify and manage their symptoms.

What are some symptoms that people think are not related to perimenopause and menopause, but actually are?

Menopause isn’t just hot flashes and night sweats—it can cause brain fog, anxiety, trouble sleeping, joint pain, and even heart palpitations. Many don’t realize that changes in skin, hair, or weight are also hormonal.  

Let’s talk about treatment. Are there foods or environmental factors that worsen symptoms and those that can improve symptoms?

Both diet and environmental factors can meaningfully affect how women experience perimenopause and menopause.

Caffeine, alcohol, spicy foods, and sugary or processed diets can worsen hot flashes, sleep issues, and mood changes. Stress and poor sleep can worsen symptoms.

A balanced diet of whole foods, plus calcium and vitamin D, supports bone health. Hydration, regular exercise, and good sleep also help.

It’s not about perfection. It’s about understanding your personal triggers and making small, sustainable adjustments.

What about Hormone Replacement Therapy as a treatment option?

Hormone Replacement Therapy (HRT) can be a highly effective option for managing menopausal symptoms.  

You may be a good candidate if:

  • You are experiencing moderate to severe symptoms like hot flashes, night sweats, or sleep disruption;
  • You are under the age of 60 or within 10 years of menopause onset;
  • You are generally in good health, without underlying risk factors.
  • You are looking to improve the quality of life and daily functioning, and you are also looking for added bone protection.

Women who are not good candidates include:

  • Women with a personal or strong family history of hormone-dependent cancers, including breast, endometrial, and uterine cancer;
  • Current or history of blood clots or clotting disorders;
  • Recent heart attack, stroke, or unstable angina;
  • Undiagnosed vaginal bleeding.

However, non-oral HRT (patch, gel, creams) carries a much lower risk than oral HRT.   For those who cannot take hormonal treatments, we do have non-hormonal options that can also help with symptoms of hot flashes and night sweats.

You recently became a Menopause Society Certified Practitioner (MSCP). Why did you pursue this certification?

What led me to the certification was really a combination of personal and professional insight.  While being perimenopausal myself, I was surprised at how difficult it was to find clear, supportive, and trustworthy information.  At the same time, I was seeing patients with similar frustrations.  I wanted to be able to offer more - to answer their questions with confidence and to truly guide them and myself through this transition.  

How does the certification help you better provide care for patients in perimenopause and active menopause?

This certification significantly expanded my ability to provide comprehensive, individualized care to patients in perimenopause and menopause. It’s given me a better understanding of the full range of symptoms women can experience, many of which often get overlooked. Most importantly, it’s helped me have more meaningful and informed conversations with my patients, so they feel heard, supported, and confident in their care. I can now prescribe both hormonal and non-hormonal treatments, depending on what’s best for the individual.

To learn more about Highland Medical Group, visit: www.highlandmedical.co