Perimenopause, the transitional phase before menopause, can feel like one of the most disorienting and unspoken chapters in a woman’s life. From hot flashes and brain fog to anxiety, back pain, and sleep disruption, the symptoms are real, but the guidance often isn’t. Too many women between the ages of 35 and 50 find themselves confused, dismissed, or unsupported by their providers.
The Perimenopause Survival Guide is a clear, compassionate, and evidence-based resource from one of the most trusted voices in women’s hormonal health. Dr. Heather Hirsch draws on her years of clinical experience to help women understand what’s happening in their bodies, and how to take charge of their care.
- What’s really driving your symptoms and how to decode them Proven, FDA-approved treatment options—plus how to evaluate what’s right for you
- The importance of managing perimenopause now for long-term health
- How to advocate for yourself and build a care plan around your individual needs and goals
Whether you’re just starting to notice subtle changes or already deep in the hormonal rollercoaster, The Perimenopause Survival Guide empowers you with clarity, confidence, and the tools to feel like yourself again.
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Confused about what to expect in midlife? Wondering how to treat mysterious symptoms like night sweats, ringing in your ear, or stubborn weight gain? Or how best to treat annoying hot flashes and insomnia? I got you. I’m Dr. Heather Hirsch, a board-certified internist, nationally accredited menopause specialist, NAMS provider, and founder of the menopause and midlife clinic at the Brigham and Women’s Hospital, and faculty at Harvard Medical School. Through my decade-long history in treating women in perimenopause and menopause, I have made it my mission to expose the gaps in midlife women's healthcare through my work. I currently see patients in my private telemedicine practice and you can learn more about me at heatherhirschmd.com
First I want to thank Heather Hirsch MD, MS, MSCP and Balance for providing me with this book so I can bring you this review.
Thank you Heather Hirsch MD, MS, MSCP from the bottom of my heart for writing this guide!! Too many women like myself are wondering what is going on with our bodies that our health care providers seem to keep blowing off. It is extremely frustrating to know something is wrong with your body but you can’t pinpoint what it is exactly. But thanks to Heather she is now opening up the conversation that we women need to start talking about and that is Perimenapause.
Heather would like to dedicate this book to her daughter Demille, Margaret Hirsch, and all the future generations of woman. May we all receive the care we need throughout our lives.
In the beginning of this book there was a very well written forward by Avrum Bluming MD, MACP who is a Medical Oncologist.
Heather wrote this book to help you develop a plan to address your symptoms and protect your long term health that combines medical treatments, prescriptions, labs, etc.
By explaining how to treat your symptoms and why doing so is so important to your health today and long term. She wants you to be seen and know she understands what you’re going through and that you are not alone.
What was eye opening to me was that during in Perimenapause our long term care can decline with our GI system, muscular system, pelvic floor, cardio and brain function can go downhill as well.
Heather Hirsch shows you how to use the book to your advantage before outlining it for you:
Part 1: “Understanding the hormonal hijacking"
Part 2: “Pinpoint your Perimenapause pausal set”
Part 3: “Set yourself up for smooth menopausal sailing”
The Perimenopausal Survival Guide is designed to help you understand what’s happening with your body, find and make shared decisions with knowledgeable about treatment and know what you can do on your own.
Heather defines the differences between Perimenapause, Menapause, and Postmenapause for us readers. For me personally I am on the crazy stage of Perimenopause which is why I took a personal interest in reading this book. But after reading this book I am not looking forward to 10 years of this lmao!!!
There is a great chart that Heather includes in the book of all the stages, symptoms, hormonal hallmarks and durations of them all as well.
Heather educates her readers on what she calls her cast of characters that make up what is going on within your body. Within these cast of characters she elaborates on what they do for the body cut as Estrogen, Progesterone, Testosterone, Follicle Stimulating Hormone, Thyroid Hormone, ETC.
Heather educates her readers on heavy periods, symptoms of Anemia, polyps, fibroids, adenomyosis, endometrosis, uterine cancer, and medications that can cause heavy bleeding.
One procedure she mentioned that I had personal experience with was an endometrial ablation. It was not an easy decision to make but being a Mom wasn’t in the cards for me. However, I am a very proud Auntie to four amazing kids.
Oh the lying awake and worrying chapter I felt like that was written just for me!!! I am an overthinker, a worrier, and an insomniac!! I have racing thoughts and there are days when I wish I could just shut off my brain!! Even a low dose of sleeping pill does not help!
She gives us advice about estrogen therapy options such as a transdermal patch (that is the one I am on the Dotti Patch), transdermal gel/spray, oral pills, vaginal ring. However, she also gives you non hormonal options as well.
If you are wondering if you have Perimenapause but not sure of the symptoms have no fear Heather has a list of symptoms for you to check to see if you match with. I have 10 of the 34!
Oh and if you wonder if any of the myths are true about Permenapause she has a list of them that she will give you the correct answer for too.
Heather thinks of everything in this book even down to the diet and gives a list of high protein and high fiber foods with portion size. She also gives exercise advice as well.
Heather Hirsch needs to be commended for all the time and effort she put into educating herself to educate her readers on this topic. Her medical knowledge, her attention to detail, and how she had a heart for what we women were going through during all of this. Amazing read! Definite 5 star read!! This needs to be on every OBGYN shelf!!



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