Dr. Melissa Caine

Why your belly changes in perimenopause 👀

Insulin resistance, Part 1 of 4.

As estrogen drops, your body becomes less responsive to insulin. That makes it easier to store fat, especially around your middle. Add natural muscle loss and poor sleep, and it compounds.

This isn't a willpower problem. It's biology, and there's a lot you can do about it.

Part 2: the signs and the tests to ask your doctor for. Follow so you don't miss it 💜

I am a doctor, but not your doctor. This information is for educational purposes only.

Why we don't test your levels 👀

You keep asking me this! In perimenopause, hormone levels can swing a lot from day to day, so a single blood test isn't a reliable guide for dosing. That's why The Menopause Society recommends adjusting MHT based on your symptoms.

Signs your dose may be too low:

💜 Hot flashes or night sweats still disrupting your life
💜 Poor sleep or mood symptoms that haven't improved

Signs your dose may be too high:

💜 Breast tenderness
💜 Bloating or nausea
💜 Headaches

Don't chase a number. Chase how you feel 💜

Send this to a friend on hormones.

I am a doctor, but not your doctor. This information is for educational purposes only.

Our new midlife date 🚗😂

Cranky wife. Has to p*e. Wants to nap. He's finding every pothole in the city.

We used to go out to dinner. Now our dates are driving to doctor's appointments together. And honestly? Still my favorite person to sit in traffic with 💕

Midlife love is showing up for each other, even for the not-so-glamorous stuff.

Tag your appointment buddy 👇

I'm a menopause doctor, and I still lose my crap sometimes 🤯

The noise. The mess. Everyone needing something at once. And suddenly I'm at 60.

Perimenopause can make your fuse so much shorter. That's real, and I'm not immune to it.

What helps in the moment: pause. Take a few slow breaths. Not everything is worth going from 0 to 60 over.

And if the rage is happening all the time, it's not a personality flaw. Hormones can play a big role, and it's treatable. Talk to your doctor 💜

Send this to a friend who needs a pause today.

I am a doctor, but not your doctor. This information is for educational purposes only.

She came in for depression. It wasn't depression. 💜

It's World Mental Health Day, and this is one of the most common stories I hear.
Perimenopause can cause anxiety, irritability, low mood, crying spells, and brain fog. The risk of depression rises during this transition, even in women who've never had it before. Yet many women are offered antidepressants without anyone asking about their cycles or hormones.

Antidepressants can absolutely help, and sometimes both treatments are needed. But if you're in your 40s and your mood suddenly changed, ask your doctor: could this be perimenopause?

Send this to a friend who needs to hear it 💜

If you're struggling right now, please reach out. In the U.S., you can call or text 988 anytime.

I am a doctor, but not your doctor. This information is for educational purposes only.

Public speaking used to terrify me. Here's what changed. 🎤

I used to have social phobia. Speaking in front of people terrified me. Then I took 's speaking courses, and she changed how I saw myself.

At the Livelong Women's Health Summit, I finally got to hear her in person. Two things she said stuck with me:

💜 Imposter syndrome isn't something to overcome; it's something to leverage.
💜 Be a lighthouse speaker, not a spotlight speaker.

A lighthouse isn't there to be looked at. It's there to guide people home. That's what I want to be for women in menopause.

My website goes live soon, and I'm getting ready to speak. It's never too late to become who you were meant to be.

Two staples I always have at home 🐻💜

One's for my sweet tooth. The other is low-dose vaginal estrogen, which can help with dryness, painful intimacy, and recurrent UTIs. It's safe for most women and one of the most underused treatments in menopause.

And yes, some women even use it on their face 😉 Your skin has estrogen receptors, and small studies suggest it may help with dryness and elasticity. That use is off-label and not right for everyone, especially if you've had breast cancer, so talk to your doctor first.

Ask your doctor about the estrogen. The gummy bears are on you 💜

I am a doctor, but not your doctor. This information is for educational purposes only.

Watching my daughter get 31 shots of Botox for her migraines 💔

Not for wrinkles. Botox is FDA-approved for chronic migraine, and 31 injections across the head and neck is the standard protocol, usually repeated every 12 weeks.

As a doctor, I know it works. As a mom, it was so hard to watch.

So proud of her for doing what she needs to feel better. And if migraines are running your life, please know you have options. Migraines are about three times more common in women, and hormones play a big role.

I ran a 3am p*e experiment 🌟

You know when you p*e in the middle of the night, get back into bed, and feel like you have to go again? Last night, I sang "Twinkle, Twinkle, Little Star" before getting up. By the end of the song, I was completely empty. I tested it again at 3am, and it worked again.

Not a study, just a theory. Try it tonight and report back in the comments 👇

Doctor note: don't push or strain. Sit fully on the seat, feet flat, lean slightly forward, and relax. If you're getting up 2+ times every night, feel burning, or never feel fully empty, talk to your doctor. Low estrogen can cause these symptoms, and they're treatable.

I am a doctor, but not your doctor. This information is for educational purposes only.

Is perimenopause ruining your marriage? 👀

Sometimes it's part of it. And we don't talk about that enough.

In one survey of women going through divorce, 7 in 10 said menopause played a role. Most were never offered treatment.

If this is your house, acknowledge it, together, and get help. You're not broken, and neither is your marriage.

Agree or disagree? Tell me below 👇

I am a doctor, but not your doctor. This information is for educational purposes only.