Dr. Diane Mueller: Hi, everyone. Welcome back to another episode on the Libido Lounge. I’m really excited about today’s guest. And as you heard in our intro, Andrea Donsky is an amazing nutritionist who’s gone far beyond what a lot of people do in their clinical career, which is that she’s put together research. And we’re going to talk about that research today because it really is addressing menopause, perimenopause.

Dr. Diane Mueller: But men, we have something for you too because what we see is that men and women are affected by this stage of life. And what we see even more is that women, when they’re affected or even men when they’re affected, it affects the couple. And I say this in so many areas of my work. Oftentimes when things get out of balance in health, they do not happen to the individual. They happen to the relationship.

Dr. Diane Mueller: And so understanding yourself, understanding your partner, understanding what they’re going through, and understanding how to help yourself, help your partner, and help your relationship as you navigate through life changes and through midlife changes, I think is so essential. So whether you’re listening as a woman, whether you’re listening as a man, whether you are in the stage of life of transition, or whether you are transitioning, like, to that stage eventually, there is something in here for you. So thank you so much, Andrea. It’s so wonderful to be with you today.

Andrea Donsky: Thank you for having me, and I so agree with you. This is a conversation for everybody to be had. It’s not just for the women who are going through it because as my research shows is that a lot of us were in long term relationships, and especially the people who the men who filled out our survey were in the relationships from ten plus, twenty plus years. So it affects them as well. So the conversation is so important to be had for both.

Dr. Diane Mueller: It really is. And we mentioned something offline that I wanted to mention here too, which is this idea of, like, medical gaslighting, right? Seen so much of this, and I know you have too. I’m thinking of a friend right now in this moment who now she’s in her mid 50s, but she was telling me when she first started going through menopause type of symptoms and she went to her doctor about it, she was told point blank, everybody goes through it. Suck it up.

Dr. Diane Mueller: Like, literally, that’s what her doctor said. And I about we were on the ski lift when she said this. I about fell off the ski lift with, like, her telling me the story of it because it was just it’s, like, so severe around this thing around, like, you know, like, it’s not that big of a deal or you just gotta get through, like, such lack of support and understanding. So I that’s what I think your research with many things is good for, but one of them is really helping people understand that this is very real. There’s things that can be done and that you don’t have to be gaslit anymore.

Andrea Donsky: So the gaslighting is very real. I have published research in this from December 2024 in the journal Menopause on doctor visits, And we know that forty percent of women in this phase of life are gaslit by a medical professional. And now, you know, I’ve I and we’ve I’ve heard all of it. You know, just deal with it. It’s natural part of aging.

Andrea Donsky: There’s nothing you can do to help. Like, it’s just so not true anymore. Women don’t have to suffer, and there is a lot we could be doing, especially now the research is showing even if we start younger in perimenopause as opposed to waiting once we have gone the full year, the three hundred and sixty five days without a period, that there’s a lot we could do to help. Now my lane is nutrition, lifestyle, supplements, and my research, but there’s also the option of hormones if that’s what you choose to do. So we know and the conversation is so important because I feel like if it was men going through this, that they wouldn’t be told that.

Andrea Donsky: Just deal with it. Or, like, they’d have they would have had all the solutions already. Right? So I just feel like it’s an unfair thing to say for anybody to say to anyone, whether it’s their doctor, health care professional, or a partner, a boss, like, it doesn’t matter who it is to just deal with it because it is it’s hard. And like so I’m a menopausal woman.

Andrea Donsky: I went through it. I was in perimenopause for fourteen years total of eleven of which I actually had no idea I was perimenopausal. And it was hell. It was really, really tough. And when you don’t know what’s going on with your body, and all of a sudden you wake up one day and you’re like, woah, where is my old self?

Andrea Donsky: It’s a very hard thing to navigate when, a, you don’t know what’s happening, and, b, you’re being told, ah, it’s in your head or just deal with it, or it’s like minimizing how you’re feeling, and that’s just not okay.

Dr. Diane Mueller: Exactly. Exactly. I’m going through it myself. I’m in perimenopause. I’m not fully menopausal yet, but I haven’t had a menses now in three months.

Dr. Diane Mueller: That’s my longest one so far. We’ll see if I make it all 12 or if I get another one. But it is. It’s crazy. I remember my first hot flash, I was actually getting on a plane, and it was, like, like, the amount of intensity with it.

Dr. Diane Mueller: It was like, you know, as soon as I could sit down, I was, like, in as few of clothes, and my pants rolled up, my socks off, like, you know, my shirt tucked up into my bra and like all of it. It’s just it’s so I mean, that’s just one of so many symptoms. And that one in many ways, it’s like the easiest one. It’s not easy from a symptom, perspective, but it’s easy from a standpoint of like, oh, there’s so much knowledge around this that at least when women go through hot flashes, it’s like usually there’s a level of like, I wonder if this is happening. But so many times we’re not making those connections.

Perimenopause Brain Fog and Losing Your Old Self in Midlife

Dr. Diane Mueller: So tell us about like the initial let’s kind of set the stage around like your research. Like what were the questions with your research? Like what were you trying to solve or learn? Walk us through kind of like the goals, the initial goals of what and what you solved by doing the study.

Andrea Donsky: Yeah. So I mean, to your point of, you know, we don’t make the connection that we know is, you know, women are going to their doctors and their health care providers and saying, okay. So I have this symptom or that symptom. And a lot of the time, it’ll take women anywhere seventy five percent of women have to see their doctor anywhere between two and five plus times before any connection is made. Because when we think about symptoms of perimenopause and menopause, like you said, the first thing that is generally connected to it are hot flashes, night sweats, mood swings, sleep issues.

Andrea Donsky: Like, these are very common and very well known symptoms that have that connection. And it was the connection that I made to make me realize, oh, wait a second. At 47, when I got my first hot flash, oh, wait. Maybe I’m in menopause. Like, I’d never even knew perimenopause existed, and that’s when I first made that, oh, wait a second.

Andrea Donsky: Oh, okay. So maybe that’s why I just had this intense in like, inferno in my body like you explained. It’s like, whew, that, you know, that and I had it for many, many years. So what made me decide to wanna do the research was years ago, I was at a party with my husband, and we ran into an old friend of mine. And I we were kinda getting caught up on what we were doing, And I asked her what she was up to, and she said that she was creating an app for menopause symptoms.

Andrea Donsky: And at the time, I was like, an app? Like, don’t you need a lot of symptoms? Like, I was one of those people that I thought, oh, wait. There’s, five or six.

Andrea Donsky: Like, how many could there be? She’s like, no. No, Andrea. There’s, like, 34 to 40 different symptoms. And I was like, really?

Andrea Donsky: That’s a lot of symptoms. I didn’t even realize that there were that many. And she’s like, yeah. Yeah. No.

Andrea Donsky: There are. So I was like, okay. And the way my body works, Diane, is like, literally came home that night, and I was like, I’m gonna create a document, and I’m gonna I’m gonna, like, start tracking what these symptoms are. And soon enough, I realized that there were way more than 34 to 40. There were about 80 to 85 different symptoms.

Andrea Donsky: And that’s when I kinda thought, wait a minute. I’ve got this incredible community. I’m gonna go to my community and ask them what type of symptoms they’re experiencing. This was, like, years apart. Anyways and I quickly learned that there are a 103 plus symptoms.

Andrea Donsky: So that’s what made me decide to launch our first our first survey, which is our signs and symptoms survey, and that was published in December 2024 in the journal menopause. And we now know that it’s old data to say that there are 34 or 40 symptoms. There are a 103 plus And the reason why this is so important is to your point of now we can validate women, and we can support women, and we could say, oh, okay. So maybe you have itchy ears. You’ve gone and you’ve got it you had everything checked out.

Andrea Donsky: No one can find a reason for it. Now let’s look at it being a possible perimenopause or menopause symptom. Same thing with phantom smells. These are when you smell things that other people don’t. I have them for many years.

Andrea Donsky: I had I had them checked out by several different doctors, and it always came back of we don’t know what’s going on. So now we know, okay, it can be a perimenopause or menopause symptom. So it gives us the vocabulary and the knowledge to be able to seek treatment options now that we have and we know that there are actually these could be symptoms of perimenopause and menopause. Yeah.

The Full List of Perimenopause Symptoms

Dr. Diane Mueller: It’s so great too because when you’re thinking of, you know, or saying things like phantom smells, I’m thinking about my own experience of I started having phantom smells right around the time that COVID was around. And so it was interesting, right, because we knew that people had loss of smells. But for me, it was like, oh, this I I was having this experience of, like, this smell that was very it was, almost like cigarettes mixed with burning metal is how I would describe it. Not if you’re going to have a phantom smell, not a pleasurable one to have for sure. But what’s interesting and why I think it’s super important in your surveys is because so many times, there can be other explanations for these symptoms.

Dr. Diane Mueller: Right? So if you also look at my history, that smell correlates perfectly with when my hormones started to change. So that, you know, it’s like this whole idea of understanding and why I really encourage people to go take the survey is that it’s so easy to have these symptoms and for your doctor, your care provider, even yourself to just, even if you’re not being gaslit, to just go down another route and just be like, Well, this is an explanation or that’s an explanation, without even considering perimenopause or menopause being the reason because of, like you’re saying, like a lot of people think of the five to six or maybe even 35 to 40, but we’re missing 60 or 70 of these types of symptoms that could be that. So really encourage everybody to go take that survey so you learn this, and we’ll have that in the show notes for you. So what else did you find?

Dr. Diane Mueller: What else once you did the survey, what tell us more about the findings.

Andrea Donsky: Yeah. So interestingly enough, we have a survey on phantom smell. So when you’re saying that you were smelling things burning, it’s actually the number one smell that women in perimenopause and menopause have. So something burning. Yeah.

Andrea Donsky: So I’ve so the reason why we launched our phantom smell survey was because it was one of my first symptoms, and I wanted to understand it better. So we now have, I think it’s like almost 1,300 responses to the survey, and by far, over seventy percent of women say they smell something burning. So it could be cigarette smoke, cigars, campfire, burning metal. So you’ve said like what you’re saying, it’s very common. Burning electronics.

Andrea Donsky: So anything burning toast, burning cough, burned coffee, anything burning is a very common one. So that was something that I found super interesting that women, you know, they’ll come up to me and they’ll say, you know, oh, like, I have like this I I’ve called the gas, you know, the gas company. They’ve come in and, like, I’ve heard crazy stories about phantom smell. So that’s why I’m very passionate about making that something that women know about because it’s very scary. I And always like you said, like, some women have said they reported it around COVID.

Andrea Donsky: It could be allergies. Like, it could be different things. So that’s why I’m always like, to your doctor, get your clean bill of health, and then come back and be like, okay. Now let’s look at it possibly being a perimenopause symptom. The other thing that we found through our research, it’s pretty fascinating.

Andrea Donsky: So there’s quite a few things. Number one is that on average, women experience 31 different symptoms. So we’re talking about not one or two different symptoms. We’re talking about a large number of symptoms, which a lot of women are and this we’re talking on average 31 different symptoms, which is a lot. We also know that the top 10 out of the top 10 most common symptoms, 90% of them are cognitive health, brain health, or mental health related.

Andrea Donsky: Ninety percent. That is something that when we saw the results from our survey for that, were like, woah. Like, think about physical symptoms, and it manifests physical symptoms manifest for women in menopause more so they do in perimenopause. Perimenopause is very much about the cognitive, the brain health related symptoms, the mental health symptoms. But that was a huge eye opener for us to be like, woah.

Andrea Donsky: Ninety percent, nine out of 10 of the top 10 most common symptoms are that are, like, mental health related. And that was, like, a huge eye opener for us.

Perimenopause Mood Swings, Perimenopause Anxiety and Feeling Like a Different Person

Dr. Diane Mueller: Yeah. I think it’s a really important thing for people too because it’s so often too, this time of life, midlife is usually one of the most chaotic times stress wise for people. A lot of people are still at the combination of being at the height of careers oftentimes, combined with still having children in the house of varying ages, and having done that for years, oftentimes that combo. So I think it’s very, very common for people from a standpoint of brain fog or where did I put my keys and those kind of things. I think it’s very common for people to be like, Well, I’m just stressed.

Dr. Diane Mueller: And it’s like, Well, their stress could be worsening menopause and worsening periating could be part of the picture, but it’s just kind of like we blame things on aging, or I’m like, Oh, I’m just getting old, or I’m just stressed. Oftentimes we’re missing like a core, core piece of it.

Andrea Donsky: Yeah, exactly. So and that’s where the you know, even on you know, for ourselves, a lot of us will say, oh, like not even other people telling us, right, that we’re stressed. We’re making up excuses. And that’s where it’s like, oh, wait a second. Our hormones are changing.

Andrea Donsky: Maybe we can do something about it so that we don’t have to suffer. Like, it’s not just aging or it’s not just stress. We do know, however, though, that stress and anxiety are very real for women in perimenopausal menopause. I have another survey that’s published on that, that 66 of women are more stressed now than they were before they went got into perimenopause and menopause and were less able to cope