As a Woman

Perimenopause Symptoms: The Early Signs You May Not Recognize with Dr. Alicia Robbins

As a Woman

Show Notes

Your periods are still regular and your labs may even look “normal.” So why aren’t you sleeping? Why has your mood changed? And why do you suddenly feel like a different version of yourself?

In this episode of the As a Woman podcast, Dr. Natalie Crawford talks with Dr. Alicia Robbins, a board-certified OB/GYN, certified Menopause Society Practitioner, and founder of The Elm. They discuss why sleep and mood can change before hot flashes or irregular periods begin, how cycle tracking may reveal patterns, and how progesterone, estrogen, and testosterone are considered in individualized perimenopause care. They also explain the connection between fertility and perimenopause, what else should be ruled out, and how to advocate for better care when your symptoms are dismissed.

IN THIS EPISODE:

00:00 What Is Perimenopause and When Does It Start?

03:20 Why Dr. Alicia Robbins Changed Her Approach to Perimenopause

09:55 Perimenopause vs. Menopause: What’s the Difference?

11:23 Fertility and Perimenopause

12:22 How Do You Know if You’re in Perimenopause?

14:47 How to Track Perimenopause Symptoms

16:02 Hormone Therapy During Perimenopause

17:38 Symptoms of Low Progesterone

18:11 Hormone Therapy, Birth Control, and Pregnancy

20:17 Testosterone and Pregnancy

21:21 Testosterone for Women

23:43 Symptoms of Low Estrogen

25:12 When to Start Hormone Therapy

27:04 Estrogen Patches vs. Pills

27:40 Do You Need Hormone Testing for Perimenopause?

30:01 Is It Perimenopause or Something Else?

32:13 How to Advocate for Better Perimenopause Care

GUEST RESOURCES:

Instagram: https://www.instagram.com/aliciarobbinsmd/

Website: https://www.theelmgreenwich.com/

Podcast: https://www.draliciarobbins.com/podcast

AS A WOMAN WITH DR. NATALIE CRAWFORD:

YouTube: https://youtube.com/playlist?list=PLveZDgg3_HZ9m7Wy3C6Vvyrj_NtEOwj_l

Apple Podcasts: https://podcasts.apple.com/us/podcast/as-a-woman/id1449553339

Spotify: https://open.spotify.com/show/12IYOLH9liu60gk5D0bRPk

HOST RESOURCES:

Order The Fertility Formula: https://www.nataliecrawfordmd.com/book

Newsletter: https://www.nataliecrawfordmd.com/newsletter

Instagram: https://www.instagram.com/nataliecrawfordmd

YouTube: https://www.youtube.com/@NatalieCrawfordMD

Become a patient: https://www.forafertility.com

Earn FREE CE/CME: https://learnatpinnacle.com/education

This episode is brought to you by The Pinnacle Podcast Network.

ABOUT DR. NATALIE CRAWFORD:

Natalie Crawford, MD, is a double board-certified OB/GYN and reproductive endocrinologist, co-founder of Fora Fertility, and author of The Fertility Formula. She helps women understand their hormones, fertility, and reproductive health so they can make informed decisions about their bodies.

Disclaimer: Natalie Crawford, MD, is a doctor, but she is not your doctor. This content is for general education and is not a substitute for individualized medical care. Learn more about your ad choices. Visit megaphone.fm/adchoices

More from As a Woman

Oct 20, 2026

Are you getting enough sleep but still waking up exhausted? Or struggling to fall asleep while your mind won’t switch off? Better sleep starts with understanding what may be getting in the way, including the two-way relationship between sleep and your hormones.

Oct 14, 2026

Why are you feeling more bloated, struggling with digestion, or noticing changes in your metabolism when your usual habits haven’t changed? During perimenopause and menopause, symptoms that seem unrelated may be part of a bigger conversation about hormones and gut health. What should you pay attention to, and where should you start?

Oct 6, 2026

Polyendocrine metabolic ovarian syndrome (PMOS), previously known as polycystic ovary syndrome (PCOS), and endometriosis can affect far more than periods or fertility. What can irregular cycles, insulin resistance, inflammation, pelvic pain, painful sex, digestive symptoms, mood changes, and fatigue reveal about your whole body health, even when pregnancy is not the goal?

Sep 29, 2026

Which IVF add-ons and fertility tests are actually worth considering, and what should you know before your next embryo transfer?

Sep 22, 2026

Food labels can make almost anything look healthy, but what is actually in the food we eat? With growing concerns about ultra processed foods, additives, seed oils, and pesticides, many women are left wondering what truly matters for their hormones and fertility.

See all episodes →