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We asked menopause coach Susie Weinberg about what brings women to her coaching practice, some of the most common misconceptions about peri/menopause, and what a good outcome from menopause coaching can look like. Based in the New York tri-state area, Weinberg is known for her popular, friendly and easy-to-follow talks about peri/menopause and women’s health.
What do your clients usually have in common when they first reach out to you?
The biggest thing is that they don’t feel like themselves. They are going from doctor to doctor trying to figure out what’s wrong with them, and they don’t really understand why they don’t feel like themselves. Their doctors don’t know how to help them and they don’t know what to do.
They’re describing the same symptoms over and over with no real answer: some are told it’s stress, some are told it’s normal aging. Labs are normal, maybe not optimal, but normal. Some are given a prescription for an SSRI for depression or anxiety, and many are handed information that doesn’t help them understand what’s happening in their bodies.
By the time they find me, they’re more exhausted, frustrated and confused than before and they still don’t know what’s wrong. They don’t know what to ask and they don’t know where to go next. That’s where I come in: I tell them what they’re feeling is real, they’re not broken, they’re not alone, and we start figuring out what questions to ask and where to go from there.
What is the biggest misconception about peri/menopause you hear from women?
The version most women have grown up with is that perimenopause just means hot flashes and missed periods, and that’s it. If they don’t have either, they think they don’t need me and they aren’t in perimenopause. Even if they’re 50 and waking up every night at 3 AM, missing words during conversations because of brain fog, not able to play tennis anymore because of shoulder issues, having nonstop UTIs, or experiencing anxiety that’s gotten a lot worse lately, they still say they aren’t in perimenopause or near menopause yet.
When all of these symptoms show up, they automatically think it’s something else, and since menopause education in medical training remains very limited, their doctors may think that too.
Women in their late 30s and early 40s have also told me they think they’re too young. The average age of menopause in the United States is 51, but perimenopause can start anywhere from 3 to 10 years before your last period. So, if we do the math, perimenopause can begin in our late 30s.
They can spend years searching for answers to symptoms that don’t have an obvious cause because no one is thinking about hormones. By the time they find me, they may realize on their own that it’s hormonal, but need guidance, support, and education. Sometimes they don’t even realize it’s hormonal; sometimes they’re not sure what’s going on. They see one of my posts listing symptoms they have and come to me and say, “Could this be hormonal?” Then we go through everything together.
What is an example of a good outcome for a menopause coaching client?
A client came to me after her doctor dropped her for wanting hormone therapy. She had questions that kept going unanswered, and she didn’t know where else to turn. We worked together to close that gap, and I helped her find a new practitioner.
I educated her on her options: estrogen and progesterone for her hot flashes and anxiety, vaginal estrogen for years of recurrent UTIs, and testosterone for decreased libido. She started having better conversations with her doctors, understood what was what and why she was asking for these things. It took time, but she started seeing relief from her symptoms.
It’s an ever-changing process because our bodies are always changing. That’s the outcome I aim for: relief from the symptoms over time, and a woman who feels informed, confident, and empowered to advocate for herself, with or without me.
Disclaimer: This Q&A is for informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Talk with your healthcare provider about your individual symptoms and treatment options.
We asked menopause coach Susie Weinberg to walk us through what working with a coach looks like, some of the surprising symptoms of peri/menopause, and the misconceptions she hears most often. Based in the New York tri-state area, Weinberg is known for her popular, friendly and easy-to-follow talks about peri/menopause and women’s health.
What does a menopause coach or menopause concierge do, and how did you become one?
I think every menopause coach brands themselves differently. I describe my business as a coach/concierge and a bridge between women and their doctors, guiding clients through perimenopause and menopause symptoms that too often go dismissed or misunderstood. Through one-on-one coaching, speaking engagements and content creation, I prepare women with the tools, resources and confidence to advocate for themselves.
I found this through lived experience. I was in entertainment for 26 years as an agent for Ford Models, and then I owned my own company called Bella Agency, which was a full-service modeling agency for commercial print talent. About a year after I had my first child, I left that company and started another company called Susan Allison Talent, where I was getting children into talent agencies and acting as their manager.
I was starting to see my body change, and I didn’t know why or what was happening. I was going from doctor to doctor with symptoms of shortness of breath, heart palpitations, dry mouth, burning mouth, swollen glands, and a lot of different things that I did not relate to anything hormonal. I went to a cardiologist, an ENT, a pulmonologist, and a rheumatologist, with everything coming back as “normal.”
Finally, after a couple of years, a pulmonologist said to me, “You know, this could be hormonal,” and I did not understand what he was talking about. I did a ton of research and realized it was perimenopause. Fast-forward to going to specialist after specialist to try and help me figure it out.
Through all of that research, I learned that I could become a menopause coach. I had stopped being a talent manager because that business had changed, and at the same time I was trying to figure out what I wanted to do with my life. I decided to get certified as a menopause coach, and here I am.
What are some surprising symptoms, and what do you most want women to understand about peri/menopause?
The list is quite long, actually, and I’m sure I’ll forget something! Burning mouth syndrome, itchy ears, frequent UTIs and urinary urgency that show up out of nowhere, heart palpitations that send women to the ER scared they’re having a heart attack, shortness of breath, anxiety and mood swings that feel completely out of character, gut issues, frozen shoulder, weight gain, and fatigue that sleep and napping don’t fix.
Here’s what I want women to understand about perimenopause and menopause: this is a full-body transition, not just a gynecological event. Estrogen, progesterone and testosterone receptors are found throughout the body, including in the brain, joints, skin, bladder, heart, ears, and mouth. When hormone levels start fluctuating, all of these areas can be affected. It’s not just hot flashes, which may be the single biggest misunderstanding behind so much of the confusion and dismissal women face around symptoms of perimenopause.
Most doctors unfortunately still treat it as a female gynecological issue. That’s why so many symptoms get missed or dismissed, and women go from doctor to doctor searching for a diagnosis to help them feel better. When women think it’s hormonal, they tend to go to their gynecologist. A cardiologist doesn’t necessarily think to ask about hormones when a 45-year-old woman comes in with heart palpitations, and a psychologist may not connect new-onset depression or anxiety in a 50-year-old woman with hormones or perimenopause. Women get treated symptom by symptom, specialist by specialist, when the common thread connecting them could be perimenopause or menopause.
One thing I want to mention: these symptoms should always be checked out by a doctor first, and by a specialist if you’re having heart palpitations, shortness of breath or any other serious symptoms that can have other causes. You don’t want to miss something scary. Rule out those things first, and then you can look at whether hormones are responsible.
If more women and doctors understood this, and doctors were better educated about it and could educate and reassure women, women would be less likely to feel like they were falling apart for no reason, scared for no reason, or alone and isolated. They would ask the right questions and stop accepting “everything is normal” as the end of the conversation.
How do you coordinate with clients and their healthcare team?
I work with clients before appointments to figure out their symptoms and how they may or may not connect to their cycles. After their appointment, we debrief: What did the doctor say? What was confusing? What needs to be done at a follow-up? And we go on from there.
Most women walk into perimenopause with zero understanding of the symptoms or what is happening, have zero prep for their appointments, and leave feeling dismissed or unheard. Together, we create a clear list of questions for the client to be armed with, so nothing is forgotten in a rushed 12-minute appointment, or even a one-hour appointment. I give clients evidence-based information so they show up to their appointments ready, and can leave with a plan they actually understand.
I don’t diagnose or prescribe; I’m not on the medical team and never try to be. I’m alongside the medical team. If a client wants me to speak directly to their practitioner, I’m happy to do so, but a big part of our work together is really about empowering the woman to advocate for herself and her needs and wants.
Disclaimer: This Q&A is for informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Talk with your healthcare provider about your individual symptoms and treatment options.
