Sarah Bentley had just turned 42 when she started noticing mood changes.

And not the normal ups and downs everyone goes through now and then.

“Real irritability,” she said. “I’d snap at people and say things I didn’t mean. … It was like my filter was suddenly broken.”

Then came the hot flashes, making a good night’s sleep feel like an impossible dream.

Bentley said she had only the vaguest sense that these might be early symptoms of menopause, also known as perimenopause.

“I guess I knew there’d be hot flashes and night sweats, but I didn’t think that would happen until I was in my 50s,” she said. “And these symptoms felt very intense.”

She reached out to a provider, who suggested she take an antidepressant.

Bentley balked at first.

“I knew I wasn’t depressed, but she explained these medications are often prescribed for other reasons, including hot flashes and impulse control.”

But Bentley didn’t like how the medications made her feel, and they didn’t seem to help much.

At that point, she had also noticed another symptom: steady weight gain.

Bentley, then working as a police officer, said she felt like a completely different person—and she didn’t care for it.

“I’ve always been athletic. Physical fitness is really important to me,” she said. “Yet all of a sudden I had no energy, no motivation and no discipline.

“I didn’t like what was happening to my body and I felt like I wasn’t in control of anything.”

Her libido started to fade, making her feel distant from her husband. And she kept battling that underlying sense of agitation.

“I didn’t like how I treated my husband, friends and coworkers,” she said. “It’s no fun to be angry at people all the time, nor is it fun to be angry with yourself.”

Frustrated, she began asking around for recommendations.

A friend suggested she try Corewell Health’s Women’s Health & Wellness Center in Grand Rapids.

There, in spring 2021, Bentley met with Julie Ondersma, CNM, a family nurse practitioner and certified menopause provider at Corewell Health.

“That’s when my journey to getting back to myself really started,” Bentley said.

‘Don’t discount how you feel’

Bentley wanted a full workup, not just of her hormone levels but of everything else that might be causing her symptoms.

“I’d never had health problems before,” she said. “By now, I was concerned. I wanted to make sure something else wasn’t going on.”

Ondersma ordered a series of tests and gently walked Bentley through an explanation of perimenopause.

It was mostly all news to Bentley.

“I don’t have sisters,” Bentley said. “And my mother and one maternal aunt had had completely different experiences of menopause. I didn’t know what to expect.”

Ultimately, Ondersma suggested Bentley begin hormone replacement therapy.

“I know it’s not for everybody,” Bentley said. “But for me, the difference has been like night and day.”

Bentley, who no longer has periods, now uses an estradiol patch, a progesterone pill and a compounded testosterone cream.

She urges others to learn more about the potential of hormone therapy.

“Don’t discount how you feel,” she said.

Hormone changes can be difficult to weather, but a specialist can help you find answers.

“Talk to someone who knows what they’re doing—and don’t be afraid of it,” Bentley said.

At the same time, Bentley dove into lifestyle changes.

She began working with a health coach to find exercise and diet strategies that suited her.

“My coach encouraged me to stop trying to run. She said, ‘That’s just not what your body needs right now.’ She didn’t even want me to lift weights at first,” Bentley said. “She said, ‘Your body is really inflamed. Let’s start with walking.’”

Bentley, who has retired from policing and now works in an office, committed to a walking program throughout the spring and summer.

After five months, she added a gentle weightlifting program.

She also changed her approach to nutrition.

“I eat a lot of plants,” she said. “It’s all regular, normal, healthy food. And I try to stick to an 80/20 lifestyle. Sometimes I’m going to have a drink, a cookie or some ice cream. But I’m going to do that in moderation.”

Bentley’s commitment to those lifestyle changes has powered her recovery, Ondersma said.

“Sarah’s really embraced accountability. Women often say, ‘I know what I have to do. I just don’t do it,'” she said. “She jumped in and started making changes.”

Navigating menopause, Ondersma said, is like many other health challenges. While some people’s symptoms are mild, others are quite intense.

“There are usually multiple levels to work on and multiple tools,” Ondersma said. “It’s not just medication, nor is it just diet. It’s about building your life and health on a solid foundation and healthy lifestyle.”

Ondersma also appreciates Bentley’s courage in talking about the hard stuff.

“Perimenopause sneaks up on women and, suddenly, our libido fades, even in marriages where sex has never been a problem,” she said. “We’re snapping at people and asking ourselves, ‘Who was that? That’s not me—and that’s not the person I want to be.'”

She encourages women in their 40s to be alert for symptoms and discuss them with a provider.

“We’re all going through menopause if we’re blessed to live that long,” Ondersma said. “So it’s just a matter of preparing for it and being ready.”