- Tech founder Ruth Shrauner faced severe perimenopause symptoms impacting her life and work.
- Shrauner initially mistook her symptoms for stress and struggled to find effective medical help.
- Bioidentical hormone replacement therapy helped her regain energy and emotional stability.
This as-told-to essay is based on a conversation with Ruth Shrauner, a 37-year-old tech founder from Kansas City, Missouri. It's been edited for length and clarity.
On paper, I'm a woman who's "made it." I'm a first-generation college grad who built a multimillion-dollar digital affiliate marketing business online and launched my own tech startup company in 2022.
I'm typically the woman that other female business owners turn to for advice and a positive pep talk. So, in the fall of 2023, when I found myself lying in bed thinking, "I just want to go to sleep and never wake up again," it felt like I was having an out-of-body experience.
It was a terrifying moment that I now know was the result of early onset perimenopause — the transitional period before menopause. It can happen to women between their mid-30s and mid-50s and cause both physical and emotional symptoms.
I thought the perimenopause symptoms were due to stress
The symptoms started in early 2022, shortly after I turned 36.
My energy started depleting. Little tasks felt like massive obstacles. Doing laundry seemed like the hardest job in the world, and making dinner felt excruciating. When I wasn't working, I'd lay on the couch as much as possible and pray that my toddler twins didn't need too much from me.
The thought of scheduling a doctor's appointment seemed complex. The mental weight of the ever-growing list of daily tasks was heavy, constant, and draining. Soon this state of being became my new normal as my anxiety became more and more debilitating.
And there was the nightly insomnia. Despite being mentally and physically exhausted, I couldn't fall asleep before 11 p.m. on a normal night. Once I finally fell asleep, I'd wake up around 2 a.m. Sometimes I'd be extremely hot and sweaty, a tell-tale perimenopause symptom.
Many nights, I'd still be wide awake by 5 a.m., then I'd move downstairs to our couch and turn on Bravo TV to put me back to sleep. If lucky, I'd get another two hours of sleep before the kids woke up for the day. I'd get about five hours of sleep on a good night, but on most nights, I'd only get three to four hours of disrupted sleep.
My family, home, and social lives suffered
My excitement for life also faded. While I still showed up to work on my multiple businesses, I felt numb most of the time.
Sleep deprivation started cutting into my business day. On the worst nights, I'd go back to bed after my kids went to day care, or I'd sleep through their morning routine as my husband took care of them and got them out the door. There were plenty of days when I just didn't get out of bed.
During my menstrual cycle, I'd have a few good days where I saw a glimmer of my old self. On those days, I'd feel motivated and excited, and I could accomplish what my former self was capable of. But most days, brain fog and overwhelm took over.
My brain was scrambled as it jumped from task to task. Things that used to be easy now felt like I was looking at a puzzle. I'd do enough to get by in my business, but not anything near what I'd been capable of producing.
I saved every bit of my energy for work while my family, home, and social lives suffered. I had invested over $150,000 of my money into my tech startup, so I felt that there was no other option.
Trying to get help from doctors felt like an ongoing battle
It was easy to dismiss the symptoms as stress. Our twins were two-and-a-half years old, we were dealing with the recent loss of my brother and sister-in-law in a tragic accident, and I'd just taken the huge financial risk of launching my tech startup.
I saw multiple doctors and therapists on numerous occasions to try to address the insomnia, my concentration issues, and my overall lack of motivation, despite being on a high dosage of ADHD medication. None of the doctors I saw ever suggested that insomnia and night sweats were signs of hormonal imbalance or perimenopause.
One night in September 2023, I laid in bed wide awake and responded to an email at 3:30 a.m. from Christine Ricci, a former nurse turned entrepreneur with whom I had a business mentorship meeting scheduled that next day.
In our meeting, Christine mentioned my "wee hours" email, and I said, "Doesn't everyone lay in bed wide awake from 2 a.m. to 5 a.m. every night?" She asked if I'd had my hormones checked while asking me about other symptoms that are related to perimenopause and hormonal imbalance.
Before this, I'd only heard women in their 60s talk about night sweats, hot flashes, and menopause. I didn't think it was something I had to worry about for another 20 years. But when I researched symptoms for perimenopause, I found an infographic mentioning all of the symptoms I'd been experiencing.
I felt a tiny glimmer of hope
Christine's company had just partnered with Dr. Daved Rosenswet, a hormone specialist who spent most of his career researching and treating menopause through bioidentical hormone replacement therapy (BHRT).
I agreed to meet with the team to see if hormone replacement therapy was a good option for me.
After completing my intake survey and interview, Christine and Dr. Rosenswet's team worked to analyze, diagnose, and create a BHRT plan for me. Finding the right hormonal balance takes patience and needs to be individualized for every woman. I was prescribed Bi-est (a topical estrogen cream), progesterone, and testosterone oils to treat my early-onset perimenopause diagnosis.
Editor's note: Bi-est is not FDA-approved.
I was told of the potential side effects of BHRT, including mood swings, bloating, insomnia, and sleepiness — all the symptoms I was already experiencing. I did a lot of research and decided to proceed with the treatment.
It felt like I was coming out of a heavy fog
With the BHRT, I began to experience emotions again. I felt excited, happy, alive, energized, motivated, passionate, sad, angry — all of the feelings that had been replaced by a constant feeling of nothingness from perimenopause.
After a month of treatment, I was able to fall asleep at a decent hour and could sleep through the entire night. I no longer woke up with night sweats or racing thoughts.
Looking back on the year and a half prior, I couldn't believe how bad my emotions and executive functions had gotten. It was as if I'd been a walking zombie who couldn't see or think clearly.
I've been on BHRT for nine months now, and the relief I feel makes me want to burst out in happy tears. I'm not sure how long people normally stay on BHRT, but after at least 10 years I plan to get a yearly evaluation of the risks and benefits.
Women's health education isn't prioritized
While I'm so happy to feel like myself again, I've experienced a lot of anger as I learn more about the lack of education and empathy surrounding women's health.
I'm angry that it took me a year and a half to find answers even though I kept advocating for myself to multiple doctors. I'm angry that women's health education isn't prioritized during medical school, in the medical community, or in clinical studies.
Most of all, I'm angry that perimenopause robbed me of precious time with my husband and kids that I'll never get back. I felt so much shame for being a zombie mom during those years, but now I understand that it wasn't something I could control or "mindset coach" my way out of.
I've connected with and learned from other women who have had similar experiences. I hope that women stop masking or making excuses for their symptoms. Rather, we must listen to our intuitions when we don't feel like ourselves. I'd recommend that women experiencing perimenopause symptoms go to a functional doctor or a hormone therapy specialist.
Instead of blaming hormones for making women crazy or lazy, I hope that society begins to see hormones as a gift that gives women unique superpowers that can be used to impact our small pieces of the world.
If you have gone through the process of identifying unknown health symptoms that affect your work and personal life and would like to share your story, email Jane Zhang at [email protected].