Perimenopause Specialist in Fort Worth, TX
Perimenopause is the transition before menopause, when estrogen and progesterone rise and fall unpredictably. It usually begins in a woman's 40s, sometimes in the mid-to-late 30s, and lasts about four years on average, though it can run longer. At Sky Women's Health in Fort Worth, Dr. Carolyn Moyers, a Menopause Society Certified Practitioner, diagnoses and treats perimenopause based on your symptoms, not just your lab results.
Medically reviewed by Dr. Carolyn Moyers, DO, FACOG, MSCP , board-certified OB-GYN · Last updated October 2026
What are the signs of perimenopause?
Symptoms vary widely, and many women do not connect them to hormones at first. Common signs include:
Periods that become irregular, heavier, lighter or closer together
Hot flashes or night sweats, sometimes only around your period
Trouble falling or staying asleep
New anxiety, irritability, rage or low mood
Brain fog and forgetfulness
Worse PMS, breast tenderness or migraines
Lower sex drive or vaginal dryness
Weight gain around the middle
Fatigue and joint aches
Am I in perimenopause?
If you are over 35 and your cycle, sleep or mood has changed without a clear reason, perimenopause is a strong possibility. Many women are told their labs are normal because hormone levels can look fine on the day of the test. Dr. Moyers looks at the full picture, including your age, cycle pattern, symptoms and health history, and uses labs to rule out other causes such as thyroid disease or anemia.
Perimenopause vs. menopause: what's the difference?
| Perimenopause | Menopause | |
|---|---|---|
| When it happens | Usually starts in the 40s; can begin in the mid-to-late 30s | Average age 51 in the U.S. |
| Periods | Still happening, but often irregular | None for 12 months in a row |
| Hormones | Estrogen and progesterone swing up and down | Estrogen and progesterone stay low |
| How it is diagnosed | Symptoms and cycle changes; labs are often inconclusive | 12 months without a period |
| Pregnancy | Still possible; use contraception if you want to avoid pregnancy | Not possible once menopause is confirmed |
| Treatment options | Low-dose hormone therapy, progesterone, hormonal IUD or birth control, non-hormonal and lifestyle options | Hormone therapy, non-hormonal and lifestyle options |
Perimenopause treatment options
Hormone therapy: low-dose estrogen and progesterone to steady symptoms. See hormone replacement therapy.
Progesterone: can help with sleep and with heavy or irregular bleeding.
Hormonal IUD or birth control: controls heavy or unpredictable bleeding and prevents pregnancy.
Non-hormonal medication: options for hot flashes, sleep and mood when hormones are not right for you.
Lifestyle medicine: nutrition, strength training, sleep and stress plans, plus medical weight loss for midlife weight gain.
Sexual health care: treatment for low libido and painful sex. See women's sexual health.
When should I see a doctor about perimenopause?
Book a visit if symptoms are affecting your sleep, work, mood or relationships. See a doctor promptly for bleeding that soaks through a pad or tampon every hour for several hours, periods less than 21 days apart, bleeding after sex, or any bleeding after 12 months without a period, as these need evaluation.
Why see a perimenopause specialist at Sky Women's Health?
Dr. Moyers holds the MSCP credential from The Menopause Society and has two decades of clinical experience. Appointments are long enough to talk through every symptom, and members can reach her directly between visits. She sees many women in their late 30s and early 40s who were told they were too young for perimenopause.
Concierge Women's Health Care in Fort Worth and Across Texas
Sky Women's Health is a concierge, membership-based gynecology practice. Appointments are longer and unhurried, members can reach Dr. Moyers directly, and care is paid through a membership or per visit. Our clinic is at 1125 S Henderson St, Fort Worth, TX 76104, and patients regularly travel from Arlington, Benbrook, Burleson, Mansfield, Keller, Southlake, North Richland Hills, Weatherford, Grapevine and Westlake. Consultations and follow-ups are also available by telehealth for patients located in Texas.
Perimenopause FAQs
What age does perimenopause start?
Most women notice perimenopause in their 40s, but it can begin in the mid-to-late 30s. It ends 12 months after your final period, which happens at an average age of 51.
How long does perimenopause last?
Perimenopause lasts about four years on average, but it can range from a few months to ten years.
Can a blood test tell me if I'm in perimenopause?
Not reliably. FSH and estrogen levels change from day to day during perimenopause, so a single test can look normal even when symptoms are hormonal. Diagnosis is based mainly on your age, symptoms and cycle changes.
Can I still get pregnant during perimenopause?
Yes. Ovulation becomes irregular but does not stop, so you need contraception until menopause is confirmed if you want to avoid pregnancy.
Is hormone therapy safe in perimenopause?
For most healthy women, yes. Low-dose hormone therapy or hormonal contraception can be used in perimenopause, and Dr. Moyers reviews your health history, blood clot risk and breast cancer risk before recommending a treatment.
Can I have a perimenopause visit by telehealth?
Yes. Consultations and follow-ups can be done by video for patients located in Texas. If you need a pelvic exam, ultrasound or in-office labs, we schedule that at our Fort Worth clinic.
SERVICES WE OFFER
Conditions & Treatments
Our services
Menopause Care
Expert treatment for hot flashes, sleep, mood, brain fog and vaginal symptoms from a Menopause Society Certified Practitioner.
Perimenopause Care
Help for the years before menopause, when periods, sleep and mood change and labs often look normal.
Hormone Therapy
Personalized estrogen, progesterone and testosterone therapy using FDA-approved patches, gels, pills and vaginal options.
Gynecology
Complete gynecology care from a female board-certified OB-GYN, from age 12 through menopause.
Well-Woman Exams and Pap Smears
Annual preventive visits, Pap and HPV testing, breast exams and STD testing in an unhurried appointment.
Sexual Health
Care for low libido, painful sex, vaginismus and orgasm concerns from an ISSWSH Fellow.
MonaLisa Touch®
Hormone-free, in-office laser treatment for vaginal dryness, irritation and painful sex.
Minimally Invasive Gynecologic Surgery
Laparoscopic, hysteroscopic and da Vinci® robotic surgery for fibroids, endometriosis, cysts and abnormal bleeding.
Medical Weight Loss
Physician-supervised GLP-1 treatment, InBody tracking and lifestyle medicine designed for women in midlife.
Osteopathic Manipulative Treatment (OMT)
Gentle hands-on treatment for pregnancy, pelvic floor, back and hip pain from an OB-GYN trained in neuromusculoskeletal medicine.
Telehealth
Secure video visits for consultations, hormone follow-ups and lab reviews for patients located in Texas.
Expert treatment for hot flashes, sleep, mood, brain fog and vaginal symptoms from a Menopause Society Certified Practitioner. Explore Menopause Care
Help for the years before menopause, when periods, sleep and mood change and labs often look normal.
Personalized estrogen, progesterone and testosterone therapy using FDA-approved patches, gels, pills and vaginal options.
Complete gynecology care from a female board-certified OB-GYN, from age 12 through menopause.
Annual preventive visits, Pap and HPV testing, breast exams and STD testing in an unhurried
appointment.
Care for low libido, painful sex, vaginismus and orgasm concerns from an ISSWSH Fellow.
Hormone-free, in-office laser treatment for vaginal dryness, irritation and painful sex.
Laparoscopic, hysteroscopic and da Vinci® robotic surgery for fibroids, endometriosis, cysts and abnormal bleeding.
Physician-supervised GLP-1 treatment, InBody tracking and lifestyle medicine designed for women in midlife.
Gentle hands-on treatment for pregnancy, pelvic floor, back and hip pain from an OB-GYN
trained in
neuromusculoskeletal
medicine.
Secure video visits for consultations, hormone follow-ups and lab reviews for patients located in Texas.
Refer a Patient
Subscribe
Join Dr. Moyers' newsletter!