“My Own Perimenopause Was A Disaster”: Dubai’s Menopause Expert On What She Would Do Differently Now

Anyone who has experienced – or is currently navigating – menopause, will read this with a knowing nod

As unsettling as the realistion of midlife itself, the physical and mental takeover that is perimenopause takes its toll on all women… even the most composed and seemingly unshakable among us. One such woman is Dr Fiona Rennie. Known to her thousands of devoted Instagram followers as @menopause_doc_dubai, she’s a trusted voice in the world of women’s health. So much so, that it can take up to six months to get an appointment with her. As October marks World Menopause Month, we asked Dr Fiona to share her own personal experience with perimenopause, one hot flash at a time…

My perimenopause was a disaster. I wouldn’t want anyone to go through what I experienced, and that is why I’m so grateful to be in a position to help women understand what is happening to them, and to guide them through the next phase of their lives, turning it into a positive – and often liberating – time.

I was in the situation so many women are in these days; I was in a busy job in corporate medicine, with the pressures that come with that. I had two small children, was in my mid-forties and, in retrospect, think I went from babies and total exhaustion straight into perimenopause. I wasn’t sleeping, would wake in the night with panic attacks, felt anxious, irrationally worrying, was overwhelmed and procrastinating at work, staying longer hours to compensate. I generally felt like I had been blindsided. I had achieved everything that I had ever wanted, had a wonderful family, and had no reason to feel like I did.

I had no idea that this was hormonal. Twenty years ago when I was going through this phase of my life, there was absolutely no awareness, and no education about it – I was a doctor, and never even thought about hormones. I graduated medical school in 1990 with the understanding when women’s periods stopped in their early fifties, they got hot flashes for a year or two and then everything settled down and they were back to normal again. How wrong that turned out to be!

Women now have very different lives to the previous generation. They generally had children in their twenties and by the time their hormones start to decline, they didn’t have quite as much to cope with as we do now. We are having children later, and in our early forties so many of us are at the peak of our careers. We are juggling young children, work, aging family members, as well as fluctuating hormones sending us into turmoil.

What has been so misunderstood by the medical world, is that hormones start to decline as early as when we are in our late thirties with a gradual progression until we reach menopause (which is defined as no period for 12 consecutive months). The average age of menopause is 52 and for some women, perimenopause can last for 10 to 12 years. One of the reasons perimenopause is misdiagnosed is that our menstrual cycle may not change at all. I see many women on antidepressants who actually just need their hormones fixed.

Symptoms of perimenopause and menopause occur because every cell in our body needs oestrogen to function normally (and to some extent progesterone and testosterone), so when thinking of peri and meno symptoms, think everything! The brain has millions of oestrogen receptors so fatigue, lack of motivation, irritability, anxiety, poor memory and concentration, and low mood are all commonplace. Muscles, joints, tendon ligaments and bones have hormone receptors – so think joint pain, tendonitis, aching muscles and slow recovery from injuries. Think dry skin, dry hair, dry eyes, hair loss, allergies, palpitations, irritable bowel and autoimmune conditions.

Weight gain is a problem for almost all women, and it comes with an inability to control it as they have previously. This is because as our oestrogen levels decline we get a redistribution of body fat – mostly belly fat and a slower metabolism. If you have been told that your hormone blood tests are ‘normal’ but you have unexplained symptoms, keep seeking help. Hormone tests are generally of no use diagnosing perimenopause.

So, what would I do differently? I wish I had known then what I know now about nutrition and exercise. I take a very holistic approach to treating perimenopause – sleep, nutrition, correct vitamin deficiencies and exercise. I believe that exercise makes women feel strong and empowered and the hormones that we produce with exercise are helpful in managing so many of the symptoms related to perimenopause and menopause.

Muscle is the organ of longevity and controls metabolism. Our metabolism is slowing due to declining hormones and age-related muscle loss. From our early forties, muscle is lost at one per cent per year and from our fifties, two per cent per year. As we lose muscle, it is replaced by fat and the metabolic changes that go with that. This leads to an increased risk of diseases of aging such as heart disease, diabetes and cancers. We need to stop focusing on numbers on the scales and focus on body composition.

Four ways to trick menopause into behaving

Raise the bar

Lift weights and build up to heavier ones – it is counter intuitive to some, but the older you get the heavier you need to lift (preferably under supervision). Start slowly, consistency is the key. If you can do some exercise at least twice a week and maintain that for the rest of your life that is more beneficial than trying to achieve too much too soon and feeling like you have failed. Along with strength training we also need to be doing some cardio (interval training is best for women) something for balance and flexibility (Pilates, yoga, stretching) and something that involves impact for bones (skipping with a rope or jumping).

Power up your plate

You can’t build muscle without protein. Keep alcohol and sugar to a minimum and take processed food out of your diet. When we feel strong, we feel empowered, we feel in control of our bodies, we feel like we have more control of reducing health challenges as we age, our hormones are more stable and we sleep better, mood improves and joints ache less with better function.

HRT and soul

I wish that I had been less afraid of hormone treatment when my hormones started changing. We didn’t know then what we know now about the long term benefits of menopausal hormone treatment, primarily heart, brain and bone (prevention of heart disease, dementia and osteoporosis) along with many other benefits. In those days we were afraid that if we used hormone treatment we would get breast cancer. The risk is now deemed as very low. The biggest risk for breast cancer is aging and lifestyle (alcohol, smoking, being overweight and lack of exercise).

Be kind to yourself and stop striving for perfection

I feel for all the women of my generation that didn’t get the help they needed, have lost their careers and in many cases their relationships haven’t survived. Take a breath, seek help and empower yourself with knowledge.

To make an appointment with Dr Fiona Rennie or for more information visit genesis-dubai.com

Images: Supplied

From Harper’s Bazaar Arabia October 2025 Issue.