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3 Private Health Questions About Perimenopause, Breast Cancer, and Sleep Aids, Answered by a Doctor

During a doctor’s visit, you may get a little hesitant to ask questions relating to your private health. But, it’s still important to get those answers in order to stay healthy and feel comfortable. We spoke to gynecologist Barbara DePree, MD, to answer three questions relating to perimenopause and clumsiness, the correlation between soy and breast cancer, and sleep aids.

Q: I’m 45 and so clumsy lately — bumping into things, dropping my keys and losing my balance, and every little thing seems to cause a bruise! My friend said it could be a sign that I’m in perimenopause, but I’ve never heard that. Help!

A: Believe it or not, your friend is right: Clumsiness and easy bruising are lesser-known but common symptoms of perimenopause. They also can occur in the week before your period, when fluctuating progesterone triggers fluid retention in the inner ear, which can lead to dizziness. The culprit in both instances: waning levels of estrogen, which affects fine motor skills and can leave you feeling unsteady or off-balance. Estrogen dips also trigger the skin to lose moisture, elasticity, and its protective fatty layer, causing bruises to develop more easily.

Thankfully, once you hit menopause, these symptoms often stabilize. Until then, I recommend working gentle exercises like yoga into your daily routine to help restore your balance and flexibility and guard against falls. (Search “balance” on for free instructional videos for all fitness levels.) Another option would be to try using a balance board, also called a wobble board (like this one from ProsourceFit), for just 10 minutes each day. It’s an effective way to strengthen large muscle groups in the legs that support balance and stability.

Finally, if you’ve recently started taking blood thinners or a fish oil supplement, this could be making your bruising worse, as both reduce the ability of your blood to clot. So if you bump yourself, the blood is more likely to leak from the tiny capillaries and cause bruising. If this is the case for you, I recommend speaking to your primary care doctor, who can offer targeted treatment options.

Q: I have a family history of breast cancer and started avoiding soy a few years ago after I read it’s off-limits. But I’m a vegetarian and I really miss tofu and soy lattes. Is it okay to have a little?

A: Yes! Because high estrogen levels are found in certain breast tumors, experts long believed soy foods increased breast cancer risk and should be avoided by women with a family history of the condition. But research now suggests that you can safely enjoy one to two servings per day of whole soy foods. In fact, some studies have found eating soy-based foods may even lower the risk of breast cancer. Bonus: Soy contains protein and fiber, and they provide other health benefits, like nixing constipation and helping you feel fuller longer, which can help you avoid weight gain.

And there are other smart strategies I can suggest for reducing your breast cancer risk: exercising regularly, eating plenty of fruits, vegetables, and whole grains, and limiting alcohol and foods high in saturated fats.

Q: My doctor suggested a sleep medicine to tame my night sweats, but I prefer a natural fix. Can you help?

A: I can. Up to 80 percent of women experience night sweats during the menopause transition. And symptoms may worsen in the summer, due to the excess demand the hot weather puts on the hypothalamus — the gland that regulates body temperature.

A small study did show that women using the prescription sleep drug Belsomra saw a reduction in night sweats after four weeks, but since you prefer a natural approach, I suggest supplementing with 400 IU of vitamin E daily. Researchers in Gynecologic and Obstetric Investigation found that doing so led to a 24 percent drop in hot-flash severity and a 36 percent drop in frequency of night sweats after four weeks. Also smart: avoiding alcohol and spicy foods, which can raise your core body temperature and make night sweats more likely.

Put FIRST to work for you!

Barbara DePree, MD, is a gynecologist in private practice and director of Women’s Midlife Services at Michigan’s Holland Hospital. A Certified Menopause Practitioner, she is the founder of, an educational resource for women’s sexual health in perimenopause and beyond. To ask her a question, send an email to

This article originally appeared in our print magazine, First For Women.

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