Is Perimenopause Secretly Sabotaging You at Work? –

Could perimenopause be the reason you’re not performing like you used to at work? Absolutely, says pharmacist Dr. Brandy Williams—the first and only Black woman to own a sterile compounding pharmacy in the state of Texas and the second in the nation.

Never heard of a compounding pharmacy? Unlike traditional pharmacies, which dispense mass-manufactured medications (one strength, one dosage form, one standard formula for everyone), compounding allows pharmacists to customize medications. That may mean adjusting the strength, changing the form from a capsule to a cream or injection, removing allergens or unnecessary dyes, or combining ingredients to improve outcomes.

“I discovered the power of compounding during my pharmacy training, and it completely changed the way I viewed patient care,” Dr. Williams says.

“I met a woman who had been struggling to find a hormone therapy that actually worked for her. The commercially available options contained fillers and inactive ingredients that her body simply could not tolerate, and no traditional pharmacy could customize the medication she needed,” she continues.

“I formulated a personalized compound specifically for her, and a couple of weeks later, she called me emotional, saying, ‘I finally feel like myself again.’ That moment stayed with me. It showed me that personalized medicine is not a luxury—for many patients, especially women navigating hormonal changes, it’s necessary healthcare.”

Dr. Williams went on to pursue advanced sterile compounding training and then built Revolution RX Compounding Pharmacy with a focus on precision medicine, hormone optimization, wellness therapies, and innovative compounded treatments, primarily through sterile preparations such as injectables, IV therapies, peptide formulations, and bioidentical hormone therapies.

Here, she shares what all Black women should know about their midlife hormonal health, and especially how it may be affecting them professionally.

What do you wish every woman knew about perimenopause?

Perimenopause does not begin the day your periods stop. It begins years before menopause, and many women are experiencing symptoms without even realizing their hormones are shifting. For some women, those changes can begin as early as mid-30s or early 40s.

The earliest signs are often subtle and frequently dismissed: disrupted sleep, waking up in the middle of the night, brain fog, increased anxiety, mood changes, unexplained weight gain, fatigue, heart palpitations, low libido, or changes in menstrual cycles. Many women start questioning themselves because nobody connected these symptoms to hormonal changes.

I want women to understand that these experiences are real, they are common, and they are not signs that you are “losing your mind.” They are often signs that hormones like estrogen, progesterone, and testosterone are fluctuating and declining.

Most importantly, I want women to know they do not have to suffer in silence or accept feeling unlike themselves as their new normal. There are options. There are solutions. Whether that involves lifestyle changes, nutrition, supplementation, stress management, bioidentical hormone therapy, or personalized wellness support, women deserve education, support, and access to care that helps them maintain their quality of life through every stage of womanhood.

Sometimes we feel like we’re losing our minds because doctors aren’t taking us seriously.

Medical gaslighting is a very real issue, and unfortunately, many Black women experience it far too often within the healthcare system. It happens when symptoms are minimized, dismissed, or explained away without a deeper evaluation of what may truly be happening in the body. Women are often told they’re “just stressed,” “just getting older,” or that their symptoms are simply something they have to live with.

For many Black women, this experience creates frustration, delayed treatment, and a loss of trust in healthcare altogether. Research continues to show disparities in how Black women’s pain, symptoms, and hormonal concerns are addressed compared to other populations, despite often experiencing more severe or longer-lasting symptoms during perimenopause and menopause.

One of the things I hear most from patients is, “I knew something was wrong, but I felt like nobody was listening to me.” That’s why patient advocacy and education are such a major part of what we do at Revolution RX Compounding Pharmacy. I believe women deserve to be heard, properly evaluated, and included in conversations about their own health. We are no longer suffering in silence!

My role is not to replace the physician, but to collaborate with healthcare providers to help patients access individualized solutions and feel empowered throughout their wellness journey. Sometimes healing begins the moment a woman finally feels seen and validated.

How are unmanaged perimenopause symptoms affecting women, specifically when it comes to work?

The impact of unmanaged perimenopause symptoms in the workplace is significant, yet often invisible. Many women are navigating brain fog, sleep disruption, chronic fatigue, anxiety, mood changes, and difficulty concentrating while still managing demanding careers, leadership roles, businesses, and families.

These symptoms can affect productivity, confidence, decision-making, communication, and overall workplace performance. Sleep disturbances alone can leave women functioning on exhaustion while still being expected to perform at a high level professionally.

What makes it even more challenging is that many women suffer silently because perimenopause and menopause are still stigmatized. Instead of seeking support, many begin questioning themselves personally and professionally. Normalizing these conversations is critical because women should not have to choose between their wellness and their professional success.

Can you share some effective strategies for managing those symptoms?

One of the most effective things women can do is start tracking their symptoms. Pay attention to patterns—such as sleep changes, anxiety, brain fog, fatigue, mood shifts, cycle irregularities, or hot flashes—because that information helps both the patient and the provider better understand what’s happening hormonally. Data is power.

It’s also important to work with a healthcare provider who listens and takes your concerns seriously. Women should feel empowered to advocate for themselves and ask questions about all available treatment options, including hormone support when appropriate.

Lifestyle matters, too. Prioritizing protein intake to help maintain muscle mass, focusing on quality sleep, incorporating stress-reduction practices like deep breathing or mindfulness, and staying hydrated can all make a meaningful difference in symptom management during perimenopause.

Strategic supplementation is important as well. Magnesium can support sleep quality, mood regulation, muscle function, and stress response, while vitamin D plays a critical role in immune health, mood support, and maintaining bone strength. Calcium and vitamin K2 are also beneficial, especially as hormonal changes increase the risk of bone loss. Vitamin K2 helps direct calcium into the bones where it belongs, supporting both bone density and cardiovascular health.

For some women, bioidentical hormone therapy can also be a valuable tool. Through a compounding pharmacy, therapies can often be customized to fit an individual patient’s needs, symptoms, and treatment goals.

And finally, community matters. So many women think they’re experiencing this alone, when in reality millions of women are navigating the same transition. That’s one of the reasons I created the Midlife Method RX (a Skool community)—to give women education, support, and a safe space to have honest conversations about midlife wellness, hormones, and healing.