Perimenopause: It’s Time We Start Talking About It

Understanding the transition, advocating for change, and exploring mindfulness tools for the journey

Repeat after me: Perimenopause.

Again: Perimenopause.

And again: Perimenopause.

Why did I ask you to repeat it? Because I want people to become more comfortable talking about a topic that still seems taboo for so many.

Over the years, I’ve learned that the blogs I write that poke at taboo subjects often get the most nods. So, here we are—talking about something that, for far too long, has been hushed, ignored, and pushed to the side.

Perimenopause is a natural transition in a woman’s life when the hormones that have supported menstruation since puberty begin to fluctuate. This can cause erratic periods: sometimes skipped, sometimes more frequent, sometimes heavy, and sometimes light.

Basically, it’s a time in life when wearing white pants can feel risky.

In addition to the lovely inconsistencies of our flow, erratic periods can be accompanied by mood fluctuations and mood swings—which can be quite scary. One moment, you’re smiling, and the next, you’re flying off the handle because the car in front of you didn’t take off the second the light turned green.

And that’s assuming you’re even paying attention to traffic and aren’t distracted by the million ads appearing in your Instagram feed about hormone replacement therapy (HRT), supplements ranging from collagen to magnesium, or some supermodel’s elixir that promises to make you look like her.

Sorry, not sorry, but you won’t.

It’s marketing doing what marketing does. And quite frankly, supermodels showing off toned abs at 60 are not the norm. Those images are often designed to make you feel as though you need to buy something—or worse, that there is something wrong with you.

There can also be disturbed sleep and waking at the ungodly hours of 2:00 to 4:00 a.m.

There may be changes in body weight—often not in our favor—and stubborn weight can seem to settle around the hips, belly, arms, neck, face...well, frankly, all over.

Then there are changes to the skin. The plumpness isn’t quite as plump. Hair may thin or fall out, which you might notice in your ponytail or at the salon when your blowouts take half the time they used to.

Plus, there can be brittle fingernails and toenails.

Corners missing from your big toenails?

Yeah, me too.

There can also be a loss of sex drive, leaving you wondering if you’ll ever get that spark back. And if not, you may start asking yourself, Is my sex life really over? I’m only 48.

Oh, and your eyesight may begin to change—or the prescription you already have may get stronger.

Then there’s walking into the kitchen and forgetting why you went in, only to find yourself reaching for the Yasso bars. But because they’re only 140 calories, you have two and convince yourself that you deserve the sugar.

And not because you’re replacing sex.

You’re simply craving the damn sugar.

You may hope and pray that people cancel plans. You may love your robe, sweatpants, and animals even more. The vitamin store becomes fun, as does pickleball, and you develop a newfound appreciation for air conditioning.

Yoga becomes heaven because you don’t have to talk to anyone.

Because if you do, you just may snap for no reason at all.

So, now that we’ve put some of these symptoms out there, what the heck do we do?

Many of us start by going to our primary care doctor, only to feel dismissed with comments such as, “It is what it is,” or to be quickly presented with treatment options without much discussion about the full picture.

Then you go to yoga, and your kind teacher says, “Just be kinder to yourself right now.”

Although that is true—and I have personally said it more than 100 times in recent months to my students and to myself—I’m sure many people have wanted to punch me after hearing that statement.

Sometimes, I want to hush my own self up with that hyper-positive babble.

Now, I am not saying that all doctors are dismissive. There are many wonderful, knowledgeable physicians who are doing important work in women’s health. However, the reality is that many women still struggle to have their symptoms recognized, understood, and properly addressed.

There has historically been far too little research and education focused specifically on perimenopause, menopause, and women’s health.

And before anyone says, “But there has been research,” yes—there has. The Women’s Health Initiative, one of the largest women’s health studies ever conducted, has provided important information about postmenopausal health, hormone therapy, heart disease, cancer, and osteoporosis.

But there is still so much we do not know.

The National Institutes of Health (NIH) has acknowledged the need for additional research to help women and healthcare providers better understand and navigate the menopausal transition.

As the NIH states:

“More research is needed to help women and their health care providers effectively navigate the menopausal transition and promote well-being through midlife and beyond.”

That statement matters.

Because perimenopause is not a new experience. Women have been going through this transition for generations. What is new is that more women are speaking openly about it—and asking why research, education, and healthcare systems have not always kept up.

We need more research focused specifically on the perimenopausal transition: why symptoms vary so dramatically from person to person, why some women experience debilitating symptoms while others do not, how hormonal changes affect the brain and body, and which treatments and lifestyle approaches are most effective for different people.

The issue is not that women are suddenly becoming more vocal about perimenopause. The issue is that women have been experiencing it all along—and the research, education, and healthcare systems have not always kept up.

Much of medical research has historically centered men, leaving significant gaps in our understanding of women’s bodies and experiences. Even when women have been included in research, the unique effects of hormonal changes throughout the female lifespan have not always received the attention they deserve.

Do men’s and women’s health have anything to do with one another?

Of course.

But are our bodies identical?

Not even close.

The system is outdated. The research needs more support. Medical education needs to improve. Healthcare providers need better tools and training to recognize and address the many ways perimenopause can affect a person’s physical, emotional, cognitive, and sexual well-being.

Something must change—and it starts at the top.

Simply put: Legislation must change.

But what does that actually mean?

It means dedicating more federal funding to perimenopause and menopause research. It means supporting clinical studies that examine the full range of symptoms and experiences—not just what happens after menopause. It means improving education for medical students and healthcare providers so that women are not routinely dismissed, misdiagnosed, or left to figure things out through Instagram ads and late-night internet searches.

It also means improving access to evidence-based care and treatment, expanding insurance coverage, funding public-health education, and creating workplace policies that recognize the very real impact that disruptive symptoms can have on a person’s quality of life and ability to work.

And progress is beginning.

Menopause-related legislation has been introduced in more than half of the United States, with states exploring ways to improve education, healthcare access, treatment coverage, and workplace support.

That matters.

Because legislation can help turn awareness into action.

Awareness can start a conversation.

Advocacy can create pressure.

But policy can help direct funding, improve education, expand access to care, and create lasting change.

There are wonderful doctors, researchers, and advocates working to move women’s health forward. Dr. Mary Claire Haver is one of them.

I read her book, The New Perimenopause, and I was basically fist-pumping as I read it. Her words made me feel less alone during this transition. She helped normalize an experience that so many women are going through but still feel uncomfortable discussing.

She also speaks about the importance of advocacy and legislative change—not simply because women deserve to be heard, but because being heard can lead to more funding, better research, improved medical education, and more knowledgeable healthcare providers.

So that women can do better.

And, quite frankly, so the men in our lives can do better, too.

In the meantime, read Dr. Haver’s books, get on your yoga mat, and yes, be kind to yourself.

I say that lightly (wink, wink).

And if you feel called to explore this transition through a mindfulness-based lens, read my guide to navigating perimenopause mindfully. You can find it on Amazon here.

The information shared in this article is intended for educational and informational purposes and is not a substitute for medical advice. Please consult a qualified healthcare professional regarding your individual health concerns, symptoms, and treatment options.

A Note on the Research

Information in this article is informed by The New Perimenopause by Dr. Mary Claire Haver, research and resources from the National Institutes of Health, and current menopause advocacy and legislative initiatives.

For additional mindfulness articles and resources, visit the One Yoga International blog: One Yoga International News.