If you spend any time on social media lately, you have probably heard the word perimenopause more than ever before. TikTok, Instagram, podcasts, you name it. Suddenly, everyone seems to be talking about hormones.
So, is perimenopause just another wellness trend?
Absolutely not.
What has changed is not perimenopause itself. Women are simply becoming more aware of this phase of their lives, talking about their symptoms, and realizing that they don't necessarily have to just “deal with it.”
What Is Perimenopause?
Perimenopause is the transitional phase that happens before menopause, when ovarian hormone production begins to change and fluctuate. And I sometimes describe it to my patients as another round of adolescence except this time, you have a career, a family, responsibilities, and absolutely no time for your hormones to be all over the place.
For some women, the transition is relatively smooth. For others, it can feel like a storm where everything seems to be happening at the same time.
Your periods may suddenly become heavier, lighter, longer, shorter, or simply unpredictable.
You may start waking up in the middle of the night even though you never had sleep problems before.
Your energy isn't what it used to be.
Your libido disappears.
Your body composition starts changing despite eating and exercising the same way you always have.
And then there are the symptoms that women don't always immediately connect with hormones:
brain fog, anxiety, irritability, headaches, joint discomfort, vaginal dryness, heart palpitations, hot flashes, night sweats, and changes in mood.
Sound familiar?
Why Does It Feel So Complicated?
Hormones don't work independently.
Estrogen, progesterone, testosterone, thyroid hormones, cortisol, insulin, and other metabolic signals interact with one another.
That's one reason I don't believe women's hormone care should be reduced to simply checking one hormone level and calling it a day.
Women are also hormonally more complex than men. Our hormones naturally fluctuate throughout the menstrual cycle, and during perimenopause those patterns can become increasingly unpredictable.
That means the conversation needs to include more than, “Are you still getting your period?”
We need to look at your symptoms, menstrual history, sleep, sexual health, metabolic health, lifestyle, medications, appropriate laboratory testing, and your individual risk factors.
The Goal Is to Feel Like Yourself Again
Perimenopause doesn't automatically mean that you need hormone replacement therapy, and there isn't one treatment plan that works for every woman.
Depending on the individual, treatment may involve nutrition, resistance training, improving sleep, stress management, targeted supplementation, addressing metabolic health, or discussing whether menopausal hormone therapy is appropriate.
My goal isn't to chase a perfect hormone number.
It's to understand what is changing in your body and help you navigate this transition with the right information and an individualized plan.
Because getting older doesn't mean you should automatically accept feeling exhausted, disconnected from your body, or like you've suddenly lost yourself.
Perimenopause is real.
Your symptoms deserve to be heard.
And this phase of life deserves a real conversation not just a TikTok trend.
- Dr. B
