Perimenopause Is Real — And Women Deserve Better Care

Perimenopause should not be a mystery, a punchline, or a dismissal. Yet time and time again, I hear the same painful story from patients: They were told their symptoms were “in their head.”They were told to “wait it out.”They were told it was “just stress,” even as their bodies, relationships, and daily functioning were unraveling.

These women are not imagining their symptoms. They are not overreacting. And they are certainly not at fault.

The Cost of Being Ignored

When perimenopause goes untreated, the consequences ripple far beyond hot flashes or irregular periods. Many women spend years bouncing between specialists, urgent care visits, supplements, and online programs—accumulating medical debt while still not getting answers. Others miss work because their symptoms are debilitating: insomnia, brain fog, anxiety, heavy bleeding, migraines, joint pain, and more.

This is not a personal failure. It’s a failure of the healthcare system to take women’s midlife health seriously.

The Evidence Is Clear: Treatment Helps

Decades of high‑quality research show that evidence‑based treatment can dramatically improve:

• Daily functioning

• Mood and cognitive clarity

• Sleep

• Sexual health

• Quality of life

Treatment is not one‑size‑fits‑all. It depends on symptoms, risk factors, personal preferences, and how someone tolerates different options. But the toolbox is real, effective, and safer than many people have been led to believe.

The Menopause Society: A Trusted Source for Evidence‑Based Care

The Menopause Society (formerly NAMS) remains one of the most respected authorities on menopause care. Their 2022 Hormone Therapy Position Statement is clear: Hormone therapy is the most effective treatment for vasomotor symptoms and genitourinary syndrome of menopause, and for most healthy women under age 60 or within 10 years of menopause onset, the benefits outweigh the risks.

This statement reflects a major shift away from outdated fear‑based messaging that left generations of women untreated. It also aligns with the recent removal of the black box warning on estrogen—another step toward correcting decades of misinformation.

Patients can explore their educational materials here: The Menopause Society – Patient Resourceshttps://menopause.org/patient-education

Primary Care Is Stepping Up

More and more primary care physicians are going out of their way to stay updated on the latest menopause research. Many of us are committed to providing thoughtful, individualized care—not quick prescriptions from a provider you never meet, never hear from, and who doesn’t know your history, your values, or your goals.

You deserve someone who can look you in the eye and see whether you understand the plan. Someone who can pause and clarify. Someone who is not financially tied to selling you a compounded hormone or pushing a product.

I do not profit from any medication I prescribe. My fulfillment comes from something far more meaningful:

A patient telling me she finally feels like herself again.

A woman saying she can think clearly at work.

A partner sharing that intimacy no longer feels painful or impossible.

A person who has spent years being dismissed finally feeling heard—and no longer gaslit.

You Deserve Care That Honors Your Perimenopause Experience

Perimenopause is a major physiological transition, not a character flaw. It deserves the same seriousness, compassion, and evidence‑based approach as any other medical condition.

If you’ve been dismissed before, please know this:

Your symptoms are real.

Your suffering is valid.

And with the right care, you can feel better.

References

1. The Menopause Society. The 2022 Hormone Therapy Position Statement of The Menopause Society. Published 2022. Accessed January 19, 2026. https://menopause.org

2. National Menopause Foundation. Menopause Symptom Checklist. Published 2024. Accessed January 19, 2026. https://nationalmenopausefoundation.org/wp-content/uploads/2024/10/NMF_SymptomChecklist2024_ENG-.pdf (nationalmenopausefoundation.org in Bing)

3. Lumsden MA, Dekkers OM, Faubion SS, et al. European Society of Endocrinology clinical practice guideline for evaluation and management of menopause and the perimenopause. Eur J Endocrinol. 2025;193(4):G49‑G81.

4. Duralde ER, Sobel TH, Manson JE. Management of perimenopausal and menopausal symptoms. BMJ. 2023;382:e072612.

5. American College of Obstetricians and Gynecologists. Menopause. Accessed January 19, 2026. https://www.acog.org/womens-health/faqs/menopause (acog.org in Bing)

6. European Society of Endocrinology. Press release: ESE announces new Clinical Practice Guideline for Management and Evaluation of Menopause and the Perimenopause. Published October 22, 2025. Accessed January 19, 2026.

7. Krewson C. New guideline on menopause and perimenopause management released. Contemporary OB/GYN. Published October 29, 2025. Accessed January 19, 2026.