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Elle
a day ago
- Health
- Elle
How Perimenopause Became the New Midlife Catchall for Aging Women
Every item on this page was chosen by an ELLE editor. We may earn commission on some of the items you choose to buy. We have reached peak perimenopause. And I don't mean that I have reached peak perimenopause, though maybe I have, I'm not sure. There's no definitive test for it, but as the saying goes: 'You'll know it when you see it.' So let's look in my mirror: I'm 44. Sometimes at night I get hot. I've been a bit moody lately. Occasionally, I'll notice something that ordinarily I wouldn't think twice about—a child holding his mother's hand, an older couple, deep in conversation—and start to cry, right there on a New York City street. I'm an ice queen by nature, so it's got to be my changing hormones. Right? What began a few years ago as an eye-opening conversation about women's health—no one told us we were going to experience a mini-menopause! A decade before actual menopause! This stinks!—has gone mass, to the point that perimenopause is now just shorthand for 'I'm in my 40s.' The watershed moment happened in 2023, when Hollywood babe Naomi Watts went public about her experiences with early menopause, introducing many to the word 'perimenopause,' and using her platform to destigmatize this time in a woman's life, which had previously been only whispered about as 'the change.' Shudder. The same year, a cover story about menopause ran in the New York Times magazine that went into detail about the author's perimenopause symptoms. Every woman of a certain age and demographic emailed it to each other with subject lines like, 'THIS IS WHY I'M SO SWEATY,' and 'I'm going on estrogen…right now!' Suddenly it was everywhere: in books (The New Menopause; Hot and Bothered; It's Not Hysteria; Millennial Menopause), articles, podcasts ('Perimenopause Power,' 'Hello, Hot Flash'), and on social media, where funny #perimenopause memes flooded my feed, the algorithm seemingly well aware of both my age and penchant for time wasting. Perimenopause, for those who are living under a rock—or who are, you know, male—is defined as the years of hormonal fluctuations leading up to menopause, the point at which a woman hasn't had a menstrual cycle for 12 months. Lately, I cannot attend moms' drinks without the subject coming up, whether it's someone sharing how they had to change sweat-soaked pajamas in the middle of the night, or confessing that they screamed at their children in a fit of hormonal anger. I was at a recent dinner with an old college roommate, and, as is often the case, talk went to perimenopause as we began comparing our symptoms as if rattling off medieval ailments—achy bones; flaky skin; hair loss. We laughed as my friend told me a story about her 'gushing blood,' having a grand old time until we noticed that the table of young finance bros next to us was listening in, quaking in fear. (Sorry to ruin your meal, guys, but at some point you too will have a wife who bleeds through her pants. Cheers!) The last time I knew so much about my friends' menstrual cycles was when we were 12, and it was a question of if you'd gotten it or not. Now it's a question of: How many times this month? Three? Women's reproductive health has been routinely understudied, and so the burst of interest in perimenopause is, on the whole, a great thing. My cohort and I feel lucky that we have information about this life stage that our mothers did not, though at the same time, knowing that we're entering this process, and all that goes with it, doesn't exactly feel great, either. We should be at the height of our powers; peak career time, kids who are out of diapers, still relatively attractive. But instead of being able to enjoy it we're all focused on our inevitable lurch towards the big M. Decline is on the horizon, ruining our day in the sun. When women feel out of control—or fat, or ugly, or old—what makes them feel better? Products! Many companies have jumped on the opportunity to profit off of the perimenopause surge, from telehealth startups, to vitamin ventures, to businesses making vaginal gels, hair masks, skin oils, and cooling towels, none of which I have bought, but many of which look bright and fun and cute. By 2033, the global menopause market, which includes products aimed at both perimenopause and menopause, is estimated to be more than $25 billion. There are perimenopause tracker apps, and jewelry that claims to relieve symptoms, and for $19.99, you can buy a Clearblue test to pee on that will inform you where you are in your perimenopause journey. (Instead of indicating you're pregnant, those two lines now just mean you're a grump.) But for all the positives, I can't get rid of the nagging sense that perimenopause—or rather, Perimenopause™—has gotten out of control, morphing into yet another cultural catchall, putting a medical term on what used to just be called 'aging.' Because it has so many potential symptoms—the list includes, among other things, mood swings, low libido, weight gain, sleep disturbances, joint pain, irregular periods, anxiety, depression, memory problems, skin changes—it's become a kind of dumping ground for the range of normal human emotions and experiences. I'm reminded of that moment a decade ago, when anyone who was shy, or a little quirky, or couldn't sit through a movie was suddenly 'on the spectrum' or self-diagnosed with ADHD. You couldn't just be an oddball anymore, it had to be a diagnosable condition. And now, I can't just be a 44-year-old woman; instead, I am perimenopausal. When I'm feeling a little bloated? It's definitely perimenopause, not that cheese plate I devoured. Snappy with my children? Perimenopause—sorry, boys! Woke up in the middle of the night? Pesky perimenopause, certainly not the two large glasses of red wine I had at dinner. Oprah said perimenopause gave her insomnia—'For two years I didn't sleep well. Never a full night. No peace,' she said. Salma Hayek said it caused her breasts to grow. 'A lot of people said that I had breast augmentation, but they have just kept growing. Many, many sizes.' And Gwyneth Paltrow said it made her sweaty and moody: 'You're all of a sudden furious for no reason.' Some of this is most certainly true. I am definitely hot at random times, and I never used to be hot. And my period is…weird. But let's say it all together now: It's not always perimenopause. It can't be. The fact that I forgot to put cookies in my kid's lunchbox? I was thinking about something else, and I just, well, forgot. My leg hurts because I banged it into the side of my bed. My skin is dry because I've always had dry skin in the winter. My sleep sucks because I'm 44 and not 24, and my mind is circling a drain of mortgages and parent-teacher conferences and unfulfilled career goals instead of just, like, which bar I'm going to that weekend. No supplement is going to reverse that fact, no matter how much I'm willing to pay for it. Here's another idea—and we all have to agree to have this be our little secret. I'm not against weaponizing perimenopause when I need to, so long as we're honest with each other that we're doing so. I'll even go one step further and say we deserve this, after everything we've been through. Remember when we used to lie about having our periods to get out of swimming at school? And who amongst us hasn't faked a heavy flow to avoid sex? I'm fine with it if you're fine with it, but we just can't tell the men. The other day, my husband and I got into an argument about something or other, I can't remember what (brain fog is a symptom of perimenopause). I was dismissive of him and slightly irrational throughout. Afterwards, when I went to apologize, I cited the raging hormones that have besieged my perimenopausal body. 'No, Emma,' he said. 'That's just your personality.' And so then I yelled at him again. Might as well use the excuse while it lasts! After menopause, I'll just be a regular old bitch again. Emma Rosenblum is the national bestselling author of Bad Summer People, Very Bad Company, and Mean Moms. She's the former chief content officer at Bustle Digital Group, overseeing content and strategy for BDG's editorial portfolios. Prior to BDG, Emma served as the executive editor of ELLE. Previously Rosenblum was a senior editor at Bloomberg Businessweek, and before that a senior editor at Glamour. She began her career at New York magazine. She lives in New York City, with her husband and two sons.
CNN
11-07-2025
- Health
- CNN
In what some call a ‘national movement,' more than a dozen states introduce menopause bills
There's a new wave of interest in improving menopause care in the United States – it's in books, on podcasts and dominating social media hashtags – and it's even generating new legislation across more than a dozen states. From New York to California, lawmakers are weighing whether to support more menopause training for clinicians or mandate comprehensive insurance coverage for menopause treatment. Advocates of such legislation argue that these changes could improve access to care and reduce the risk that menopause symptoms will be dismissed by providers. At least two dozen bills have been introduced across 15 states this year, according to data from Jennifer Weiss-Wolf, executive director of the Birnbaum Women's Leadership Center at the New York University School of Law, and her colleagues who have been tracking menopause legislation. Most of the legislation is related to insurance coverage for menopause care, awareness and education, clinician training or menopause in the workplace. When it comes to menopause care, there continues to be a 'lack of standardized treatment protocols' and 'inadequate insurance coverage for evidence-based therapies like hormone replacement,' Dr. Mary Claire Haver, an ob/gyn at the Mary Claire Wellness Clinic in Galveston, Texas, and author of the book 'The New Menopause,' said in an email. She hopes that some of the new legislation introduced this year – and future policies – may change that. Menopause is a natural phase of aging in which a woman has gone at least 12 consecutive months without a menstrual period due to a decline in her reproductive hormones. These hormonal changes can cause uncomfortable symptoms, including hot flashes, insomnia, vaginal and urinary problems, mood changes and weight gain, and can have long-term health implications. In the United States, an estimated 1.3 million women enter menopause each year, and most have symptoms. 'For decades, menopause has been overlooked in both clinical research and health care policy, largely because it affects women in midlife — a group that has historically been underrepresented and undervalued in medicine,' said Haver, who collaborated with Weiss-Wolf on developing A Citizen's Guide to Menopause Advocacy. 'Women in midlife are speaking out, demanding better care, and using their voices on platforms where they've historically been ignored,' she said. 'We're also seeing more female physicians, researchers, and public figures normalize the conversation around menopause — which is finally translating into policy discussions and workplace changes.' As the 2025 legislative session has come to an end in most states, some more recently introduced menopause bills may be up for action next year. Most of the bills may not become laws, but that's not a loss, said Weiss-Wolf, author of the book 'Periods Gone Public: Taking a Stand for Menstrual Equity.' 'This only sets us up for what I hope will be a really impactful, successful state legislative session in 2026,' she said. 'So, for me as an advocate, I'm not only marking success by bills passed, but just that the conversation has gotten to the point where state legislators are willing to step out on this issue.' Two bills introduced in March relate to raising awareness around menopause, according to Weiss-Wolf and her colleagues. One Illinois bill, passed in May, declares October 12-18 to be Menopause Awareness Week in the state. The other bill, introduced in Nevada, would have designated October as Menopause Awareness Month, but it was vetoed by the governor in June. Seven bills were introduced this year related to education, aiming to enable health care providers with more education about menopause treatment or requiring health departments to distribute educational resources for the public. One, in Maine, was signed by the governor and enacted last week. When it comes to enhancing menopause training for clinicians, California and New Jersey both introduced bills related to those themes this year. In California, legislation would require an assessment of physicians' education and training on menopause diagnosis and treatment. In New Jersey, the bill would permit up to three credits of continuing medical education on menopause to be used by providers to renew their licenses. Meanwhile, five bills have been introduced related to requiring insurance coverage for menopause care. One in New Jersey passed the Assembly, and one in Oregon is awaiting the governor's signature. 'This is absolutely a national movement, and the momentum is undeniable. It's not just happening in California — Washington State, Oregon, Illinois, and Louisiana have all had bills either introduced or successfully passed in this space, with most of them looking to create similar insurance coverage mandates,' California Assemblymember Rebecca Bauer-Kahan said in an email. This year, Bauer-Kahan introduced Assembly Bill 432, which would mandate coverage for menopause evaluation and treatment options, among other orders. She said the bill was born out of her own experience of having perimenopausal symptoms and being dismissed when she asked her doctors for care. 'I didn't know what was happening to me. So like many people would, I went to my internist. She said I was fine. But I knew I wasn't fine. I knew something was fundamentally wrong with my body. I went to my ob/gyn. Here I am, a woman in my mid-40s, telling my doctor that my brain isn't working properly, and once again, I was dismissed as 'fine,' ' Bauer-Kahan said in the email. 'Women are over half the population, and yet our healthcare system fails to provide us with the care we need as we age,' she wrote. 'This legislation closes the care gap, ensuring that menopause is treated as the central health need it is, not as an afterthought. We deserve comprehensive coverage and informed medical care, just like any other stage of life.' A Rhode Island bill related to menopause in the workplace was signed into law last week, making it the first state to enact workplace protections for menopausal women – and more could be coming. Legislation introduced this year in New York and New Jersey aims to address menopause in the workplace by preventing discrimination, extending workplace protections and requiring employers to allow remote work or paid leave for employees with symptoms. Then there are a few other bills, such as in Massachusetts and New York, related to a combination of menopause issues. 'What's particularly encouraging is that menopause crosses party lines,' Bauer-Kahan said. 'On the Assembly floor, my bill passed 70-1. This isn't a political issue; it's about recognizing that half our population deserves proper healthcare.' Of the menopause bills introduced this year so far, 11 are in committee, seven have passed in some capacity with four to be enacted, five either were vetoed or died in committee and one was amended. What appears to be a renewed interest in menopause policy comes after more than two decades of 'silence' around menopause, said Dr. Sharon Malone, chief medical adviser at Alloy Women's Health and author of the book 'Grown Woman Talk.' In 2002, a national Women's Health Initiative study was terminated early after it linked hormone therapy for menopause to an increased risk of breast cancer. The Women's Health Initiative is an ongoing research project conducted by the US National Institutes of Health, focused on preventing disease in older women. Although the objective of the study was never to test the use of menopausal hormone therapy to treat symptoms of menopause, and it was halted early without definitive findings, it had long-lasting impacts on menopause care in the United States. Many women stopped using hormone therapy because of the study, and some practitioners no longer recommended it for their patients. But since then, a growing body of research has found that the benefits of hormone therapy outweigh any small risks for most women with menopause symptoms, emphasizing that hormone therapy can be an effective way to treat symptoms because it helps replace the hormones that the body stops making during menopause. Next week, the US Food and Drug Administration plans to hold a public discussion about menopause and hormone replacement therapy for women. The panel will include FDA Commissioner Dr. Marty Makary and Dr. Sara Brenner, the agency's principal deputy commissioner, who are expected to discuss treatments, education and comprehensive care beyond managing symptoms. Years of physician training and research around menopause care and hormone therapy was lost after 2002, Malone said. 'We are still digging ourselves out of a hole of the past 23 years, understanding that there are 23 years of physicians who have not been trained in how to treat and how to deal with conditions of women during menopause. So, if you graduated from medical school and trained any time after the year 2000, you probably were never even given a fair discussion of hormone therapy,' Malone said. 'And the biggest problem that we're facing now is that there's 23 years of research that wasn't done because everybody took the Women's Health Initiative as the definitive answer, which it was not,' she said. 'If I could wave a magic wand, what I would do is eliminate the disinformation that's out there about hormone therapy.' Dr. Monica Christmas, an associate professor of obstetrics and gynecology at the University of Chicago and associate medical director for The Menopause Society, finished medical school and started residency around the time the Women's Health Initiative findings were released in the early 2000s. 'At that time, there was a lot of fear and trepidation around hormone therapy in particular,' said Christmas, who also serves as director of the menopause program at UChicago Medicine. 'I was fortunate that where I did residency, here in Chicago, I was trained by gynecologists who managed menopausal patients. Looking back on it now, they were probably menopausal themselves,' she said. 'And they were still fairly comfortable with prescribing hormone therapy and really understood what later the data came back to show – that, yes, there's this window of opportunity where the benefits seem to outweigh the risks for most people. That window is under the age of 60 or within 10 years of the onset of menopause.' Increased menopause awareness and additional education for providers are important issues, Christmas said, but she views extended coverage for menopause care and the treatment of symptoms as the most pressing matter. 'Physicians can have a wealth of knowledge, which they do; however, if the person's insurance doesn't cover treatment, then it stops there,' Christmas said, adding that it's not fair to put responsibility on health care practitioners alone to change the landscape of menopause care. 'The policy focus needs to be on ensuring comprehensive and equitable access to medical care, resources for innovative research and new treatment options, and supportive work conditions.'
Yahoo
09-07-2025
- Health
- Yahoo
Mary Claire Haver
Credit - Eric McCandless—Disney/Getty Images Fifteen percent of women glide through menopause. Dr. Mary Claire Haver was not among them, suffering debilitating hot flashes and sleepless nights. She also noticed that, even though the condition will affect about half the population, information on how to manage symptoms was hard to find. (Last year, a British study showed that only 9% of women felt informed enough to handle menopause.) So, the telegenic Dr. Haver, a board-certified ob-gyn based in Texas, stepped into the breach. In 2021, she opened her own clinic in Galveston; in 2023, she published a book on menopause diets; and in 2024, she followed up with The New Menopause, a comprehensive guide for women. Both sold briskly, but it's on social media where the 56-year-old's advice really lands—particularly on Instagram, where she speaks to her nearly 3 million followers, offering advice and talking through the latest research. Her guidance is considered aggressive by some menopause experts—she's an advocate for hormone therapy—and her promotion of her own supplements and diet plans has raised eyebrows. But her intelligence and candor have made her a staple for the 45-and-over set. As she told TIME last year, 'This is a time when we should be living our best lives.' Data and insights powered by #paid Contact us at letters@
Yahoo
09-07-2025
- Health
- Yahoo
Mary Claire Haver
Credit - Eric McCandless—Disney/Getty Images Fifteen percent of women glide through menopause. Dr. Mary Claire Haver was not among them, suffering debilitating hot flashes and sleepless nights. She also noticed that, even though the condition will affect about half the population, information on how to manage symptoms was hard to find. (Last year, a British study showed that only 9% of women felt informed enough to handle menopause.) So, the telegenic Dr. Haver, a board-certified ob-gyn based in Texas, stepped into the breach. In 2021, she opened her own clinic in Galveston; in 2023, she published a book on menopause diets; and in 2024, she followed up with The New Menopause, a comprehensive guide for women. Both sold briskly, but it's on social media where the 56-year-old's advice really lands—particularly on Instagram, where she speaks to her nearly 3 million followers, offering advice and talking through the latest research. Her guidance is considered aggressive by some menopause experts—she's an advocate for hormone therapy—and her promotion of her own supplements and diet plans has raised eyebrows. But her intelligence and candor have made her a staple for the 45-and-over set. As she told TIME last year, 'This is a time when we should be living our best lives.' Data and insights powered by #paid Contact us at letters@
Time Magazine
26-06-2025
- Health
- Time Magazine
Why Does Menopause Treatment Always Include a Diet?
We are finally, as a culture, having conversations about menopause. What was once spoken only in whispers, if at all, by our mothers and grandmothers, is now trending on TikTok. There is an abundance of books on the topic by everyone from physicians to researchers to Naomi Watts; emerging research, and concrete information to help women navigate the often sudden, severe, and frequently misdiagnosed physical, emotional, and mental health symptoms that go along with it. This is progress. Unfortunately, like so much in the women's health space, a disproportionate amount of the advice is weight loss-related, involving food restriction, fasting, and exercise. This is especially concerning, since according to experts in the field, women approaching menopause—a process known as 'perimenopause'—may be at an elevated risk for developing an eating disorder. Deprivation, along with a preoccupation with food, our bodies, and working out, only increases that vulnerability. Beginning in your 30s, 40s, or 50s, perimenopause can last anywhere from a few months to eight years. Twelve consecutive months without a period means you've entered menopause, but until then, there's an 'are we there yet?' quality. There are no concrete tools for diagnosis apart from the symptoms themselves. I'm in it now—I think. I'm around the 'right' age, and after decades of regular periods, sometimes I miss one. I don't (yet?) have any of the classic hallmarks like hot flashes, which is sort of the 'Born to Run' of perimenopause symptoms, and if you get that reference, you're probably in perimenopause, too. But I'm bracing for any others to come—the list is long and runs the gamut—insomnia, anxiety, brain fog, incontinence, high cholesterol, dental problems, and so many more. All the results of declining estrogen, a group of hormones which, in addition to sexual and reproductive health, impact bone density, metabolism, cholesterol, and just about every organ system in the body. Read More: 8 Signs You're in Perimenopause Weight gain happens, too, along with changes in shape, as fat redistributes around the mid-section of the body. It's often the first symptom that women notice, and the first thing we try to 'fix.' 'I think the unrealistic expectations for aging has led to much more of a consumer demand for advice and treatment about weight loss for women going through menopause,' said Jessica Baker, PhD, and senior research manager for Equip Health, which offers virtual eating disorder treatment. 'Of all the bodily changes that happen during this period of time, weight gain is the most talked about, publicized, and advertised.' The messages are everywhere. 'One of the main reasons people visit my office is this unwelcomed and often unexpected change,' Mary Claire Haver, MD, wrote in her best-selling book, The New Menopause, referring specifically to weight gain. Haver's book is groundbreaking in its outlining of the wide range of symptoms and compassion for those who are suffering. But it happens to also be filled with weight loss advice, including a nutrition tracking app, weight lifting, and intermittent fasting. Companies like Noom and Hers now offer menopause-specific weight loss programs. Recently, on the Today Show, Halle Berry's personal trainer demonstrated exercises for 'combatting' menopausal weight gain. But depending on a woman's history, all of this advice could encourage behaviors that push her toward the first steps of an unhealthy relationship with food and her body, says Cynthia Bulik, founding director of the University of North Carolina Center of Excellence for Eating Disorders, and one of the leading researchers in the field. ''You must eat at minimum 1200 mg of calcium per day and 1.0 g per kg of protein per day. You must take 12,500 steps per day to improve health and fight impending obesity.' All of these things, if rigidly adhered to, can be a trap and an entrée to an eating disorder or at least eating disorder behaviors,' Bulik says. Haver posted on Instagram that those who may be vulnerable to an eating disorder should not fast. What complicates the matter, though, is that many people with an eating disorder may not know they have one, and will never be properly diagnosed. I know this personally. I've struggled on and off for much of my life with eating disorders until, after multiple rounds of treatment and too many relapses to mention, I finally found something that worked. I was fortunate. By some estimates, only 20% of people with eating disorders get treatment, relapse rates are high, and most people never even get properly diagnosed. There is no standard of care for eating disorders in the U.S., despite the fact that they have among the highest mortality rates of any mental illness. Read More: What Recovery Looks Like When You Have an Eating Disorder Eating disorders are complex, often life-threatening illnesses that even experts in the field don't fully understand. Contributing factors include genetics, stress, trauma, and a culture that prizes thinness. Dieting is the most important predictor of developing an eating disorder, according to one of the largest studies done on the subject. All the focus on weight neglects the very real risk for developing an eating disorder during this phase of life, in part because eating disorders are still so often inaccurately stereotyped as only a teenage affliction. But about 60% of women with an eating disorder in midlife have had a previous one that was perhaps less severe, but reemerged during perimenopause. 'I consider puberty and menopause to be reproductive and metabolic bookends,' said Bulik. 'Both are marked by prolonged shifts in the hormonal milieu.' Hormone shifts affect mood, appetite and cravings. In addition to weight, menopause often brings changes in hair texture, thinning of skin, and vaginal dryness. 'All of these things can lead to intensified body dissatisfaction and even worse, body disgust and body hatred,' Bulik added. Personally, I feel solid in my own body acceptance (today, at least), but I want to be healthy, and it's so easy to conflate health with weight. Reviewing the protein recommendations in Haver's book— a certain number of grams per pound you weigh in order to maintain muscle mass—I found myself opening up MyFitnessPal, an app I haven't looked at since my own recovery from anorexia many years ago. My password, skinnybitch, was still saved. I told myself I wouldn't track calories—only protein. After three days of protein tracking, I quickly realized how easy it would be to go back down that obsessive road, and I stopped. Yes, I want to be strong as I age, but that includes mental health, too. Revising a preoccupation with food and my body would erode my hard-won recovery. While women lose muscle mass and bone density during the menopausal transition, and many have concerns about visceral fat, commonly called 'belly fat,' which resides in the abdominal wall, here is where our behaviors matter more than results. As one public health researcher told me when I was writing my book: You can control your behaviors. You can't control your weight. We would be well-advised to carry that guidance into menopause. Exercise benefits our health and reduces the risk of chronic diseases, whether we lose weight or not—a vast body of research supports this. Same for quitting smoking, getting a good night's sleep, limiting alcohol, and adding foods rich in omega-3s. Not to mention, people who eat a plant-based diet may have fewer hot flashes than those who do not, according to a recent study in Menopause, the journal of The Menopause Society. Most weight loss advice during this period, however, is not evidence based, Bulik pointed out. 'So often PCPs will say, 'It's going to be a lot harder to work off that hamburger at your age than it used to be,' (and) yes, there are some data behind those comments,'' she says. 'It is easier to gain weight when you are older, and your caloric requirements do go down. But the delivery is so negative and focuses on the loss of the previous self. How about, 'What are you planning to do nice for yourself with the money you save on tampons and pads every month?'' In The Menopause Brain, neuroscientist Lisa Mosconi also cautioned against intermittent fasting, encouraging instead eating mindfully, reducing stress, and practicing yoga. In so much of the new writing and advice on menopause, authors open with some version of: You're not crazy, and it's not in your head, validating women's symptoms, which for centuries, and even today, still often go undiagnosed. I wish they would extend that compassion to the way our bodies look, too. And for menopause to be the time in a woman's life where—finally—her body is just fine the way it is.
