Last spring, a small group of women met at the Beaverbrook Estate in Surrey, England, a 470-acre country idyll outside London that has already hosted guests including Elizabeth Taylor and Ian Fleming. The sprawling property, which has become a destination for wellness programs offering everything from lectures on traditional Chinese massage to Wim Hof’s cold plunges, had drawn attendees for a women’s health retreat. Topics included abdominal massage therapy and guided lectures on estrogen depletion. “It’s the first time we’ve been so many,” said a gut health expert. Amanda Porter relayed to the group, adding the staggering statistic that almost a billion women are expected to experience the onset of symptoms including hot flashes and brain fog by 2025. These are the many, confused, perimenopausal.
“Think of it like puberty,” says Jen Gunter, MD, Canadian-American gynecologist and author of The Menopause Manifesto. “There really isn’t a hard start date, and you don’t know you’re there until you’re really inside. She goes on to describe an often undiagnosed array of symptoms associated with perimenopause, which precedes menopause (when you’ve gone 12 consecutive months without a period) and can begin as early as your mid-30s: cycle irregularities, increased anxiety, and depression, insomnia, night sweats, weight gain, decimated libido. A lack of visibility does not help. When I turned 43, feeling utterly unequipped for my own experience with mood swings and spontaneously heavy periods — and without the help of my doctor — I found myself Googling “flash periods” after an episode of And just like that… (the one where Charlotte memorably bleeds through a white jumpsuit at a charity paint party). “There was just this lack of information and support,” actor Naomi Watts admitted when we broached the subject earlier this year. “I had enough of it.” In September, Watts will join an increasingly vocal group of entrepreneurs, celebrities and medical providers determined to change that dynamic when she launches a new wellness brand focused on perimenopause and menopause with the biotech company. of Bay Area Amyris.
It’s true that hormones – their unpredictability and ripple effect on how we look and feel – are increasingly part of the beauty conversation. “The first part of perimenopause is usually characterized by fluctuating, but still quite high, estrogen levels and falling progesterone levels. And then the second part has to do with estrogen going down very quickly” says Anna Barbieri, MD, an obstetrician at Mount Sinai Hospital in New York City. Hormone replacement therapy (HRT), in which synthetic versions of these hormones can bolster dwindling supplies, remains a proven treatment. “Any of us entering or going through this transition should be aware of the hormone therapy option and its risks and benefits,” says Barbieri, who is also the founding physician of Electra Health, a digital women’s health platform offering one-on-one virtual menopause care with credentialed providers and accountability counselors known as “menopause doulas.” But now there are also products such as Kindra hot flushes and night sweats. Refreshing mist; Wile drinks your feelings, an adaptogenic anti-stress powder that can be mixed with your daily matcha; and soothing the skin Meditation Cream-Gel from Knours, a whole range of treatments adapted to fluctuating cycles. Veracitya six-product skincare line formulated to address indirect issues, including excess oil production and thinning skin, recently inspired a hormone-balancing facial at Well, Manhattan’s bustling destination for conscious beauty. A 60 minute treatment left my skin much less inflamed than usual and my soul soothed.
Despite an increase in home diagnostic tests of Thriva and Everlywell, there is no clinically proven way to test for perimenopause. “Anyone who tells you we can just measure your estrogen and progesterone is giving you some bullshit,” says Alicia Jackson, PhD, founder of Still, a telehealth company that aims to provide patients with 24/7 online perimenopause support, as well as virtual hormone therapy plans. This is because our hormone levels during this transition vary wildly from day to day, so testing them for a quantifiable diagnosis is unreliable. “There is no set value for them,” agrees Barbieri. What hormonal test box helping, she says, is to rule out other conditions (like thyroid abnormalities, for example) that can often present as perimenopause. Somi Javaid, MD, a Cincinnati-based obstetrician, uses hormone testing to HerMDpractice she runs in Ohio and Kentucky, for a different reason: “If women see that their FSH [follicle-stimulating hormone]responsible for controlling our menstrual cycles, increases and their estrogen and testosterone levels decrease, I may not be able to tell them that they are in perimenopause, but it helps them understand that some things continues,” says Javaid, adding that this type of validation is extremely important: “So many women who complain about perimenopausal symptoms get fired.”
According to a recent report published in The New York Times, female patients – and especially women of color – are far more likely than men to undergo some kind of medical gaslighting (in which legitimate symptoms are invalidated by doctors); when it comes to perimenopause, this rejection may be even more widespread. Stacy London has experienced this. The longtime fashion stylist’s hormonal transition at age 46 had a number of typical markers. “I started feeling anxious all the time, my skin got worse, my joints were sore, I had insomnia and terrible brain fog,” says London. “I thought my brain was shorted out, because I couldn’t remember the words.” The London doctor acknowledged his symptoms but provided little recourse for treatment. “She said, ‘It’s just menopause, you’ll be fine,'” London recalled. The experience compelled her to join State ofa skin and body care line she became CEO of in 2021 that aims to give the menopause transition a makeover, one beautifully packaged tube of joint cream at a time.