We Need to Talk About Perimenopause

It's a milestone health experience that may come for us all...so why are we so clueless?

- By Hannah Chubb

As a former marketing executive, Kerri Devine spent her entire career responding to crises. So it was a shock to everyone herself included-when one day, in her mid-40s, she had a complete meltdown in the middle of a craft store. It was so bad that she left with a mild concussion (don't ask). "But I never even thought about going to a doctor for it," she says. She just chalked it up to stress and the insomnia and anxiety she'd been dealing with for years. Until a friend suggested it could be something else entirely.

Most of us are familiar with and getting more comfortable with the idea of menopause thanks in no small part to the way pop culture has embraced the previously hushed-up "life change." (See: an entire plotline in Sex and the City 2 and candid commentary by A-listers like Gwyneth Paltrow and Oprah.) But its precursor, perimenopause, not so much. A recent study found that 60 percent of women over the age of 40 said they felt "not informed at all" on the topic, even though it can be a yearslong, mind- and body-altering event.

Perimenopause usually arrives in a woman's mid-40s (although sometimes as early as mid-30s), when the body's levels of estrogen and progesterone start fluctuating, explains Samantha M. Dunham, MD, codirector of the Center for Midlife Health and Menopause at NYU Langone Health. It typically lasts four to eight years and ends when you officially hit menopause, signaled by a full year without a period.