Welcome to the age of wearable tech, TikTok trends, and oat milk lattes... and yet somehow, perimenopause still gets treated like a feral possum (Avoid, ignore, pretend you don't see all the mess). But not anymore. We’re dragging it out into the daylight (not the possum, just the perimenopause 😉) —where the real heat is coming from our internal thermostat gone rogue.

Whether you’re here because your sleep sucks, your jeans don’t fit anymore, or you’ve cried over a squirrel in a commercial (again), welcome. Let’s talk about Perimenopause in the 21st Century—what it is, what it’s always been, and how we’re finally starting to see solutions on the horizon....

What Even Is Perimenopause?

Ah, perimenopause. The pre-party to menopause, except nobody RSVP’d and the music’s just someone sobbing to Adele.

Scientifically speaking, perimenopause refers to the transitional years leading up to menopause—the point at which a woman hasn’t had a period for 12 months. Perimenopause can start as early as your mid-30s (yes, really) but most women begin noticing symptoms in their 40s, with the average age of menopause being around 51 in the U.S. (North American Menopause Society, 2022).

Estrogen levels become erratic—rising and falling unpredictably—while progesterone gradually declines due to fewer ovulations. These hormonal changes affect the brain, metabolism, mood, sleep, and temperature regulation. Symptoms like hot flashes, anxiety, irregular periods, and fatigue are common.

It's a hormonal rollercoaster...

• Estrogen levels fluctuate like crypto prices.
• Progesterone does a disappearing act.
• Periods go from clockwork to abstract art.
• Hot flashes, night sweats, mood swings, anxiety, weight gain, fatigue, brain fog, and vaginal dryness stroll in like they own the place.

And the kicker? It can last 4 to 10 years. (Johns Hopkins Medicine)

A Brief History of Perimenopause (Spoiler: It Wasn’t Always Called That)

Historically, menopause has been spoken of in hushed tones—or not at all. In Victorian England, it was dubbed “the change” (dramatic, yet vague). Ancient Greeks thought menopause was due to “wandering wombs.” And even as recently as the 1950s, the medical world largely treated menopause as a female deficiency disorder to be fixed with sedatives, amphetamines, or—truly—animal hormones.

Fun fact: In the 1960s, estrogen was advertised as a way to “keep women feminine forever.” Because apparently your self-worth evaporated with your eggs.

It wasn’t until the 1990s that the term perimenopause was coined and recognized as its own distinct life phase—because science finally caught up to what women have been saying for centuries: “Something’s happening and it’s not just in my head.”

Socio-Cultural Impact on Self-Esteem

📚 1. Foucault and the Medical Gaze

Michel Foucault, the French philosopher who loved a good existential crisis, introduced the idea of the “medical gaze.”This is the lens through which medical professionals observe and define the body—often reducing a person to symptoms, not context.

Applied to perimenopause?

It becomes a diagnosis to manage, rather than a transition to support. Women's experiences are filtered through male-dominated medicine, where hormonal changes are labeled deficiency syndromes (as if you broke down like a car without enough estrogen).

Women in perimenopause aren’t seen—they’re studied, subdued, or shrugged off.

🔬 Study Spotlight: In a 2017 review published in Social Science & Medicine, researchers found that medical discourse still treats menopause as a "problem to be solved," reinforcing gendered ideas of aging as decline. (Lock & Kaufert, 2001)

🧠 2. Objectification Theory and Aging

Barbara Fredrickson and Tomi-Ann Roberts’ Objectification Theory (1997) suggests that women are socialized to see themselves as objects to be evaluated. Their worth is external—tied to appearance, youth, and desirability.

Now add aging, hormonal acne, brain fog, or weight gain.

Cue: identity crisis.

Perimenopause becomes not just a health journey, but a psychological reckoning. Who are you if your body no longer conforms to society’s narrow expectations of beauty, fertility, and “feminine” behavior?

🔍 Psych Study: Women with more internalized appearance-based self-worth report more distress and shame during perimenopause (Chrisler et al., 2018). The more you were taught to prize thinness, smooth skin, and emotional "niceness"—the harder this shift can hit.

⛪️ 3. Symbolic Erasure and the “Post-Reproductive Woman”

Philosopher Susan Bordo argues that Western culture idealizes control over the body—especially the female body. Menstruation, childbirth, and menopause are messy, uncontrollable, and therefore culturally suspect.

Once women are no longer fertile, they are often rendered socially invisible—a form of “symbolic erasure.”

And if culture stops seeing you... do you stop seeing yourself?

It’s no wonder many women experience a dip in self-esteem, purpose, or visibility during this stage. Especially when advertising, media, and even healthcare settings continue to spotlight youth as the pinnacle of relevance.

📉 Survey Says: A UK survey by Menopause Matters (2021) found 81% of women felt perimenopause negatively affected their confidence, with many reporting feeling "invisible" at work and in relationships.

Changing Attitudes (Finally) Toward Perimenopause and Women

Here’s the deal: women today are living longer (average lifespan: 81), spending nearly a third to half of their lives post-menopausal. In fact, one of the complaints we get on our ads is that 'this is normal for women - just deal with it', but in fact, until 1900's, many women died around 50 - meaning their experiences were vastly different!

Anyway - historically, once women stopped reproducing, society gave us a metaphorical pat on the back and escorted us to the margins. But it’s 2025, and we’re done with being invisible.

• Celebrities like Naomi Watts, Drew Barrymore, and Oprah are talking menopause on national TV.
• Global sales of menopause-related wellness products are projected to hit $24 billion by 2030 (Grand View Research).
• Workplace policies in the UK now include menopause leave (imagine that—acknowledging women’s biology in HR!).

This shift isn’t just about hot flashes—it’s about reclaiming power, rewriting narratives, and saying: “Yes, I am hormonal. Yes, I am exhausted. And yes, I will still run this meeting in killer heels and make you wish you’d read the agenda.”

Perimenopause Around the World

The experience of perimenopause is far from universal—and how it’s talked about varies dramatically by culture:

• Japan: Women describe menopause with the term konenki, which translates more to "renewal years" than “falling apart.” Hot flashes? Rare. (Some researchers suspect high soy intake may help—soy contains phytoestrogens.)
• India: Menopause is often met with spiritual significance, as a transition into the “wise woman” stage of life. Still, access to treatment and education is a struggle in rural areas.
• Mayans: Elder women are celebrated as spiritual leaders. Wrinkles = wisdom, not a reason to be sold collagen gummies on Instagram.
• United States: Only recently has menopause escaped its taboo status, but perimenopause? Still playing catch-up. Many women are misdiagnosed or dismissed entirely.

Lesson? Culture shapes not only our attitudes, but possibly our symptoms! In fact, studies have shown that Western women report more severe symptoms than their Eastern counterparts (Avis et al., Menopause, 2001). Why? Stress. Stigma. (And probably not enough fermented soy).

What Actually Helps Perimenopause?

Okay, you’re sold. This isn’t just a bad PMS week—it’s a hormone revolution. So what can you do about it?

Let’s break it down:

🧬 Hormone Therapy

Bioidentical hormone therapy (BHRT) can be a game-changer for many. Think progesterone for sleep and anxiety, and estriol for vaginal dryness.

🍵 Lifestyle Tweaks

• Sleep: Create a consistent sleep routine. Magnesium and GABA can help—your brain loves them.
• Diet: Phytoestrogens (soy, flaxseed), omega-3s, and fermented foods for gut health.
• Movement: Strength training reduces muscle loss and boosts metabolism.

💆‍♀️ Mind-Body Tools

• Meditation, breathwork, CBT, therapy, journaling.
• Adaptogens like ashwagandha or rhodiola may help modulate stress responses.

🧠 Community + Education

Perimenopause is not something to suffer through in silence. Read, talk, share. Join our Sexy Sassy Sisterhood, follow menopause advocates, or create your own gang of hormonal heroines - the Peri-Puff Girls, PowerPause Rangers, Birds of Perimenopause... (ok, ok, we'll stop).

You’re Not Broken. You’re Evolving.

Perimenopause in the 21st century isn’t just about managing symptoms—it’s about rewriting what this stage of life means.

Wear the stretchy pants. Cry at that dog food ad. Forget someone’s name mid-sentence. And still know: you are powerful, you are wise, and you are not alone.

Because if there's one thing perimenopause has taught us?

It takes a village. Preferably one with science, solutions, and sisterhood!

REFERENCES:

Cleveland Clinic. (n.d.). Perimenopause. Retrieved April 23, 2025, from https://my.clevelandclinic.org/health/diseases/21608-perimenopause
Johns Hopkins Medicine. (n.d.). Introduction to menopause. Retrieved April 23, 2025, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause
Lock, M., & Kaufert, P. (2001). Menopause, local biologies, and cultures of aging. Current Anthropology, 42(4), 481–493. https://doi.org/10.1086/320861
Mayo Clinic. (n.d.). Perimenopause: Symptoms and causes. Retrieved April 23, 2025, from https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
My Menopause Centre. (n.d.). Loss of confidence and self-esteem. Retrieved April 23, 2025, from https://www.mymenopausecentre.com/symptoms/loss-of-confidence-and-self-esteem
My Menopause Centre. (n.d.). Understanding hormonal changes during perimenopause. Retrieved April 23, 2025, from https://www.mymenopausecentre.com/hormonal-changes/hormonal-changes-tracking/understanding-hormonal-changes-during-perimenopause
Reuters. (2015, June 15). Culture may influence how women experience menopause. Reuters Health News. https://www.reuters.com/article/us-health-menopause-culture-idUSKBN0OR1XG20150615
ScienceDirect. (1994). Culture and menopause. Maturitas, 19(3), 199–209. https://doi.org/10.1016/0378-5122(94)90011-6
ScienceDirect. (2019). Psychosocial factors promoting resilience during menopause. Maturitas, 128, 55–60. https://doi.org/10.1016/j.maturitas.2019.07.010
The Menopause Charity. (2023, May 12). Menopause and mental health. https://themenopausecharity.org/2023/05/12/menopause-and-mental-health
UnityPoint Health. (n.d.). Perimenopause. Retrieved April 23, 2025, from https://www.unitypoint.org/find-a-service/womens-health/perimenopause
Women's Health Network. (n.d.). Menopause in different cultures. Retrieved April 23, 2025, from https://www.womenshealthnetwork.com/menopause-and-perimenopause/menopause-in-different-cultures