Everything We’ve Been Told About Perimenopause Is Wrong

Every time I—or another colleague—post about perimenopause, the comments from women are what stay with me.

They’re heartbreaking.

Women are regularly told things like:

“You can’t be in perimenopause if you’re only 40.”
“We can’t treat perimenopause if you’re still having periods.”
“If you’re not having hot flashes, it’s not perimenopause.”

And yet these women know something has changed. They don’t feel like themselves anymore.

Because of the lack of training and education around perimenopause, so many women’s experiences are dismissed. They leave appointments questioning their own reality. Feeling dramatic. Feeling crazy. Feeling gaslit.

The truth is this:
Perimenopause starts long before periods become irregular.

It shows up in quieter, sneakier ways—hair thinning, crushing anxiety that seems to appear overnight, foot or joint pain that won’t go away, rage that feels unfamiliar, weight settling in places it never used to, sleep that suddenly disappears.

These changes are not in your head.

To clinicians: believe women when they tell you something feels different.

The lack of education around perimenopause—for both clinicians and women—is equal parts ridiculous and infuriating. It’s enough to make you cry… and we all know how easily tears can flow in this season.

Thankfully, there is a shift happening. Women are laughing, learning, and finally talking about what’s really going on—because they have to. The traditional medical system simply isn’t set up to support this phase of life in a meaningful way. That gap is exactly why Not Young exists. We’re here to be an alternative to dismissal, confusion, and “just deal with it.” To give women language, tools, and real support in a season that has been ignored for far too long. We refuse to let perimenopause stay invisible.

What Is Perimenopause?

Perimenopause literally means “around the pause of monthly cycles,” and for most women it begins in the late 30s to mid-40s. It’s the phase when estrogen and progesterone begin fluctuating and declining as the body prepares for menopause.

Yes, it marks the beginning of the end of fertility—but it’s so much more than that.

Estrogen touches nearly every system in the body. When it starts changing, everything can feel off: mood, sleep, metabolism, cognition, joints, skin, hair, energy. This is a critical window to build habits and support that will carry women into the next phase of life—through nutrition, movement, stress support, and nutritional supplements that align with this stage of life.

Why Is Perimenopause So Hard to Diagnose?

First, because most clinicians receive shockingly little training on menopause—often just a few hours in their entire education.

Second, perimenopause is a clinical diagnosis. There is no single test. Doctors are meant to listen for patterns and checklists of symptoms. But here’s the catch: everyone’s list looks different.

For one woman it’s brain fog and migraines.
For another it’s insomnia and sudden belly weight.
For another it’s anxiety, rage, or loss of libido.

Instead of these being connected as one hormonal transition, women are often given an anxiety prescription, a sleep aid, or an antidepressant and sent on their way.

Meanwhile, the fallout is real.

Divorce rates peak in midlife, with the highest rates among couples ages 45–54.
And in the U.S., women between 45 and 64 have experienced one of the fastest-rising suicide rates over the past two decades.

That’s not coincidence. That’s a population going through massive biological, emotional, and identity shifts without adequate support.

When women are told “nothing is wrong” while everything feels wrong, it erodes confidence. It strains marriages. It isolates. It breaks people down.

Common Myths Women Need to Stop Believing

Myth: Every woman in perimenopause has hot flashes.
Fact: While hot flashes are common, they are far from universal. Research from The Menopause Society shows that up to 20% of women never experience them at all. Perimenopause has been associated with more than 50 different symptoms, including anxiety, mood swings, joint pain, migraines, itchy ears, fatigue, low libido, brain fog, and sleep disruption. Many women enter this phase with no heat-related symptoms—so the absence of hot flashes does not mean nothing hormonal is happening.

Myth: I need a hormone test to know I’m in perimenopause.
Fact: There is no single blood, urine, or saliva test that can reliably diagnose perimenopause. Hormones fluctuate wildly during this transition—sometimes day to day, even hour to hour. A lab test only captures a snapshot of that moment, often landing within “normal” ranges and falsely reassuring both patient and provider. Perimenopause is diagnosed clinically, by listening to symptoms and patterns over time. A normal test result does not invalidate lived experience.

Myth: Perimenopause starts in your 40s.
Fact: Many women begin experiencing symptoms in their late 30s, and some even earlier. Studies show that Black and Hispanic women often enter this transition sooner than white women. Perimenopause lasts an average of 3–4 years, but for many it stretches closer to a decade.

Myth: If I’m still getting periods, nothing can be done.
Fact: Having a period does not rule out perimenopause—or the need for support. In fact, for many women, changes to their cycle are one of the first signs something is shifting. Periods may become heavier, lighter, longer, shorter, closer together, farther apart, or wildly unpredictable. You don’t have to “lose” your cycle for your hormones to be in flux. This phase is defined by change, not by the absence of a period. If your cycle no longer feels like your cycle, that matters—and it deserves attention.

Myth: Any doctor can guide me through perimenopause.
Fact: Most clinicians receive very little training in menopause care, which means many women are told everything is “normal” and sent on their way. This is why knowledge matters. When women understand the signs of perimenopause, they can recognize what’s happening in their own bodies, ask better questions, and take agency over their care. Medical support is one path. Lifestyle, nutrition, nervous-system support, and targeted supplementation are others. The power starts with awareness—and with women realizing they are allowed to participate in what comes next.

Perimenopause can be exhausting. Confusing. Confidence-eroding.

And that’s exactly why Not Young exists.

This brand was born out of lived experience—the “what is happening to me?” moments, the dismissal, the sense of losing yourself inside your own body. We’re here to normalize this stage, give women language for what they’re feeling, and offer real tools and education so no one has to white-knuckle their way through it.

We talk about it.
We build for it.
We advocate for it.

Because women in this season deserve to feel steady, supported, and understood—not invisible, not dismissed, not alone.

Perimenopause isn’t a personal failing.
It’s a biological transition.

And it matters.