Definition
Perimenopause is the multi-year transition into menopause characterized by fluctuating hormones, symptom variability, and real physiological effects that are frequently under-diagnosed and under-treated.
Why it matters
Perimenopause is one of the most-neglected life stages in mainstream medicine. Recognizing it changes both self-understanding and treatment.
The Science
Hormonal fluctuation — not simply decline — characterizes perimenopause. Symptoms include vasomotor changes, sleep disruption, mood shifts, cognitive changes, and menstrual irregularity. Menopausal hormone therapy (MHT) has undergone major reappraisal since the WHI reanalysis; for many women, it is a legitimate option.
The NSI Perspective
NSI treats perimenopause as a serious developmental transition deserving informed clinical attention.
Clinical Implications
Standard care should include cardiometabolic, bone, sleep, mood, and cognitive evaluation. MHT should be discussed as one option among several.
Practical Application
If your body is changing in ways that feel new, that is biology, not imagination. You deserve care that names it.
References
- 1.Santoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: signs, symptoms, and management options. J Clin Endocrinol Metab. 2021;106(1):1–15.