There is a post in the largest perimenopause community whose title is a single furious question, and it scored 1.5K:
Why the heck aren't women given peri and menopause information from their doctor when they hit 40?!
The woman who wrote it thinks her symptoms began at 47. She describes the next three years as guesswork, in one line that a great many readers recognised:
Instead I was piecing together my symptoms with Doctor Reddit.
And then, in capitals, the sentence the whole thread was really about:
THIS IS INFORMATION EVERY WOMAN SHOULD BE GIVEN. Why aren't we?!
If you are reading this because you have just worked out, at 41 or 44 or 46, that the last two years might have a name, this page is for the part after the name. How women actually find out, why the fortieth birthday so rarely comes with the conversation, what to read first, and three things to do this month.
Why did nobody tell me about perimenopause when I turned 40?
Nobody told you about perimenopause at 40 because, for most people, the word menopause means something that happens in your fifties. The average age of menopause in the United States is 52, according to the US National Institute on Aging, and the same source says most women begin the menopausal transition between 45 and 55, and it may last several years. A fortieth-birthday check-up is rarely built around something that sounds ten years off.
The trouble is that the conversation is not ten years off for the women who write in these communities. In the largest perimenopause community, the median stated age is 43, and 67% of stated ages fall between 38 and 47. That is a description of who posts, not a schedule for anyone's body, and a typical window is not a floor. But it does mean the people asking the question most loudly are, in large part, younger than the picture in everyone's head.
The vocabulary does not help either. Perimenopause is the years before periods stop; menopause is the point after twelve months without one. If the only word you have heard is the second one, you have no reason to connect it with a new 3 a.m. habit at 41 while your periods are still arriving. One woman put it with 1,076 upvotes behind her:
I thought menopause = 50s, hot flashes, no period.
How do women actually find out about perimenopause?
Women in these communities mostly find out about perimenopause from each other. The pattern across the main and the adjacent communities is that she almost always works it out herself, from a community, a podcast, a friend or her mother, and rarely from a clinician. A doctor does appear in the stories, but more often after she has raised it than before.
A thread titled simply How many of us didn't even know about Peri? scored 595 and drew 153 comments. The answers have a shape.
The subreddit. The single most common route in the stories we read is the community itself, often found by accident while searching for something else.
I couldn't figure out what was going on and then found this sub and realized I most likely have started perimenopause.
That scored 419.
A friend. From a woman of 41, in a post that scored 125:
I never knew it existed and I have two degrees in biology
She learned the word when a friend of 44 described her own symptoms mid-conversation, and she had to stop her and ask what it meant.
A mother, or a manager. One woman shared an image she had seen with her mother and got back, in a post scoring 108, "oh yeah, makes sense. I started at 39." Another, scoring 266, heard it at work first:
A few months earlier a manager had suggested I look into perimenopause… I had heard the term but it was something I associated with women much older than me.
A podcast. A long interview with a specialist is the other route the community names again and again, often passed on from the subreddit itself.
What almost nobody describes is a doctor bringing it up first, at a routine visit, before anything was wrong. That is the thing the 1.5K post was asking for, and it is still not the usual experience in these communities.
Before anything else: when it is not perimenopause
Working out that perimenopause might explain things is a relief, and relief can make it tempting to file every new symptom under it. Some things should never wait for a month of reading. Go now, the same day, to urgent care or emergency services if you have:
- Chest pain, or a racing heart with breathlessness, faintness or collapse
- A sudden, severe headache unlike any you have had, or new weakness, numbness or confusion on one side
- Thoughts of ending your life or of harming yourself; call your local emergency number or a crisis line now
- Bleeding so heavy that you are soaking through protection every hour, or you feel faint with it
Book a prompt appointment, rather than waiting to see, for bleeding after sex, bleeding between periods, any bleeding after a year without a period, periods stopping before 40, a new lump anywhere, or weight loss you cannot explain. None of those is a perimenopause question first.
What should I read first about perimenopause?
Read the free community wiki first. It lives at menopausewiki.ca, and it describes itself as the official wiki of a menopause community and its Reddit siblings, the two largest subreddits on the subject. It carries no products and no sponsorship. Both subreddits send every newcomer there, and the usual advice in the threads is four words long:
Have you read the wiki? Start there.
That comment scored 120, and it is good advice. The wiki is better than anything a brand will write about what perimenopause is, how the dismissal tends to sound, and what the treatment conversation covers. We say that plainly because it is true, and because a page like ours that tries to compete with it on information would lose and would deserve to.
Three parts are worth an evening:
- The home page, read once all the way through, for the shape of the thing.
- The page that asks whether this is perimenopause, which is where she usually recognises herself.
- The providers page, so you know where to look if your usual clinician will not have the conversation.
Where the wiki stops is where the rest of this site lives. It tells you to track your symptoms and to learn how to ask your doctor. It does not give you the page or the words. Those are below.
One more thing to read, and one thing not to. Do read a few threads in the community, slowly, without posting, because the recognition is half the point. Do not spend money in the first month on a test kit, a supplement stack or a programme that promises the answers. One woman described that market, in a post that scored 47, better than we could:
Buy this herbal blend. Buy this workout schedule. Buy this course.
The three things to do in the first month
The first month is for turning a suspicion into something a clinician can respond to, without losing another year.
1. Read the wiki, this week
One evening, the three pages above. That is the whole task. The point is not to become an expert. It is to have the vocabulary, so that when you sit down with a doctor you are not hearing the word for the first time in the room.
2. Start a one-page record, tonight
One line a day, in the evening, for as long as it takes to get two cycles. The method is set out in full in how to track symptoms for an appointment; the short version is five columns:
- the date and the day of your cycle
- the time you woke in the night, and how often
- your three worst symptoms, scored nought to three
- what it cost you that day, in one flat sentence
- anything else: alcohol, illness, a new medication, a deadline
Above the grid, write down your last six period start dates, rebuilt from a phone, a diary or a receipt if you have to, and everything you take, prescribed or not.
If your periods have stopped or gone very irregular, you do not need two cycles before you book. Book now and bring what you have.
3. Book one prepared appointment
Book it this week, even if the first slot is a month away. Ask, when you book, whether there is someone in the practice who sees a lot of perimenopause. If the answer is no, the wiki's providers page is where to look.
For many women in these communities the first appointment is not the last. The path she describes is typically two to four years of symptoms and three to six providers before anyone takes it seriously. A page of notes and a prepared sentence will not guarantee the first appointment goes well. They change what it is about: a pattern on paper rather than whether you are a reliable narrator.
Ask, too, for the other common causes to be checked alongside, thyroid and iron among them. That is not a hedge. If something else is going on, you want to know, and asking for it makes the rest of the request harder to wave away.
The conversation at home
The household usually does not know either, and has drawn its own conclusions. One short conversation in a calm week, saying what you think is going on, that it is not about them, and what you are doing about it this month, does more than a run of apologies. If there is a partner, what to tell your husband has the words and the one link to send him. It is the wiki.
You were not supposed to have to find this yourself
The anger in that 1.5K thread is not really about one doctor. It is about having lost time to guesswork, and about learning the word from a stranger online at eleven at night instead of from anyone whose job it was to say it.
Why didn't anyone warn us?
That one scored 1,025, and the answer in these communities is the same every time: nobody did, so they warn each other. The wiki exists because women wrote it for the women after them. The threads exist for the same reason.
You have the word now. Read the free thing first, put the pattern on one page, and have one prepared conversation. The rest of this site is here for the parts that come after, which is most of it.