Starre Julia Vartan

The first of a couple of feature stories based on my book for New Scientist, this piece analyzes how both doctors and patients can make assumptions about healthcare for women in midlife. While it’s wonderful that perimenopause and menopause are receiving some (VERY!) long overdue attention, there’s also some pretty serious bandwagoning going on, with every health complaint, mental or physical, assigned to the perimenopause category. This can mean overlooking other serious health issues that can mimic the symptoms of perimenopause. And with women self-diagnosing and then going through telehealth providers for HRT, this can get dangerous, fast. I interviewed Stephanie for the piece, who told me about how what she thought were perimenopause symptoms were actually a life-threatening fibroid which she finally got removed before it caused any more problems.

From the article: “Classic hallmarks  [of perimenopause]– hot flushes, night sweats, vaginal dryness and midlife changes in menstrual bleeding patterns – are highly likely to be hormonally driven. But most other symptoms commonly cited online, from sleep problems and joint pain to mood changes, may have multiple contributing factors.

That’s the challenge: fatigue might be due to fluctuating oestrogen levels, but it could just as easily be caused by an underactive thyroid, iron-deficiency anaemia, depression or autoimmune conditions like lupus. Brain fog might signal perimenopause, but could be the result of a vitamin B12 deficiency or sleep apnoea, or be an early sign of neurological issues. “Pain with intercourse can be due to perimenopause, but it also can be other conditions like sexually transmitted infections or some specific skin conditions like sclerosis,” says Mary Parman, who has practised obstetrics and gynaecology for 20 years in Silicon Valley, California.”