Perimenopause is a psyop ☼

Increased visibility for menopause is a net positive. Being marketed to is inevitable.

At age 35 I felt my body change: I had detectable HPV for the first time (all adventurous women do!) and ureaplasma. I had lost an alarming amount of weight after quitting drinking and had spent all my new found free time doing the opposite of what they tell you to do (sleeping with anyone and everyone, sorry dad). My body changed again at 37 and 38. I gained weight, I lost weight. My finger nails developed ridges for the first time. My hair thinned at my widow’s peak. My jawline softened. Years earlier, my body changed significantly: at 14 and then 16, when I had my first period, followed by a year of mononucleosis at 17. At 22, I lost all my baby fat and emerged from a semester of dance classes, a woman.

My body continued to change and all the while, three to four times a year, I had periods so painful and prolonged, I routinely locked myself in bathrooms out of embarassment and fear, and felt pain so acute, I passed out. Every time, I would break into a cold sweat, lose feeling in my lips and hands, cry on the floor until I passed out, all the while passing blood clots the size of peach pits. For years I was told I was dramatic, that I was exagerating, a doctor refused me vicodin, thinking I was an addict (I was, but not to vicodin lol). Both men and women told me this was the curse of Eve—as in Adam and Eve—since she’d commited the first sin, demonstrating curiosity about the tree of life and its tantalizing fruits.

My last major painful period where I barfed into a bucket, doused in sweat after waking up in the middle of the night seized with pain, was at age 38, two years ago. No doctors have been able to name my condition, no ultrasound has seen more than a luteal cyst on my ovaries. I’m too broke to get the excision surgery to find out if it’s endometriosis, though I don’t have the exact symptoms. I did pelvic floor physical therapy, tried birth control, learned to control my breath. I resigned to believe my body is a mysterious and miraculous machine, sinful and supple, and whatever came next in menopause would be nothing compared to the last twenty-six years.

So when I approached age forty last winter, my social media algorithm made a dramatic snap: suddenly, everyone around me was apparently in perimenopause, and so was I. I got ad after ad for hormone testing from companies like Winona and Hone, offering solace in blood panels against a sea of dismissive doctors and debilitating symptoms. While research for hormone therapy and women’s bodies in general runs decades behind men’s and tends to calcify at the intersection of race and gender identity, the sudden surge in content about perimenopause—the period when a body approaches menopause—struck me as odd and out of cadence.

I headed to a cursed commons—Threads—to see what the perimenopause groups were sharing. Some comments were helpful but none were particularly rooted in any studies or books, no doctors appeared in my scrolling other than self-styled perimenopause experts, a phrase I hadn’t heard before, with no credentials or authored papers. These figures were akin to life coaches and repeated the same information about vague symptoms, as if given a script. Everyone had itchy ears, sore joints, wacky periods, and my favorite, uncontrollable surges of rage. “Okay, so we’re all living on earth,” I thought, but couldn’t find any substantial overlaps or meaningful correlations between these posters’ symptoms and actual documented hormonal shifts. Post after post reasserted helplessness and abandonment—no one knew what was going on and no one could help, save for this forum, where everyone had the same suite of afflictions, ranging from anhedonia to brain fog. This made menopause seem murkier and random. Something punitive your body waged against you. Words like “chaos” next to cutesy depictions of bowel movements as if discussing one’s body is transgressive, and forgetfulness (”I will inevitably put one copy of [a menopause book] in the refrigerator as is now my habit,”) ran across my screen. Another thread lists the seven signs of perimenopause after 35 including anxiety, changing periods, difficulty finding words, aching joints, low libido, weight gain—by that measure, I’ve been in perimenopause my entire life. When I objected from my burner account (since deleted in shame!), I was flooded with snarky responses about how I was probably in perimenopause and they felt bad for my husband (what husband?) and “how millennial women never listen to Gen X.” Rude!

In tin foil hat style, I started tracking comments and self-published essays. Like the marketing psy op that pushed the band Geese, I wondered if perimenopause as a catchall term was an industry plant where Gen X and millennials were the unwitting target audience. While I am envious of women who have apparently never felt destabilizing rage or brain fog, I feel these may be the same women who post Kamala memes, who considered themselves “girl bosses” with “ladyfriends,” and who dress up in Handmaiden’s Tale robes for Halloween, ie a very marketable crowd. I won’t be elaborating but I do suspect that they are also those who see Dove’s new marketing campaign as feminist and not another chance to nickel and dime aging women in an era of abject inflation and a dwindling job market. (Although I do love to see naturally aging faces in advertising, this is another conversation entirely.) Over and over, across social media, women blamed every stomach ache, sore muscle, bad mood, and slight breeze as perimenopause.

This past May, The Cut published an article about women taking antihistamines and pepcid AC for perimenopause and PMDD symptoms, but only interviewed individuals in menopause or transitioning. Symptoms included brain fog (I have ADHD and PMDD both so I am a spoilt variable), fatigue, loss of interest in normal activies (depression, basically, another of my long time afflictions), insomnia (born with it, I take a sleeping pill), and inflammation (yes I have that as well). Doctors describe miracles. Experts say it’s plausible. Studies support the correlation but offer few cut and dry answers. This Threads post in particular encapsulates a widespread frustration but also reads as a girlboss type mantra: Every woman over 35 is basically running an independent clinical trial on herself at this point. To which I say, have we not this whole time? And why are we overvaluing strangers’ posts on social media over medical papers, researchers, and published authors? Self-diagnosis as a trend is quickly becoming a scourge with a whingey battle cry: we’re all autistic, we all have POTS, and we’re all in perimenopause.

While folksy, Threads and other social media have transmogrified into spectacle-level displays of solipsism and anti-intellectualism, and this feels no different. I wrote recently that the sudden burst in perimenopause content feels consumptive—engineered to make women distrust themselves and reach out for answers by way of a product, enter Hone or Winona, for example. AP News published an article that interviewed doctors who welcome the growing attention around menopause (let alone perimenopause, the time leading up to it) since it’s a historically overlooked area of women’s health. But they also warn that the influx of commercial products creates a risk where marketing will outpace medical evidence and that anyone experiencing significant symptoms should seek research-backed treatment. Thus creating an ourobouros and an algorithmic echo-chamber. Literally any symptom a woman over 35 reports is being shucked into the perimenopause category and the people who insist you’re in it, don’t have any clear or personalized answers.

(I want to note: I have friends who are in menopause and/or have genuinely felt a change when they hit their forties—hot flashes, insomnia, weight gain, the works—and have sought HRT and resolved their symptoms and discomfort—so far. I watched my aunt suffer through endometriosis. I’ve been through enough personal body horror to last a lifetime. I am not denying the hallmarks and symptoms of perimenopause or menopause or any hormonal fluctuation that may affect women and trans individuals using HRT, nor would I tell anyone with symptoms that they’re victims of a serious marketing push. We know our bodies best, doctors more often than not ignore us, and if antihistamines give you relief, incredible. I take them often myself.)

I recently struck out on my own, determined to get some answers, low key went to those hormone testing sites and copied all their recommended blood tests, and took it to my OBGYN. My tests showed that I had no low or high markers, everything within “normal” range. Dr. Mary Claire Haver, a menopause advocate, writes that hormone testing is not enough to detect peri/menopausal shifts, rendering hormone testing products kind of useless compared to their marketing promise. The second half of my thirties was marked by dramatic change. Covid hit when I was 33, I was sober from alcohol by 34. My body and brain chemistry changed entirely, with intermittent bouts of Covid. The first period after my first vaccine was worse than others (studies at the time confirmed cases of menstrual disorders post-vaccine but don’t tell the antivaxxers!!!), I moved cities and saw my asthma worsen.

Was all that perimenopause or was I just getting older? Losing collagen? Was it living under a second Trump administration? Having long Covid without being diagnosed? Being relentlessly harassed by my landlord? Watching neighborhoods flood and burn during cataclysmic climate disasters? Seeing inflation squeeze even my most prosperous friends to their last dollar month after month? Seeing ICE brutalize my neighbors? Witness Israel bomb and torment Palestinians, hour after hour, streaming through my phone? Finding my way through the identity crisis that getting sober gave me? I’d been having sudden, uncontrollable surges of rage since I was fourteen—so what were these perimenopausal people living through that I wasn’t seeing? And how are they just now getting angry being in the same age bracket as myself, living through all the bullshit of the 21st century?

When I posed these questions to social media, friends flooded my DMs: “The marketing bros have only just found out about [perimenopause] and they are about to have a field day and mark up everything related to peri/menopause in any way. So stupid.”

Another hit the nail on the head, offering her theory that “perimenopause” as a term and concept is so popular because it’s a euphemism for aging, “a word millennial women are terrified to say.” ☼

THAT SAID: If you have a study or book on menopause that you recommend, please leave the title and author in a comment!