The Truth About Perimenopause: The Hormonal Storm We Need to Talk About

With the recent celebrations for Women’s History Month fresh on my mind, there is no better time to talk about a subject that, while uniquely female, needs to be part of the conversation for all genders.What am I talking about?

Here’s a hint: It affects women in their 40’s and 50’s to varying degrees, is ‘incurable’, and, barring extenuating circumstances, none of us is exempt.What am I talking about?You guessed it: The big M – menopause.

Except… I’m not here to talk about menopause.

Menopause is just a point in time, the moment the body stops producing estrogen, conception becomes impossible. It comes at the end of a long, arduous (at least for most women) journey. This is the big P - perimenopause, and that’s what I really want to talk about.

Haven’t heard of it? Neither had I until last year – and I’m 44 and officially perimenopausal.

I was unaware that this strange limbo between regular and post-menopause womanhood had a name. I also didn’t know it could make you feel like your mind and body were staging a quiet rebellion while you’re just trying to answer emails and remember where you parked your car.

When did I first hear of perimenopause? Last July, as I was sitting in my doctor’s office, explaining, between sobs, that I felt like I was unraveling. My body hurt. My brain felt like it had filled with black fog. I was crying over literally everything, and I was always so tired. That’s when my doctor, calm as ever, said, “This sounds like perimenopause.”

Come again? What is this perimenopause of which you speak?

Like most women I know, I thought I didn’t need to deal with menopause until I was in my 50s. I figured I had a good half-decade before I needed to worry about any of this. But here’s the thing: perimenopause can start as early as your late 30s. That’s right, before you even hit ‘middle age.’

Why didn’t I know about this? Why don’t we know about this?

Sure, menopause is slowly gaining acceptance in general parlance. There are even commercials, podcasts, and fancy menopause skincare lines. But perimenopause? That’s the unglamorous understudy, sweating in the wings, just waiting to make her entrance while nobody’s paying attention.

Once I started looking into it (read: obsessively Googling and asking every woman I knew in my age range or older), I realized I wasn’t alone. An estimated 1.3 million women enter menopause each year in the U.S., but the years before that, perimenopause, are often harder and longer. They are packed with symptoms that are so varied and vague, they can easily be mistaken for anxiety, depression, burnout, or just...life.

Common Symptoms of Perimenopause

Symptoms vary for each woman, and may include:

Sudden mood swings
Fatigue
Insomnia
Night sweats, hot flashes, and cold flashes
Weight gain, particularly around the middle
Brain fog
Thinning hair and dry skin
Digestive issues
Exacerbation of other mental health issues, such as depression, anxiety, or ADHD

And yes, some days you might feel totally fine, which makes the bad days even more confusing.

Why It Matters: Perimenopause in the Workplace

While perimenopause is deeply personal, it doesn’t happen in a vacuum—most of us are juggling work, family, and daily life while our bodies are busy rewriting the hormonal script. And yet, the impact of perimenopause on women in the workplace is still widely overlooked. From missed days to missed promotions, here’s a quick look at how this transition is showing up at work—and why it deserves more attention.

It affects performance: 1 in 7 women aged 45–60 report missed days or reduced performance due to symptoms. Mayo Clinic
It shapes careers: 35% of women say symptoms influenced big career decisions—like stepping back or turning down promotions. PMC Study
It’s often misunderstood: Fatigue, anxiety, and brain fog are often blamed on burnout—not hormones—leading to delayed support. Jean Hailes Foundation
Support is still rare: Most workplaces don’t offer policies or space to talk about menopause—leaving women to navigate it solo. Fortune

Good News: Perimenopause Support Is Finally on the Rise

More people are talking about perimenopause now, and more resources are becoming available. You just have to know that it has a name and be willing to talk about it.

Even the hotel world is starting to take notice. Some companies are offering actual support for guests and employees dealing with hormone shifts:

Six Senses has launched its first-ever Female Wellness programs, created with women’s health advocate Dr. Mindy Pelz, to support hormonal and metabolic balance during perimenopause and menopause. These bespoke 3-, 5-, or 7-day retreats use fasting, sleep tracking, movement, and clean eating—aligned with the menstrual cycle—to empower women with practical tools for long-term well-being. Programs are now available at five global Six Senses resorts, with more to come.
Equinox Hotels in New York partnered with Stripes Beauty to launch a menopause-focused spa treatment circuit. Finally, a wellness space where someone might actually ask how your hormones are doing.
Fairmont Windsor Park teamed up with GenM to offer a “Menopause Revolution” package, including personalized wellness treatments.
Valor Hospitality has introduced menopause-friendly workplace policies to support staff going through this stage of life.

Making Perimenopause Manageable

There’s no one-size-fits-all fix, but there are ways to make this ride a little smoother. My doctor gave me a few helpful starting points:

Track your symptoms. Even if you’re not sure what’s happening, writing it down gives you data—and a bit of sanity.
Get your hormones tested. It’s not perfect, but it can help rule things out and give you a clearer picture.
Exercise, sleep, hydrate, repeat. I know, easier said than done. But it helps.
Talk to someone. Your doctor, a therapist, or a friend who’s been through it. Or all three.
And most importantly: don’t ignore it. You’re not crazy. You’re not weak. You’re not alone.

Considering Hormone Replacement Therapy (HRT)

These are all helpful tips – and not just during perimenopause. But what if they don’t help enough? What if you still feel like you can’t function?

Consider hormone replacement therapy: In spite of the intimidating name, this is just estrogen (and sometimes progesterone) in a small pill you take daily. To compound the PR challenge, past research – recently discredited – touted the risks of this treatment. According to the latest research, it is safe and might even lower the risk of a host of aging-related ailments. Read more here.

What Helped Me Cope

A few other things that helped me:

Being honest with myself: This is a natural part of getting older, not a moral failing or reflection on who I am as a person
Naming it: Giving something a name depersonalizes it. It helps us remember that our symptoms are just that – reflections of something physical happening to our bodies. They are not who we are. I call mine Perry, but feel free to be more creative than this obvious nickname
Being open with others: At first, I was ashamed and embarrassed by the havoc being wreaked on my life and tried to hide my symptoms from my husband. Thankfully, he is perceptive enough to know something was going on. When I explained what was going on and opened up about my own challenges, I felt like a huge weight had been lifted from my shoulders. And now, when the symptoms rear their ugly heads, I can just say “Perry” and he knows how to respond.
Giving myself grace: Self-compassion is a great treatment for many ailments and is especially useful in this case. When I feel like I really just can’t function, I give myself permission to take some time off from what I am working on – taking a nap, playing mindless games on my phone, cuddling with my dog, whatever works. I can’t control when the symptoms kick in, but I can control how I respond when they do.

Let’s Keep the Conversation Going

Perimenopause might be invisible to the outside world, but it doesn’t have to be. The more we talk about it, the less alone we all feel.

So happy belated Women’s History Month. Let’s make a little history of our own—by saying the quiet part out loud.

Lynn Zwibak is the Founder and President of Zwibak Revenue Management, which provides revenue management training to non-revenue managers. Her mission is to educate the hotel industry on revenue management principles so that hotels can be more profitable. She is also a professor of revenue management at Virginia Tech University. Lynn has lived and worked in Kenya and the Philippines and now lives in El Salvador.