Hormonal Transitions Aren’t a Crisis—They’re a Continuum
There’s a funny thing that happens in women’s health—we start out loud and end in a whisper.
We talk openly about puberty. Sure, it’s awkward and cringey, but it’s a rite of passage. There are books, classes, and well-meaning “what to expect” talks. Same goes for postpartum. In recent years, conversations about maternal mental health, sleep deprivation, and the rollercoaster of emotions after birth have taken up more space—and that’s a good thing.
But when it comes to perimenopause and menopause? Silence. Evasion. Misinformation. Or worse—dismissal.
This disconnect isn’t just cultural. It shows up in our doctor’s offices too. Teenagers struggling with irregular periods? Birth control. No questions asked. Postpartum women drowning in hormone shifts and sleepless nights? Antidepressants, often without a second thought. But mention hot flashes, brain fog, or crushing fatigue in perimenopause and suddenly you're told to just "wait it out" or try yoga.
Here’s the thing—puberty, postpartum, and perimenopause are all built on the same foundation: major hormonal upheaval. And yet, only some of those phases are treated with urgency and respect.
Let’s lay it bare.
Puberty, Postpartum, and Perimenopause: More Alike Than You Think
Each of these life stages involves:
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Huge hormonal shifts that impact mood, sleep, weight, libido, and mental clarity
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Physical changes that challenge how we train, work, and show up in our relationships
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Identity transitions that can shake us up and ask us to reimagine who we are
But here’s where it gets sticky—puberty is expected. Postpartum is validated (to a point). And perimenopause? It’s often ignored, brushed aside, or misdiagnosed.
All three stages require support. All three impact performance, emotional wellbeing, and daily life. So why the silence around menopause?
Hormonal Transitions Across Life Stages
| Life Stage | Key Hormones Involved | What’s Happening | Common Symptoms |
|---|---|---|---|
| Puberty | Estrogen ↑, Progesterone ↑ | Hormones kick in to start menstrual cycles and develop secondary sex characteristics. | Mood swings, acne, irregular periods, breast development, body composition changes |
| Postpartum | Estrogen ↓↓↓, Progesterone ↓↓↓ | Hormones crash after delivery; body recalibrates after pregnancy. | Depression/anxiety, fatigue, night sweats, low libido, brain fog |
| Perimenopause | Estrogen ↕ (fluctuates wildly), Progesterone ↓ | Ovarian function becomes erratic; transition into menopause begins. | Hot flashes, anxiety, insomnia, irregular cycles, mood swings, weight changes |
| Menopause | Estrogen ↓, Progesterone ↓ | Menstrual cycles stop completely; hormones settle at low levels. | Vaginal dryness, bone loss, low energy, memory issues, heart health concerns |
The Medical Double Standard No One Wants to Talk About
Let’s get real: there is a huge gap in care when it comes to midlife women.
Hormonal birth control is widely prescribed to teens—not just for pregnancy prevention but to "manage" their cycles, acne, and other symptoms. And while that might be appropriate in some cases, it’s often handed out without looking deeper.
Fast forward to the postpartum period. Women are handed antidepressants to manage mood swings, anxiety, or rage—again, without always examining the role plummeting hormones might be playing.
And yet, when a perimenopausal woman walks into her doctor’s office reporting sleep disruption, night sweats, anxiety, or a complete loss of self? She’s told it’s “just stress” or that she should try a supplement. Maybe she’s offered an SSRI. Rarely is HRT even discussed—let alone offered as a valid, evidence-based option.
The inconsistency is maddening.
HRT Isn’t a Last Resort. It’s a Legitimate First Step.
This isn’t about pushing one solution over another—it’s about giving women options and treating them like the grown adults they are. Women in their 30s, 40s, and 50s are navigating massive hormonal shifts while juggling careers, caregiving, training, and healing.
They deserve full-spectrum care. They deserve conversations about all their options—including hormone replacement therapy (HRT). Not just when symptoms are extreme, and not just after jumping through hoops.
They deserve what teenagers and postpartum women are already getting: proactive support and real talk about hormones.
This Silence Isn’t Harmless. It’s Costing Us.
When we ignore perimenopause, we rob women of their agency. We normalize suffering instead of supporting transformation. And we create generations of women who think they just have to “tough it out.”
But here’s the truth: perimenopause isn’t a breakdown. It’s a recalibration. Just like puberty and postpartum, it’s messy and powerful and yes, sometimes brutal. But it’s also an opportunity to rebuild in a way that serves who you are now—not who you were before.
We have to start naming the patterns. Calling out the inconsistencies. And making room for nuanced, hormone-informed conversations across all life stages—not just the ones that fit neatly into the narrative.
If we can celebrate the beginning of our hormone journey, we damn well deserve to honor the middle too.
Let’s stop whispering. Let’s start leading.