Help Rewrite the Science on Perimenopause

Not enough is known about the lived experiences of perimenopause, the years leading up to menopause.  

At 42, I started waking up at 2 a.m. and couldn’t fall back to sleep for an hour or more. I asked my primary care physician and gynecologist if it could be perimenopause, and they both told me no. They said I was too young and pointed out that I was still getting a period every month. But my mood was also changing. I felt more fragile and was more easily overwhelmed. These were not typical feelings for me. I just didn’t feel like myself.

I was certain something physiological had shifted for me. After a deep dive into the scientific literature, I had a hunch it was related to my fluctuating hormones. A friend who was noticing similar changes and I took on that investigation together. In the end, we learned so much we hadn’t known but should have about our cycles and how they change. We knew we had to share it with other women. Translating the research into women-friendly language, we launched the Women Living Better website in 2018. 

In 2019, I did a segment with Maria Shriver for the Today show. I told her I thought more research was the key to a better understanding and ultimately a better experience for women and I hoped to find a way to do it.

I was lucky to connect with two amazing collaborators: Dr. Nancy Woods, a PhD, epidemiologist and one of the pioneers of women’s midlife health and Dr. Marcie Richardson, a gynecologist who founded a menopause clinic 25 years ago. They listened to my hypothesis that for some women, changes associated with perimenopause begin before very noticeable menstrual cycle changes. 

In 2020 we launched our first Women Living Better survey to test that hypothesis. That study helped define a range of symptoms, when they begin and how they were similar and different before and after noticeable menstrual cycle changes.

That original research exceeded expectations:

• We published seven papers in peer-reviewed journals.
• Our findings have been cited in several papers and in an international white paper on menopausal hormone therapy.
• We presented our research in a plenary talk at The Menopause Society’s annual conference in 2025 challenging assumptions about when menopause-related changes actually begin.
• We’ve put the phrase “Not Feeling Like Myself” during perimenopause on the map and begun to better define the constellation of symptoms behind it.

Now, we’re launching a second study, focused specifically on mood changes during perimenopause—a topic that resonates with many women but remains under researched. As a result, mood changes are not validated nor normalized enough leaving women feeling surprised, concerned about what these new feelings might represent and alone.

With this new survey, we aim to answer key questions about mood in midlife such as:

• When do mood changes typically begin in relation to shifts in the menstrual cycle?
• What other symptoms or life stressors might be connected to these emotional shifts?
• Which strategies, supports, or treatments help — and which don’t?

Our vision is for women to have better information, to normalize and validate their experiences and ultimately get better care. This study will fill important knowledge gaps toward enabling that. And if you’re between the ages of 35 and 55, you can help us in our goal of greater understanding and take the anonymous survey here.