Women Navigate Perimenopause Care Amid Growing Awareness

The conversation surrounding perimenopause is gaining momentum, yet many women still struggle to access appropriate care. Celia Ellenberg, a former beauty director at Vogue, experienced this firsthand. At age 40, she began facing symptoms such as hair loss, insomnia, and menstrual irregularities. Despite her knowledge of perimenopause, both her primary care doctor and her OB-GYN dismissed her concerns, claiming she was too young for such issues.

Ellenberg’s journey reflects a broader trend as women increasingly share their experiences and search for solutions within their networks. The term ‘perimenopause’ describes the transitional phase before menstruation ceases, and its visibility has grown significantly in popular culture. Celebrities frequently discuss it in interviews, and products targeting women in midlife are becoming more common. Yet, for many, finding effective treatment remains a daunting challenge.

Challenges in Securing Care

As Ellenberg’s symptoms worsened, she sought help from various healthcare providers, including an herbalist who suggested hormone testing. However, consultations with specialists often came with high costs—one hormone expert charged $900 per visit and did not accept insurance. Ellenberg eventually reached out to her OB-GYN’s after-hours service, only to discover that the next available in-person appointment was four months away.

“I am a global wellness expert and I live in New York City, and I still couldn’t find help. It’s so crazy to me,” Ellenberg stated, highlighting the frustrations faced by many women in similar situations. The delays in care often lead to women turning to informal channels for advice, sharing contacts for telehealth companies and concierge services that offer more immediate assistance.

Women are increasingly relying on their social circles for information, with many reporting that they learn more from online discussions or friends than from medical appointments. Lauren Caulk, a retoucher based in New York City, noted, “We’re all whispering and trying to find the answers.” This informal network has become vital as traditional healthcare avenues often overlook perimenopausal symptoms, which can include debilitating conditions like insomnia and depression.

Healthcare System Shortcomings

The healthcare landscape reveals significant gaps in support for women undergoing perimenopause. According to Anne Fulenwider, co-founder of Alloy Health, there are over 85 million women in the United States experiencing perimenopause or menopause, yet fewer than 3,000 certified menopause providers are available. “Demand still massively outpaces access,” she stated, underscoring the challenges women face in seeking care.

Many gynecologists focus primarily on routine exams, often neglecting discussions about perimenopause. This oversight can lead to women feeling dismissed or misdiagnosed. Dr. Robert P. Kauffman, a professor of obstetrics and gynecology, emphasized that symptoms related to perimenopause can be complex and require thorough evaluation, which is often not feasible in standard practice due to time constraints.

The stigma surrounding hormone replacement therapy (HRT) has also contributed to the challenges women face. A 2002 study by the Women’s Health Initiative linked HRT to certain health risks, leading many doctors to hesitate in prescribing it. Dr. Kauffman noted, “Many doctors got it wrong, and much of the media got it wrong, and we’re still paying the price for it.”

Women like Alicia Robbins, an OB-GYN who shifted her practice to cater specifically to midlife women’s needs, recognize the inadequacies of traditional care. “Historically, we only focused on ‘bikini medicine’—or care of women’s breasts and reproductive organs,” she explained. Robbins has expanded her practice in response to the growing demand for comprehensive care options.

As the discussion around perimenopause continues to evolve, women are actively seeking solutions that fit their needs. With the support of informal networks and a push for more accessible healthcare options, there is hope for improvement in the treatment landscape. Ellenberg’s experience illustrates the pressing need for change, as many women remain eager for effective care that acknowledges their unique health challenges during this transitional phase.