Perimenopause took me by surprise. That's exactly the problem. | Opinion

Perimenopause caught me by surprise, and it shouldn’t have.

I work in the wellness industry. I stay on top of my health. I go to my doctor’s appointments. I have close girlfriends I’ve known since childhood who never shy away from honest, uncomfortable conversations.

And yet, at a point in life when I expected things to feel easier – when my kids were becoming more independent and I was deeply fulfilled in my work – I felt anything but. I wasn’t sleeping. I was constantly exhausted. My clothes stopped fitting. Even running, something I had grown to love in my 30s, started to feel like a struggle. I felt slower, weaker and disconnected from my own body.

The most unsettling part of it all was not just the symptoms, but the feeling that I didn’t fully understand what was happening to me, or why. So, I did what so many women do – I assumed the problem was me. It must be stress. An inability to accept change. The new job. A lack of discipline. Just part of getting older.

It wasn’t until I stepped back and connected the dots that it became clear: This wasn’t random. This was perimenopause – and that realization opened the door to two years of searching for answers.

What followed made that realization even more frustrating.

Despite being proactive about my health, perimenopause was never discussed with me. The closest reference was a passing mention from my gynecologist to track if my cycle dropped below 30 days – without ever naming perimenopause. Framed as a metric, not a conversation, it was easy to overlook.

So, when symptoms began around 50, I was completely caught off guard – left trying to make sense of a disjointed set of symptoms without a clear path forward. It wasn’t until a particularly intense moment – a four-hour hot flash on a family vacation – that I finally sought out a new doctor to have a real conversation about hormone replacement therapy.

Perimenopause isn't a 'closing chapter'

That was two years into perimenopause. As a chief growth officer, I often think in terms of time and opportunity – and realizing how much of both I had lost was the most frustrating part.

My experience isn’t unique. The conversation around women’s health has come a long way thanks to leaders like Dr. Mary Claire Haver and companies like Alloy Health and Midi, who have brought long-overdue visibility to this stage of life. Clinicians like Dr. Sara Szal Gottfried – with whom I’ve had the privilege of working at Thorne – are also giving visibility to women’s health – combining clinical rigor with a deep commitment to educating and supporting women through these transitions.

Like many phases in women’s health, perimenopause is too often framed as the start of a “closing chapter.” I find that both reductive and misplaced. It implies a loss of value tied to fertility, rather than recognizing it as an important phase of life that deserves attention and care. As women, we’re given a comprehensive playbook for “what to expect when you’re expecting,” but far less support for the much longer phase of life when you’re not.

That lack of preparation points to a broader issue – and a clear opportunity for change.

First, there’s a significant education gap. Data shows 71% of women were unprepared for how disruptive menopause symptoms would be.Without that foundation, it’s easy to misinterpret what’s happening – or worse, to blame yourself, as I did.

Second, we still don’t approach perimenopause and menopause as part of a continuous health journey. Women’s health doesn’t begin and end at major milestones – it evolves over time. Yet our systems, from health care to broader cultural conversations, continue to treat these phases as isolated events rather than predictable, manageable transitions.

And lastly, too much responsibility still falls on the individual. We often celebrate women for becoming their own advocates, but in many ways, that’s a reflection of a system that hasn’t been designed to prioritize women’s needs.

How women should shape our health care

The real shift is toward personalized care grounded in data. No two women experience these transitions the same way. “This is just part of aging” is no longer an acceptable answer – especially when we now have unprecedented access to our own health data. As individuals gain more visibility into their biology – through labs, biomarkers and digital tools – practitioners and wellness companies have both the opportunity and the responsibility to translate that data into actionable, individualized guidance.

That’s how we move from reactive care to proactive support – delivering solutions that are more informed, more precise and ultimately more human.

And to truly make that shift, we need greater representation in decision-making. Today, only about one-third of patients in clinical trials are female, and women make up just 38% of all physicians in the United States. If we want better outcomes, more women need to be shaping the research, care models and products designed for them. In my own work at Thorne, I’ve seen how much stronger and more relevant solutions become when they reflect the realities women are actually navigating.

I wasn’t prepared for perimenopause. Despite my background, despite my access to information, I still found myself searching for answers and piecing together my own path forward. And that shouldn’t be the expectation.

The next generation of women deserves something different. They deserve to walk into this stage of life with clarity, with support and with access to guidance that reflects both the science and their lived experience. They deserve systems that anticipate their needs – not react to them.

We have the tools. We have the data. We have the voices. Now it’s about using them – intentionally – to build a future where women feel informed, supported and confident in every phase of their health journey.

Mary Beech is chief growth officer at Thorne, the leader in science-backed health and wellness solutions.