Perimenopause — the years-long transition before menopause when hormone levels fluctuate wildly — has become a major topic on social media, with influencers and wellness brands urging women to recognize its symptoms and seek treatment. But according to a deeply skeptical analysis in MIT Technology Review, much of what is being sold as perimenopause science does not hold up to scrutiny.
“There is no such thing as a perimenopause test,” Mary Ann Lumsden, former president of the International Menopause Society, told the publication. “You can’t interpret hormone measures because they change so much. And that is quite normal.”
The article, written by senior health reporter Jessica Hamzelou, argues that the commercialization of perimenopause has outpaced the evidence, creating a market for unregulated supplements, unnecessary prescriptions, and a diagnostic label that is being applied far too broadly.
No test, no definition, no clear diagnosis
Menopause is straightforward to define: it occurs one year after a person’s last menstrual period. Perimenopause, by contrast, is a fuzzy, retrospective diagnosis. It refers to the years when ovarian hormone production begins to fluctuate — but those fluctuations are precisely what make it impossible to diagnose with a single blood test. Symptoms such as hot flashes, sleep disruption, mood changes, and vaginal dryness do overlap with perimenopause, the article notes, but they also overlap with stress, thyroid disorders, depression, and a dozen other conditions.
“Attributing everything unpleasant that happens to a woman over 35 to perimenopause is not based on any scientific evidence,” said Nanette Santoro, professor of obstetrics and gynecology at the University of Colorado Anschutz.
The HRT problem
Hormone replacement therapy (HRT) is effective for menopausal women whose ovaries have stopped producing estrogen. But in perimenopausal women, the ovaries are still producing estrogen — erratically, but often at high levels. Standard HRT doses, Lumsden explained, “may well get swamped by the woman’s own hormone production,” potentially causing abnormal bleeding and other complications.
Paula Briggs, former chair of the British Menopause Society, described the current push for HRT as “almost cult-like.” The concern is that women who do not need it are demanding prescriptions based on social media trends rather than medical evaluation.
Supplements without evidence
Testosterone supplements marketed for perimenopause are a particular concern. Lumsden noted that patients taking these supplements showed no increase in blood testosterone levels. “Whatever they are getting, it is not testosterone,” she said.
More broadly, the article warns that the perimenopause label can mask other serious conditions. Hamzelou describes her own experience of pelvic pain that she initially attributed to perimenopause — it turned out to be endometriosis, a condition that HRT can actually worsen.
The broader picture
The article does not argue that perimenopause symptoms are unreal or that women should suffer in silence. Rather, it warns that a one-size-fits-all narrative promoted by commercial interests — supplement companies, private clinics, and influencers — may lead women to demand treatments they do not need and miss diagnoses they do.
“If you experience symptoms, get a medical evaluation,” Hamzelou concludes. “But do not assume it is perimenopause, and do not demand HRT before a proper diagnosis is made.”
Source
- Hamzelou J. “There’s a lot of hype around perimenopause. Don’t buy it.” MIT Technology Review, July 17, 2026. Full article