Is ‘Perimenopause’ the New Women’s Health Epidemic—or Misinformation?

The conversation around women’s health is shifting, but not always in a helpful direction. A fresh film, “The M Factor 2: Before the Pause,” which premiered on PBS March 19, 2026, is reigniting debate about the medicalization of midlife and the potential for overdiagnosis. While proponents frame it as a necessary step toward destigmatizing perimenopause, critics argue the film expands the definition of a medical condition to encompass normal life experiences, potentially leading to unnecessary interventions and fueling a booming industry built on women’s anxieties.

A History of Medicalizing Women’s Experiences

The idea that hormonal fluctuations are inherently destabilizing to women is not new. Historically, women’s bodies and behaviors have been pathologized, with diagnoses ranging from “troublesomeness” to “erotic tendencies” used to justify medical interventions, including the surgical removal of ovaries. As Barker-Benfield details in *The Horrors of the Half-Known Life*, this practice was shockingly common in the early 20th century. The current focus on perimenopause, some argue, echoes this history, framing a natural transition as a crisis requiring medical management.

“Before the Pause” builds on the foundation laid by the original “The M Factor,” which itself faced scrutiny and ultimately lost accreditation as a continuing medical education activity after concerns were raised about misinformation. The sequel aims to broaden the scope, suggesting that hormonal changes in a woman’s 30s can derail cognitive function, physical health, and mental well-being. The film opens with a dramatic account of a woman forgetting her own name, immediately establishing a tone of alarm.

What is Perimenopause, Exactly?

Defining perimenopause is surprisingly complex. Menopause is clearly defined as the cessation of menstruation – one year without a period. But perimenopause, meaning “around menopause,” is far more ambiguous. It encompasses the years leading up to menopause, typically beginning in a woman’s 40s, but increasingly recognized as starting earlier, even in the 30s. During this time, hormone levels fluctuate, menstrual cycles grow irregular, and women may experience a range of symptoms. However, as a 2005 National Institutes of Health (NIH) expert panel concluded, only vasomotor symptoms (hot flashes and night sweats), vaginal dryness, and potentially sleep disturbances are definitively attributable to menopause itself.

The challenge lies in disentangling the effects of hormonal changes from other factors that commonly occur during midlife – stress, career pressures, family responsibilities, and the natural aging process. The film, and a growing chorus of voices online and in the media as reported by the Washington Post, attribute a vast array of symptoms to perimenopause, including weight gain, decreased libido, “brain fog,” and even flu-like symptoms. This broad attribution risks pathologizing normal experiences and overlooking other potential causes.

The Rise of Perimenopause as a “Crisis”

The prominence of perimenopause as a distinct and frightening phase in a woman’s life is being fueled by a network of influencers, advocates, and healthcare providers. The M Factor website itself offers merchandise to “shred the silence” and spread awareness. However, many of these individuals also stand to profit from the growing market for perimenopause-related products and services, raising concerns about potential conflicts of interest. STAT News recently reported on the booming business of perimenopause, highlighting the proliferation of supplements, apps, and therapies targeting this demographic.

It’s important to acknowledge that some women do experience significant and debilitating symptoms during perimenopause, particularly vasomotor symptoms. These symptoms deserve attention and appropriate treatment. However, the tendency to attribute *any* symptom to perimenopause can be harmful. As journalist Jessica Toonkel discovered, attributing persistent itchiness to perimenopause delayed the diagnosis of her Hodgkin’s lymphoma, highlighting the dangers of overlooking other potential causes.

Are Symptoms Unique to Women?

Research suggests that many symptoms commonly attributed to perimenopause are not exclusive to women. A 1994 Dutch study compared midlife symptoms in men and women and found that, with the exception of excessive sweating, there were no significant differences. Similarly, a 2018 Korean study found similar gender differences, with both men and women experiencing forgetfulness, decreased sexual desire, and increasing waist circumference during midlife. This suggests that many of these symptoms may be more closely linked to aging and lifestyle factors than to hormonal changes specific to perimenopause.

The narrative that women are at the mercy of their hormones for most of their adult lives is not only inaccurate but also disempowering. Midlife can be a challenging time for both men and women, but it is not a medical condition. Focusing on healthy lifestyle choices – diet, exercise, mental health, and social support – can benefit individuals of all ages and genders.

Instead of framing perimenopause as a crisis to be “fixed,” a more empowering approach would be to embrace the concept of menopause empowerment, as advocated by some researchers. This approach emphasizes education, self-care, and a holistic understanding of women’s health, rather than solely focusing on hormonal manipulation.

Patricia Bencivenga, M.S., is the special projects manager at PharmedOut, a rational prescribing project at Georgetown University Medical Center. Adriane Fugh-Berman, M.D., is a professor at GUMC and director of PharmedOut. She is a paid expert witness in litigation regarding pharmaceutical marketing practices and was an expert in multi-district litigation regarding menopausal hormone therapy in 2012.