Perimenopause and Menopause: What Every Woman Should Know in 2026

For a long time, menopause was something women whispered about, if they talked about it at all. That's finally changing. More women are speaking openly about their symptoms, more doctors are paying attention, and in late 2025 there was a major change to how hormone therapy is labeled in the United States. Here's what every woman should know.

Perimenopause vs. Menopause

Perimenopause is the transition leading up to menopause, when hormone levels, especially estrogen, start to rise and fall unevenly. It often begins in your 40s, sometimes earlier, and can last several years. Menopause is officially reached after 12 months in a row without a period. For most women in the U.S., that happens in their early 50s. The years after that are called postmenopause.

Common Symptoms

• Irregular periods (shorter, longer, heavier or lighter)
• Hot flashes and night sweats
• Trouble sleeping
• Mood changes, irritability or anxiety
• Brain fog and trouble concentrating
• Vaginal dryness and changes in libido
• Joint aches and changes in weight or body shape

Every woman's experience is different. Some barely notice the change; others find symptoms affect their work, sleep and relationships. If yours are bothering you, you don't have to just put up with them.

The 2025 Change to Hormone Therapy Labels

In November 2025, the FDA announced it would remove the "black box" warnings from menopause hormone therapy products containing estrogen. Those warnings had been in place since 2002, after the Women's Health Initiative study, and many experts say they discouraged women from treatment that could have helped them. The updated labels include guidance that women may benefit most when they start hormone therapy within 10 years of menopause. One boxed warning stays: estrogen-only therapy still carries a warning about endometrial cancer risk for women who have a uterus.

Hormone therapy isn't right for everyone. Whether it makes sense for you depends on your age, symptoms, personal and family health history, and other conditions. The best next step is an honest conversation with your doctor.

Everyday Habits That Help

• Lift weights. Strength training helps protect bone and muscle, which both decline faster after menopause. Read my strength training guide.
• Protect your sleep. Keep your bedroom cool, wear breathable layers to bed, and keep a regular bedtime.
• Notice your triggers. Alcohol, caffeine, spicy food and stress can make hot flashes worse for some women.
• Eat for your bones and heart. Focus on calcium, vitamin D, protein, fiber, fruits and vegetables.
• Look after your heart. Heart disease risk rises after menopause. See my post on heart health for women.

Questions to Ask Your Doctor

• Are my symptoms related to perimenopause or something else?
• Am I a good candidate for hormone therapy? What are the benefits and risks for me?
• What non-hormonal options are there?
• Should I have a bone density test or any heart health screenings?

Tip: track your symptoms and cycle for a month or two before your appointment. It makes the conversation much more productive.

This article is for general information and isn't medical advice. Talk with your doctor or another qualified health professional about your own health, especially before starting a new exercise plan or treatment.

Sources: FDA announcement (Nov. 2025), Harvard Health.