When Awareness Isn’t Enough: The Hidden Cost of Oversimplifying Perimenopause
Jul 17, 2025
By: Autumn Backhaus, PhD
For all the good that information-sharing, social media, and awareness campaigns have done to break the silence around midlife and menopause, there’s a quieter downside we need to talk about.
Increased visibility doesn’t always come with increased nuance. In fact, it often flattens complexity into slogans, product lines, and protocols. Women are finally being told that what they’re experiencing is real—and that’s a step forward. But the follow-up message is often dangerously simple: “Here’s the fix.”
The problem is, perimenopause isn’t a single problem at a single point in time. And it doesn’t come with a single solution.
Perimenopause Is a Moving System, Not a Static Diagnosis
Perimenopause is not a diagnosis. It’s a physiological transition marked by hormonal variability, shifting symptom profiles, and non-linear progression. Symptoms fluctuate. Contexts change. And treatment responses should evolve accordingly.
Yet too much of midlife care—along with the awareness and education that shape it—still treats this stage as a single state: something you identify, treat, and stabilize.
In reality, no two women experience this transition the same way. Symptoms can shift day to day, week to week, year to year. And that’s just the hormonal layer. Overlaid on top are the life stressors, relational changes, identity shifts, and cumulative demands that stretch across the same time span. When we reduce care—or the messaging around it—to a one-time solution, we erase the lived reality of a process that’s anything but linear.
We also risk something deeper: giving women the impression that if the plan doesn’t work, there must be something even worse—something more serious, more complicated, more fundamentally wrong with them. Many are told they’ll “feel like themselves again”—or even better than before. And that can be true. But for highly functional, complex, kick-ass women—the ones who already carry more than their share—it often doesn’t unfold that neatly. When the promised reset doesn’t materialize, they don’t just feel disappointed. They start to question themselves. Maybe they’re not as resilient, sharp, or together as they thought they were.
They are. But the model—and the messaging—isn’t.
If She Feels Like She’s the Problem, Something’s Off
We see this often. A woman tries the intervention she was told would help. Maybe it helped. Maybe it helped some. Or maybe it worked at first—but now she’s saying things like, “It kind of worked, but I still feel off,” or “I’m doing everything right, but something’s not adding up.”
And then comes the spiral. She wonders if she misunderstood her own symptoms. She questions whether she’s just anxious. She starts looking for what she must be doing wrong.
In a world that flattens complexity—especially when it comes to women’s health—that response is predictable. But perimenopause is not a one-visit condition. It’s a dynamic, multi-system transition that can unfold over the better part of a decade. When women are led to believe their symptoms should resolve with a single course correction, we set them up to feel like failures the moment things shift.
Care, Education, and Awareness Must Evolve Alongside the Patient
Perimenopause isn’t static. Hormonal shifts occur unevenly over time. Symptoms move across domains—sleep, mood, cognition, pain—and psychosocial context can amplify or shift those experiences.
If awareness campaigns and care systems don’t prepare patients for that reality, we aren’t setting expectations—we’re setting traps. Recent research backs this up: a 2025 Menopause study showed that heightened stress worsens menopause symptoms across physical, psychological, and sexual domains, and that those symptom increases—not just stress alone—are linked to depression risk. It’s the interaction that matters.
It’s Not About Doing More. It’s About Making Space for Complexity.
Responsive care means checking in, not just checking boxes. It means making room for recalibration when something shifts—and it will. Especially in midlife, when women are carrying more than ever, care plans must flex alongside them.
We absolutely shouldn’t abandon evidence-based interventions. But we do need to giving the impression that the fix is a one-and-done fix.
Holding Both Gratitude and Grace for What’s Complex and What is to Come
I’m personally and professionally grateful for how far we’ve come—more awareness, better education, improved research, expanded treatment options. These are real wins. But we can’t let the momentum pull us toward easy answers or rigid protocols. Not for something as complex, variable, and deeply personal as perimenopause.
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Fleischer J.G. et al. (2022). Heightened menopausal symptoms mediate the relationship between stress and depression during the menopause transition. Menopause, 29(5), 553–561. https://doi.org/10.1097/GME.0000000000001957
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Santoro N. et al. (2015). Menopausal symptoms and their management. Endocrinology and Metabolism Clinics, 44(3), 497–515.
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Guthrie J.R. et al. (2004). The menopausal transition: A 9-year prospective population-based study. J Clin Endocrinol Metab, 89(10), 5025–5032.
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