Perimenopause: The important life stage women are not talking about enough

Every week, PhilSTAR L!fe explores issues and topics from the perspectives of different age groups, encouraging healthy but meaningful conversations on why they matter. This is Generations.

Our moms taught us about our first period. They gave us pads, told us what to expect, walked us through our fears, and taught us how to care for ourselves. But somehow, nobody talked about what comes next: perimenopause.

Most of us are only familiar with menopause—that time when your period stops for 12 consecutive months. No one told me there was a transition phase before it that could last for years. No one told me it had a name. No one told me it could affect every aspect of my life: my body, my emotions, my sleep, my confidence, my relationships, and even my sense of who I am. 

But I don’t blame them. The more I learned, the more I realized that perimenopause and menopause have long been wrapped in silence, stigma, and the fear of “getting old.” Perhaps the women before me didn't fully understand it themselves. Perhaps they were taught, like many of us, to simply endure.

When perimenopause begins

In a previous interview with PhilSTAR L!fe, obstetrician-gynecologist Agnes L. Soriano-Estrella defined perimenopause as the transition leading up to menopause, when hormonal changes begin even before a woman's menstruation stops completely. Obstetrician-gynecologist Maria Jesusa Banal-Silao said it can start five to seven years before menopause, with symptoms varying widely from one woman to another.

Last year, I entered this stage myself.

The first symptoms were muscle and joint pains, and an overwhelming fatigue that felt different from anything I had experienced before. At times, I felt feverish, yet every time I checked my temperature, it was normal. I remember wondering, "What is happening to me?"

Like many women, I turned to my trusted girlfriends for answers. To my surprise, almost all of them said they had been experiencing similar changes. Some admitted they thought it was just them, while others assumed it was simply stress.

Their answers comforted me and reminded me I wasn’t alone, but they also revealed something else: Many of us have been going through the same thing, but not all of us knew exactly what to do about it. 

For many years, the majority of women had simply learned to let the symptoms pass. A 2022 study showed that almost half of midlife women haven't even consulted their doctors due to stigma or lack of help.

I refused to believe enduring was the only option. Determined to find better answers, I started advocating for myself: I researched, listened to experts, and consulted several doctors. But honestly, some of those consultations left me frustrated. Some normalized everything without offering solutions, while others barely discussed perimenopause at all.  
 
Eventually, I found doctors who truly understood this stage and made me feel seen, heard, and supported. That made me realize that while there may be many doctors for women, not all doctors are deeply trained or experienced in perimenopause and menopause care. 

Why many women miss the signs

I asked Dr. Menefrida Reyes—OB-GYN at St. Luke’s Medical Center in Quezon City and Board Secretary of the Philippine Society of Climacteric Medicine, a professional medical organization in the Philippines dedicated to women’s midlife and menopause health—why many Filipinas miss the signs of perimenopause. "It is primarily because of the lack of awareness on the side of the women and also for our part as doctors, since there's still a lack of physician engagement and a lack of patient education into this very significant stage in a woman’s life," she said.

Perhaps that is exactly the issue. Many women don’t necessarily miss the signs of perimenopause; they simply don't know that the changes they are experiencing are symptoms. Some of us may even dismiss them and chalk it all up to aging.

But while aging is natural, perimenopause is more than simply getting old. It is a major biological transition that every woman will go through, which is why it deserves understanding, support, medical attention, and compassion. 

Awareness should only be the beginning of a conversation about how women can take care of themselves through this transition.

Dr. Reyes encouraged women to take proactive steps like prioritizing proper nutrition and regular exercise, avoiding smoking, limiting alcohol intake, and maintaining meaningful social connections to help manage stress.

The women's health expert also suggested paying attention to changes in your menstrual cycles and moods, and seeking medical advice when the changes begin to affect your daily life. She likewise stressed the value of routine health screenings and good sleep hygiene to allow the body the recovery it needs. 

Caring for yourself during perimenopause doesn't mean doing everything perfectly overnight. Sometimes it only requires simple steps like listening to your body, moving and resting with intention, finding your people, talking to the right doctor, and most importantly, admitting that this stage is real: You are not “losing it”; you don’t have to endure it; and you are definitely not alone.

Maybe this is our responsibility now—to do better for ourselves and for the next generation of women, to openly talk about it, and to prepare our daughters, nieces, younger friends, and future generations for a stage in life no one prepared us for.

No woman should have to discover perimenopause only after months—or years—of questioning her own body. The goal isn’t simply to normalize the conversation, but to ensure that women have the knowledge to recognize the signs, the support to seek care, and the confidence to advocate for themselves. When awareness grows, confusion gives way to understanding, and silent suffering no longer has to be part of the journey.