Experts warn against perimenopause misinformation and unsupervised HRT use
Specialists from the International Menopause Society and the British Menopause Society urge patients to seek clinical evaluation for midlife symptoms rather than relying on unproven supplements or unsupervised hormone replacement therapy.
Medical experts from the International Menopause Society and the British Menopause Society have issued warnings against the growing prevalence of misinformation surrounding perimenopause. Specialists caution that social media-driven narratives are encouraging self-diagnosis and unsupervised hormone replacement therapy (HRT), which can lead to ineffective treatment and health risks. The societies emphasise that standard HRT is generally unsuitable for perimenopausal women due to fluctuating natural hormone levels, which can render the therapy ineffective or cause abnormal bleeding.
Mary Ann Lumsden, former president of the International Menopause Society, noted that perimenopause typically begins around age 46 or 47 and is characterised by wild fluctuations in hormones such as oestrogen, progesterone, luteinising hormone, and follicle-stimulating hormone. These variations make hormone testing unreliable for diagnosis. Lumsden stated that hormone measures cannot be accurately interpreted during this stage because such changes are normal, and there is currently no definitive test for perimenopause.
Paula Briggs, former chair of the British Menopause Society, described the social media messaging around perimenopause as almost cult-like. She expressed concern that younger women are being encouraged to assume they are perimenopausal and seek HRT treatment. Briggs warned that standard HRT is designed for menopausal women whose hormone levels have declined, and administering it to perimenopausal women may result in the treatment being swamped by their own hormone production. This can lead to abnormal bleeding and fails to address symptoms effectively.
The experts also highlighted a lack of evidence for many marketed supplements. Lumsden pointed out that some patients take testosterone supplements based on social media advice, yet blood tests reveal no increase in testosterone levels, suggesting the products contain unregulated or ineffective ingredients. Furthermore, Nanette Santoro, a professor of obstetrics and gynaecology at the University of Colorado Anschutz, advised against attributing all midlife symptoms to hormonal changes. She noted that symptoms such as fatigue, brain fog, and digestive issues do not link closely to menstrual cycle changes and should be medically investigated to rule out other conditions.
Santoro emphasised that attributing every unpleasant symptom in women over 35 to perimenopause lacks scientific evidence. The article notes that the author’s own pelvic pain was identified as endometriosis, a condition that can be exacerbated by HRT, rather than perimenopause. Experts advise that women experiencing symptoms such as pain or fatigue should seek medical evaluation to ensure they are not caused by other underlying issues, rather than automatically assuming hormonal changes are the cause.
