By DR ELLIE CANNON, MAIL ON SUNDAY COLUMNIST AND GP
Published: 11:45 BST, 22 August 2026 | Updated: 13:53 BST, 22 August 2026
It’s ‘just the perimenopause’. It’s a refrain I’ve increasingly heard from friends and patients – and it’s left me worried. Many might argue that more women talking about the perimenopause is a good thing. After all, our understanding of this pre-menopausal condition – where female sex hormone levels begin to fluctuate causing periods to become irregular – has come on in leaps and bounds in recent decades.
With that greater understanding has come greater awareness – and better treatment – for those experiencing uncomfortable perimenopause symptoms. However, there has been a dangerous downside – because as research into perimenopause has grown, so too has the list of possible symptoms.
At the same time, perimenopause has become a massive talking point on social media. Self-appointed perimenopause ‘experts’ have made whole careers from making TikTok videos and Instagram posts about the symptoms and treatments.
I’m beginning to worry we are getting to a point where our obsession with perimenopause means other medical conditions are being missed. These might be psychological problems such as depression or anxiety – but they could be life-threatening too.
Take some of the women who recently told me about supposed perimenopause troubles. One told of new vaginal bleeding, another of pain while peeing and one had a sudden loss in weight.
All these symptoms could be due to the perimenopause – but they all could be signs of cancer too. Crucially, none of these women had been tested for the deadly disease – or anything else. Instead, they’d been handed hormone replacement therapy [HRT].
My fear is there are countless women who are being wrongly told they have perimenopause – meaning they are not being treated for the true cause.
So, how can you know whether your symptoms are down to perimenopause? First, it’s important to explain what is occurring in the body during perimenopause. The condition occurs when levels of female sex hormones oestrogen and progesterone begin to fluctuate. This usually happens when women are in their mid to late 40s.
My fear is there are countless women who are being wrongly told they have perimenopause – meaning they are not being treated for the true cause, writes Dr Ellie
Perimenopause and menopause are often used interchangeably, but they are not the same. Menopause is when sex hormone levels drop permanently and periods stop. While many still experience symptoms after the menopause, the most uncomfortable and distressing issues tend to occur during perimenopause as this is when sex hormones are most erratic.
The most common of these are hot flushes, sleep issues, mood swings and vaginal dryness.
But the list of perimenopause symptoms has grown. For my recent book, The Little Book of HRT, I tallied up an astonishing 45.
The problem is when doctors assume any middle-aged woman who develops vague symptoms is experiencing perimenopause. There are so many other explanations. Psychological issues such as trouble sleeping or brain fog could be due to mental health problems.