The busiest time at Femtech Insider? Early March around International Women's Day.
The second busiest? World Menopause Month.
Unsurprisingly as October 1 kicks off World Menopause Day tomorrow, my calendar is already packed. But this year something shifted - September was earmarked as Perimenopause Awareness Month this year, which started the conversations noticeably early as more and more companies, media outlets, and social media conversations focused on it.
While menopause has achieved mainstream recognition, perimenopause is (imho) really just starting that journey. And the perimenopause market today reminds me a lot of where menopause was a few years ago - at an inflection point where increased awareness creates both opportunity and risk.
Why Perimenopause Is Different
We know menopause is defined as 12 consecutive months without a period - binary, measurable, clear.
Technically, menopause is just a moment in time. What precedes it is perimenopause, what follows is the postmenopausal period. But when we talk about "menopause," we're usually referring to the postmenopausal phase. The term has become shorthand for something we can point to and somewhat easily define.
Perimenopause on the other hand has no such clarity. It's a transition that can last 2-10 years, with symptoms that vary wildly between women and overlap with dozens of other conditions. There's no one blood test, no scan, no definitive marker.
This diagnostic ambiguity isn't just a clinical problem - it shapes everything about how this market is developing.
Earlier today we wrote about Millie Health, a maternal health company expanding into perimenopause care. In a statement founder Anu Sharma described experiencing "the intersection of postpartum and perimenopause [herself]. It was hard to tell whether [her] weight gain, sleep disturbances, mood changes, and chronic pain were due to new motherhood or perimenopause."
That uncertainty - "is this perimenopause or something else?" - is familiar for many women in their early 40s.
And it's this ambiguity creates a market dynamic we've seen before in women's health.
The Double-Edged Sword of Ambiguity
When symptoms are vague and diagnosis uncertain, two things happen simultaneously.
First, there's legitimate innovation opportunity. We need better biomarkers that identify hormonal patterns. Symptom tracking tools that distinguish between perimenopause and thyroid issues, depression, or sleep disorders. Personalized treatment approaches accounting for how differently this transition affects different women. These are real gaps in care that research and companies are starting to address.
But second, the lack of clear diagnostic criteria means the market can expand beyond women actually experiencing perimenopause. Every woman in her late 30s or early 40s experiencing fatigue, mood changes, or sleep issues becomes a potential customer, whether or not hormonal transition is her primary issue. We're seeing companies relabel existing supplements with "perimenopause" and call it innovation.
Someone once told me that the reason so much "snake oil" gets sold to women is because the people targeting them were, for the longest time, the only ones taking their concerns seriously. And when mainstream medicine dismisses symptoms, any acknowledgment - even from questionable sources - feels validating.
This is particularly powerful in perimenopause, where women's experiences are still routinely minimized or misattributed to stress or overreaction.
What We Learned From Menopause
This pattern isn't unique to perimenopause. We've seen it in PCOS, endometriosis, and other conditions lacking clear diagnostic criteria.
The window for questionable products opens widest when medical understanding is incomplete and women feel dismissed by traditional healthcare.
But menopause's journey into mainstream awareness showed us something interesting: As we develop better diagnostics, reduce stigma, and create evidence-based care pathways, the space for real innovation expands while questionable approaches (Anyone remember H&B's menopause chocolate?!) start to lose their foothold.
When women can access trained clinicians who take symptoms seriously, when there are clear treatment protocols, when insurance covers appropriate care - legitimate companies can build sustainable businesses and women get the healthcare they need.
I believe that the perimenopause market is reaching that same point now. We're seeing companies develop better biomarkers and tests, personalized symptom management tools, and integrated care models.
The awareness is creating demand. The question is whether healthcare systems, insurers, and innovators can meet that demand with real solutions fast enough.
So as we close Perimenopause Awareness Month today, let me leave you with one thought today: Yes, Awareness is great, but it is rarely ever enough.
What actually closes the window for questionable products is building legitimate infrastructure: Better diagnostics, trained providers, evidence-based treatments, and systems that take women seriously from the start. That's the lesson from menopause, and it is also the opportunity I see for perimenopause and many, many other areas in women's health right now.
