Not all women’s midlife health problems can be blamed on perimenopause

Nov 5, 2026 – 5.00am Doctors say they are seeing a worrying rise in women in their late 30s and early 40s demanding hormone replacement therapy (HRT) treatment for symptoms such as night-time wakings, anxiety, trouble concentrating and brain fog, believing they must be signs of perimenopause.

Yet evidence shows that in the absence of changed menstrual patterns and hot flushes or night sweats, those issues are more often caused by life stress or unrelated health conditions in women so young. That means hormones are unlikely to fix them, and starting therapy too early carries health risks.

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