Perimenopause crisis: What works, what doesn’t—and how the hype machine turns anxiety into a $200-a-month payday

Lisa Schrenk, a federal IT specialist, was contemplating suicide before fellow hikers on Virginia’s Old Rag Mountain casually mentioned hormone therapy — and her intense anger, anxiety, and exhaustion suddenly made sense as perimenopause, as Wired reports in a new investigation by Katie Knibbs. Two gynecologists had already given her an “automatic no” on switching from birth control to hormone therapy; a telehealth startup called Midi finally said yes. Five months later, Schrenk says, “I’m no longer planning my own funeral.”

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The real medicine, and the overreach

Estrogen and progesterone genuinely treat hot flashes, night sweats, and bone loss, and the FDA lifted its “black box” warning on hormone therapy last fall. Kathleen Jordan, Midi’s chief medical officer, calls hormones “a very effective tool for health and wellness.” But Stephanie Faubion, the Menopause Society’s medical director, says the “hype machine has gotten completely out of hand,” pinning fatigue and mood swings on hormones with little evidence — and calls popular estrogen face creams “garbage.” Midi itself had to drop an ad claiming 91 percent of patients “find relief within 2 months” after a truth-in-advertising complaint.

Meanwhile, subscriptions run up to $200 a month, supplements go unregulated, and rising demand — often from people who aren’t even sure they’re perimenopausal — is straining the actual drug supply.

Supplement bottles on a store shelf
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