Dr. Betty MurrayHelping Women Navigate Menopause | Speaker, Author, and Advocate for Women's Health Over 40

Perimenopause Is More Than Hot Flashes

24 Jul 2026 · 1 min

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In this video excerpt, Dr. Betty Murray argues that the conventional definition of menopause—centered on hot flashes and the cessation of periods—is incomplete and misleading. She emphasizes that the early phase of perimenopause is primarily neurological, manifesting as sleep disruption, anxiety, depression, irritability, mood instability, body‑composition changes, and severe brain fog, even when menstrual cycles appear normal. Dr. Murray also critiques the clinical reliance on static blood hormone panels, noting that hormones fluctuate dynamically during perimenopause, making single‑time‑point tests insufficient. She calls for a broader, symptom‑focused understanding and more nuanced hormonal assessment to better support women navigating this transition.

Chapters

So mainstream advice tells women you're in menopause when you get hot flashes and your period stops. So if you listen to me, you know, that's complete and utter bullshit. This completely misses the boat and it misleads women into thinking that the years leading up to this moment where we're experiencing sleep disruption, anxiety, depression, body composition changes, and things like irritability and mood instability and a brain that feels like mush because you have extraordinary brain fog despite having normal cycles are all in your head. The symptoms of perimenopause are largely neurological in the beginning, and mainstream clinical practice also over-relies on static blood panels in a dynamic moving target. So they don't even look at your hormones. So therefore you get told we can't look at 'em because they're changing too much.