Perimenopause Can Make You Furious. Medicine Has No Name for It.
Hot flashes have a name. Brain fog has a name. Sleep loss has a name. Perimenopausal rage does not.
In an essay for TIME, OB-GYN Dr. Sarah Berg argues that the public menopause conversation has focused almost entirely on symptoms that are easiest to measure and study: the ones with a clear physiological mechanism, a clinical name, a treatment option. Rage is not one of them. It gets folded into depression or categorized as a subtype of anxiety. There is no diagnostic code for it. There is no guideline that tells a clinician what to do when a patient says she has started feeling a level of fury she cannot explain.
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The gap has real professional consequences. Irritability and depression are studied because they fit existing psychiatric frameworks. Rage is harder to categorize and harder to study. Berg notes that perimenopausal mood changes have historically been attributed to stress, relationship problems, or other life factors rather than recognized as a biological phenomenon tied to hormonal fluctuation. When rage is eventually acknowledged, it is usually treated as a mood disorder rather than a hormone-related symptom.
The practical result is that women in perimenopause who describe intense, unfamiliar anger are often offered antidepressants or referred to therapy. Some of those approaches help. But if the underlying driver is hormonal and the treatment does not address hormones, the symptom may persist regardless.
Berg founded Selfority, a company that sells menopause education to employers, so she has a commercial stake in the workplace argument she is making. The clinical gap she describes, however, is well documented in the research literature. Perimenopause mood symptoms remain one of the most underresearched areas in women’s health.
The UNC trial studying perimenopausal irritability is an early step. A diagnostic category, a treatment protocol, and a clinical guideline are further away. In the meantime, clinicians have no standard framework for recognizing perimenopause as the source of a patient’s anger, and patients have no standard language to use when describing it.