Perimenopause Awareness Month 2026: the five biggest wins of September

Win 1: Congress held its first ever hearing on menopause

On September 16, the Senate Special Committee on Aging held the first congressional hearing in United States history devoted to menopause. The title was "Half the Country, Zero Hearings," which is the most accurate thing the Senate has said in a while.

It was bipartisan. Chairman Rick Scott, a Florida Republican, and Ranking Member Kirsten Gillibrand, a New York Democrat, ran it together. Four witnesses testified: a public health researcher from the University at Buffalo, an OB-GYN representing ACOG, an attorney and advocate from NYU Law, and a physician from the HHS Office on Women's Health. They covered the research gap, the training gap, and the care gap, which regular readers of this library will recognize as the three horsemen of "your labs look fine."

Two things came out of it that matter:

• A bipartisan GAO request. Scott and Gillibrand followed the hearing with a request for the Government Accountability Office to examine how federal agencies fund and coordinate menopause research and care. Translation: someone with subpoena-level curiosity is now going to count the money.
• Momentum for the money bill. The Advancing Menopause Care and Mid-Life Women's Health Act, reintroduced this year by Senators Patty Murray and Lisa Murkowski, would authorize 275 million dollars over five years for menopause and midlife women's health. That is roughly 25 million a year in new research funding, against an NIH menopause portfolio that currently sits under 60 million a year. Not a fix. A real start.

Why it counts for you: a hearing is how a topic stops being a personal problem and starts being a policy problem. Once it is a policy problem, it gets budgets, staff, and follow-up. Half the country just got its first hearing. There will be a second.

Win 2: The FDA finally looked at testosterone for women

The very next day, September 17, the FDA's Office of Women's Health and Center for Drug Evaluation and Research held a full-day public workshop on testosterone use in menopausal women. It was the first time the agency has publicly taken up the question in more than twenty years.

Here is the situation the workshop was built around. There is no FDA-approved testosterone product for women in the United States. Women who use it are prescribed it off-label, often as a small fraction of a dose designed for men. Meanwhile, use is climbing, driven by social media and by women who tried everything else. If you have read our testosterone article, none of this is news to you.

What the workshop actually did:

• FDA officials acknowledged the rising off-label use out loud and said the evidence is strongest for low sexual desire, with everything else (mood, energy, cognition) still needing real trials.
• Multiple participants called for testosterone at physiologic doses for women to be removed from its controlled substance designation, which is one of the practical reasons it is such a pain to get.
• The FDA repeatedly invited drug companies to come talk to them about developing a women's product. Legal and regulatory analysts read that as the agency signaling a potential approval pathway.
• The FDA said that more than 80 percent of the comments on its docket came from women. Women put this on the agenda. The agency said so.

Why it counts for you: you can still weigh in. The public comment docket, FDA-2026-N-5479, is open until October 19, 2026 at 11:59 p.m. Eastern. Go to regulations.gov, search the docket number, and tell them what your experience has been. It does not need to be eloquent. It needs to be counted.

Win 3: ACOG built a perimenopause playbook for your doctor

On September 23, the American College of Obstetricians and Gynecologists published a clinical toolkit specifically for managing perimenopause, in its journal Obstetrics & Gynecology.

Read that again: perimenopause, not menopause. Most guidelines are written for women whose periods have already stopped. Perimenopause is messier, because you can still ovulate, still get pregnant, still have cycles, and still have every symptom on the list at the same time. The toolkit walks clinicians through exactly that mess. It separates women who need contraception or want to suppress ovulation from women who do not, and lays out the hormonal options for each path, including progesterone alone or progesterone plus estrogen at menopausal hormone therapy levels.

The clinicians who reviewed it made the quiet point that matters most: most care providers are not familiar with treating this stage, and the default move has been to hand over a birth control pill and hope. Now there is a written framework that says "here are the other options, and here is how to choose."

Why it counts for you: you can name it. "ACOG published a perimenopause management toolkit in September. Can we look at where I fit in it?" is a sentence that changes an appointment. Pair it with our guide for when you are told you do not qualify for HRT.

Win 4: Science proved perimenopause is measurable (you are not imagining this)

On September 22, Nature Medicine published a study showing that menopause leaves a distinct signature in the blood. Researchers measured 118 brain-health-related proteins in carefully staged premenopausal, perimenopausal, and postmenopausal women, then validated the pattern in thousands more.

The headline finding: 16 proteins rise across the transition, covering inflammation, metabolism, synaptic function, and Alzheimer's-related biology. The researchers combined them into a single "menopause proteomic score," and the score climbed step by step from premenopause to perimenopause to postmenopause. The changes tracked with hormones, not with age. Women with more hot flashes showed the most pronounced inflammatory shift.

The part that will make headlines is the link to later brain aging and dementia risk, so let us be precise about it. The increase in risk was modest. It is an association, not a cause. Most women who go through menopause never develop dementia, and the authors say so. The researchers' own framing is that this signature may help identify who benefits from which interventions, and when.

Why it counts for you: for decades the official line was that perimenopause is a vibe, and the vibe was yours to manage. This study says the transition is biologically distinct, detectable, and tied to hormones rather than birthdays. The next time someone suggests it is all in your head, you can point out that it is also in your blood, and that a peer-reviewed journal checked.

Win 5: Perimenopause got written into proclamations and law

Awareness months are easy to roll your eyes at. This one came with paperwork.

• Governors said the word. Michigan Governor Gretchen Whitmer and North Dakota Governor Kelly Armstrong both formally proclaimed September 2026 Perimenopause Awareness Month. The proclamations acknowledge that perimenopause can last five to ten years, disrupts mood, sleep, and physical health, and that women and healthcare professionals do not know enough about it. Two governors from two very different states, same sentence.
• Advocates went to Capitol Hill. On September 22, Women's Health Advocates, the National Menopause Foundation, and Perry hosted a Perimenopause and Menopause Capitol Hill Day, with a congressional briefing and office-by-office meetings pushing the Menopause Policy Imperative. On September 25, Baltimore hosted the first multidisciplinary Perimenopause Symposium for clinicians.
• Workplace protections are locked in for 2027. Illinois Governor JB Pritzker signed the Illinois Menopause Equity and Care Act in August, and the coverage landed this month: starting January 1, 2027, employers with four or more employees must provide reasonable accommodations for perimenopause and menopause, which can include flexible schedules, temperature-adjusted workspaces, and private rest space. Insurers there will have to cover menopause care starting in 2028. Philadelphia's ordinance making menstruation, perimenopause, and menopause protected classes also takes effect January 1, 2027. Rhode Island went first in 2025. The list is getting longer.

Why it counts for you: "perimenopause" is now a word that appears in employment law, not just in group chats. If you work in Illinois or Philadelphia, print the statute before your next accommodation conversation. If you do not, share it with someone who does, and watch your own state. More than half of them have introduced menopause-related bills.

One more headline you will see this week

On September 28, a large Danish study in The BMJ reported that oral hormone therapy is associated with a higher risk of blood clots regardless of dose or duration, while transdermal hormone therapy (patches and gels) showed no general increase in clot risk. Stroke and heart attack risk showed up only with prolonged high-dose oral use. This is not new territory, and it is not a reason to panic. It is one more piece of evidence for the thing menopause specialists have been saying for years: the delivery method matters. Our patch vs gel vs pill comparison explains why.

What to do with all of this

1. File a comment with the FDA before October 19. Docket FDA-2026-N-5479 on regulations.gov. Two paragraphs about your own experience is enough.
2. Bring the ACOG toolkit into your next appointment by name, especially if the only thing you have ever been offered is birth control.
3. Save the Senate hearing title and date. "Half the Country, Zero Hearings," September 16, 2026. It is a useful thing to say to a partner, a manager, or a doctor who thinks you are exaggerating.
4. Check your state. More than half of US states have introduced menopause legislation. Yours might be one signature away.
5. Track your own data. Every win on this list happened because women counted themselves in. Your symptom log is the smallest version of the same thing.

The bottom line

In one month: a first-ever congressional hearing, a first-ever FDA workshop on testosterone for women, a perimenopause-specific toolkit from the country's largest OB-GYN body, a Nature Medicine study proving the transition is biologically real and measurable, and perimenopause written into proclamations and workplace law. None of it happened because the system woke up one morning feeling generous. It happened because women kept saying the word until other people had to. Keep saying it.

Where PeriSlayer fits

Every win above started with women describing what was actually happening to them. PeriSlayer is where you do that for yourself: log symptoms in a few taps, let the app find the patterns, and walk into your next appointment with a timeline instead of a memory. Receipts instead of vibes, on a national scale and on a personal one.