Welcome to the game show where the prize is a diagnosis and the consolation prize is also a diagnosis: Perimenopause or Just Tuesday?

Here's how it works. Below are common experiences from the second puberty, the one we call cougar puberty. For each one, ask yourself: is this hormones, or is this simply what being alive in your 40s is now? Spoiler: frequently, both.

Hot flash, or the office heat is on?

You are suddenly radiating heat like a space heater. Everyone around you is wearing a cardigan. Is it a hot flash, or did someone turn up the thermostat?

Diagnosis: likely a hot flash; they're the most common menopause symptom, affecting up to three out of four women Established: OWH. Also possible: the office heat is on. These are not mutually exclusive.

Brain fog, or did you just have three tabs open?

You walked into the kitchen and cannot remember why. You've said "what was I saying?" twice in one conversation. Is it brain fog, or are you just carrying a normal amount of mental load?

Diagnosis: could be either. The unhelpful truth is that perimenopause changes can include cognitive blips, and so does having a life. The helpful truth: writing things down fixes most of both.

Crying at the dog commercial, or did it hit different?

A commercial with a golden retriever and a soldier has you fully weeping. Is it hormones, or was that commercial just well-made?

Diagnosis: hormones can absolutely amplify emotional responses during perimenopause. But that dog really was doing his best. Both things can be true.

The 3 a.m. wake-up, or did you drink water at 9 p.m.?

You are awake at 3:17 a.m., fully alert, mildly annoyed. Is it a night sweat / hormone wake-up, or did your bladder stage an intervention?

Diagnosis: both are extremely normal. Night sweats are hot flashes that happen during sleep Established: The Menopause Society, and a 9 p.m. glass of water is a 3 a.m. event. The full inventory is in The 3 AM Starter Pack.

The thermostat war, or is your partner a lizard?

You are sweating at 68 degrees. Your partner is under a duvet, visibly content. Is this a temperature-regulation change, or has your partner's body simply evolved for a colder climate?

Diagnosis: perimenopause can genuinely change how your body regulates temperature Established: The Menopause Society. Your partner may also be a lizard. Resolve via: one leg out of the covers, a fan, a separate blanket, and possibly sheets that don't trap heat like a greenhouse. See The Cool Down for the full arsenal.

The period that's doing something new, or a calendar error?

Your period arrived early, then late, then heavy, then light, like it's auditioning for something. Is this perimenopause, or did you misread the calendar?

Diagnosis: changing cycles are often the first sign of perimenopause Established: OWH. This one's worth tracking, and worth a mention to your clinician, especially if bleeding is heavy, prolonged, or between periods.

The skincare crisis, or did you switch products?

Your face is suddenly dry in new places and oily in others. Is it hormones, or did that new serum betray you?

Diagnosis: skin changes are a real perimenopause experience, and so is product betrayal. Your skin has entered the chat.

When to stop playing the game

The game is fun until it isn't. Play "Perimenopause or Just Tuesday?" with these exceptions; no guessing allowed:

  • Heavy, prolonged, or between-period bleeding
  • Chest pain, pressure, or a racing heart that's new
  • Severe depression, anxiety, or thoughts of self-harm
  • Night sweats with fever, cough, or unexplained weight loss

Those get a clinician, not a shrug. The rest of the list? Welcome to the club: the second puberty is real, it's normal, and you're not losing it. What cougar puberty actually is →

Cougar Puberty Club is a media publication, not a medical practice. This page is not medical advice. Read the medical disclaimer.