7 Domains of Women's Health

The menopause industry is booming, but not every product, test, or treatment is backed by good science. From hormone panels and compounded therapies to supplements, social media influencers, and telemedicine startups, women navigating perimenopause are increasingly being asked to spend money on solutions that may offer little evidence—or prioritize profit over patient care.

In the financial domain of perimenopause, Kirtly Jones, MD, and Katie Ward, PhD, examine the business of perimenopause care through the lens of evidence-based medicine. They revisit the history of hormone therapy, unpack how past research continues to shape public perception, and explore why misinformation can become a profitable business model. The conversation also offers practical guidance for evaluating health claims and finding trustworthy, high-quality care without unnecessary costs.

While many women experience “brain fog” during the menopausal transition, research shows that healthy lifestyle habits—including regular exercise, quality sleep, and cardiovascular health—remain among the most effective ways to protect long-term brain function.

In the intellectual domain of perimenopause, Kirtly Jones, MD, and Katie Ward, PhD, are joined by neurologist Christine Cliatt Brown, MD, to separate fact from fiction about the aging female brain. They discuss why cognitive changes are common during perimenopause, how brain fog differs from neurocognitive disorders like Alzheimer’s disease, and when memory concerns warrant further evaluation. The conversation also examines what current research tells us about hormones and brain health, the growing influence of misinformation surrounding perimenopause, and the evidence-based strategies women can adopt to support cognitive health throughout midlife and beyond.

Humans are one of only a handful of species in which females routinely live decades beyond their reproductive years. One leading explanation, known as the “grandmother hypothesis,” suggests older women helped humans survive and thrive by supporting children and grandchildren long after their own childbearing years had ended.

In the social domain of perimenopause, Kirtly Jones, MD, and Katie Ward, PhD, are joined by Kristen Hawkes, PhD, distinguished professor of anthropology and pioneer of the grandmother hypothesis, to explore the evolutionary and social significance of menopause. At a time when many women are told to fear aging or mourn the end of fertility, they examine why post-reproductive women have long played a vital role in human communities, how older generations contribute to the health and success of families, and what this reveals about our deeply social nature.

About 20 percent of women experience depression during the menopausal transition, and many more report increased anxiety, irritability, mood swings, or changes in sexual desire. Yet these symptoms are rarely caused by hormones alone. Genetics, life experiences, relationships, health conditions, aging, and the demands of midlife all intersect during this period, making the psychological and behavioral effects of perimenopause far more complex than fluctuating estrogen levels.

In the emotional domain of perimenopause, Anna Nash, PhD, joins Kirtly Jones, MD, and Katie Ward, PhD, to examine the mood, mental health, and relationship changes that often accompany the transition to menopause. The conversation explores perimenopause within the broader context of a woman’s life—offering a thoughtful look at how women’s sense of self, relationships, and overall well-being evolve with age, experience, and changing priorities.

About 1.3 million women in the United States enter menopause each year, but the transition often begins long before the final menstrual period. In fact, perimenopause can start in a woman’s 40s—or even her late 30s—and may last several years as hormone levels fluctuate unpredictably. Despite affecting half the population, many women are surprised by the wide range of physical symptoms that can accompany this transition.

In the physical domain of perimenopause, Kirtly Jones, MD, and Katie Ward, PhD, launch the 7 Domains of Perimenopause series by exploring what is actually happening in the body during these transitional years. From irregular periods, hot flashes, sleep disturbances, and changing metabolism to the often-misunderstood role of hormone fluctuations, they separate common myths from evidence-based medicine.