What do you think?
Rate this book
The Perimenopause Survival Guide: Make Sense of Your Symptoms and Build Your Personalized Treatment Plan
A robust roadmap to surviving—and thriving in—perimenopause.
Perimenopause— the period of time during which a woman moves toward, but is not yet in, menopause— can be one of the biggest transitions of a women’s adult life, marked by massive hormonal changes. Troubled by symptoms like hot flashes, back pain, anxiety, brain fog—just to name a few—and without any clear guidance from their health care providers about the changes happening in their bodies, many women between the ages of 35 and 50 are left to navigate this overwhelming season of life on their own. But it doesn’t have to be this way.
The Perimenopause Survival Guide is the ultimate resource for understanding the hormonal shifts happening within your body so you can make informed decisions about how best to address your symptoms. Written by Dr. Heather Hirsch, MD, MS, MSCP, a certified menopausal medicine doctor and board certified in internal medicine, this crucial guide demystifies your symptoms, outlines how to treat them, and explains why doing so is important to your health today and in the years to come. You’’ll also learn how to better advocate for yourself with your doctors so you can choose a treatment plan that suits your unique symptom set, health history, and priorities. The Perimenopause Survival Guide will set you up for an easier menopause journey so you can take back your health and feel like yourself again.
Perimenopause— the period of time during which a woman moves toward, but is not yet in, menopause— can be one of the biggest transitions of a women’s adult life, marked by massive hormonal changes. Troubled by symptoms like hot flashes, back pain, anxiety, brain fog—just to name a few—and without any clear guidance from their health care providers about the changes happening in their bodies, many women between the ages of 35 and 50 are left to navigate this overwhelming season of life on their own. But it doesn’t have to be this way.
The Perimenopause Survival Guide is the ultimate resource for understanding the hormonal shifts happening within your body so you can make informed decisions about how best to address your symptoms. Written by Dr. Heather Hirsch, MD, MS, MSCP, a certified menopausal medicine doctor and board certified in internal medicine, this crucial guide demystifies your symptoms, outlines how to treat them, and explains why doing so is important to your health today and in the years to come. You’’ll also learn how to better advocate for yourself with your doctors so you can choose a treatment plan that suits your unique symptom set, health history, and priorities. The Perimenopause Survival Guide will set you up for an easier menopause journey so you can take back your health and feel like yourself again.
336 pages, Hardcover
Published October 14, 2025
111 people are currently reading
4453 people want to read
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 29 of 29 reviews
October 5, 2025
4 stars
I think that this is a great book to pick up for any woman close to, just beginning or even right in the thick of Perimenopause. I think it gives well rounded and backed information on symptoms( with medical description of how and why they happen), steps to take to help from exercise, medicinal, or medical to help with these. I really liked that she gave several options and examples. I felt informed and better prepared with the treatment and steps that you could take really gave you more of a sense of control in how you tackle this next phase in life. It was easy to follow, had great pace and it did not read like a medical text or lecture. I did find a couple repetitive but it really could not be helped. Overall I think that this is a great one if you're really looking for information and what are the steps you can do.
I received an advanced ebook, via Netgalley. This review is my own honest opinion.
January 4, 2026
I read this book in less than 24 hours.
I cried. I raged. I felt seen. I learned. I found hope. And I took SO many notes. Every woman close to 40 should read this book.
If you have had symptoms and thought to yourself, "that's weird." Then you need to read this book.
I cried. I raged. I felt seen. I learned. I found hope. And I took SO many notes. Every woman close to 40 should read this book.
If you have had symptoms and thought to yourself, "that's weird." Then you need to read this book.
November 26, 2025
I HIGHLY recommend this book to any woman approaching or going through menopause. I was shocked at how accurate it discussed and offered suggestions for the symptoms I have experiencing! Definitely a good to have on hand book for any woman approaching menopause or perimenopause.
January 19, 2026
The Perimenopause Survival Guide: Make Sense of Your Symptoms and Build Your Personalized Treatment Plan - A Book Review
Hirsch, Heather, MD, MS, MSCP. The Perimenopause Survival Guide: Make Sense of Your Symptoms and Build Your Personalized Treatment Plan. Balance, 2025. 336 pp. ISBN 9781538774106.
Disclosure: I received a print copy of this book from Balance for review purposes. All thoughts and opinions expressed in this review are my own.
Introduction: Addressing a Critical Gap in Women’s Healthcare
Dr. Heather Hirsch’s The Perimenopause Survival Guide arrives at a crucial moment in the evolution of women’s health discourse. Published in October 2025, this 336-page volume confronts what might be characterized as a systemic failure within contemporary healthcare: the widespread medical and cultural dismissal of perimenopause as a significant life transition deserving comprehensive clinical attention and patient education. By positioning herself as both medical authority—certified in menopausal medicine and board-certified in internal medicine—and advocate for patient empowerment, Hirsch occupies a unique rhetorical position that allows her to simultaneously validate women’s experiences while providing evidence-based medical guidance. This dual stance addresses what scholarship in medical humanities has long identified as the problematic gap between clinical knowledge and patient experience, particularly in conditions disproportionately affecting women.
The Epistemological Problem: Naming and Knowing Perimenopause
The book’s central intervention lies in its assertion that perimenopause constitutes “one of the biggest transitions of a woman’s adult life,” a claim that directly challenges the medical establishment’s historical tendency to minimize or pathologize women’s reproductive health experiences. The catalogue of symptoms—hot flashes, back pain, anxiety, brain fog—represents only a fraction of the potential manifestations, yet their very enumeration performs important cultural work. By naming and categorizing these experiences within a legitimate medical framework, Hirsch participates in what might be termed an epistemological rescue operation, retrieving women’s embodied knowledge from the realm of the anecdotal or psychosomatic and relocating it within evidence-based medical discourse.
The temporal framing of perimenopause as affecting women “between the ages of 35 and 50” is particularly significant, as it acknowledges that hormonal transition can begin far earlier than many women—and their healthcare providers—anticipate. This expanded timeline challenges the persistent cultural narrative that positions menopause as an event occurring in one’s fifties, effectively rendering invisible the experiences of women who begin experiencing symptoms in their late thirties or early forties. The demographic breadth of this affected population underscores the public health implications of adequate perimenopause education and treatment.
Structural Innovation: Personalization as Pedagogical Strategy
The subtitle’s emphasis on building a “personalized treatment plan” signals a significant departure from one-size-fits-all medical advice literature. Rather than prescribing universal protocols, Hirsch’s approach appears to embrace the heterogeneity of perimenopausal experience, acknowledging that symptom presentation, severity, health history, and individual priorities necessitate individualized therapeutic strategies. This personalization framework serves multiple rhetorical and practical functions:
Validation of Individual Experience: By refusing to homogenize perimenopausal women, the text implicitly validates that differences in symptom experience are real and medically significant, not merely variations in pain tolerance or psychological resilience.
Patient Agency and Autonomy: The concept of building one’s own treatment plan positions readers as active participants in their healthcare rather than passive recipients of medical authority, aligning with contemporary bioethical emphasis on patient autonomy and shared decision-making.
Recognition of Intersecting Variables: Personalization necessarily accounts for the complex interaction of biological, environmental, psychological, and social factors that shape both symptom experience and treatment efficacy.
At 336 pages, the text provides substantial space for this nuanced approach, suggesting depth beyond superficial symptom lists and generic recommendations that characterize less rigorous health literature.
The Advocacy Imperative: Navigating Healthcare Systems
Perhaps the book’s most significant contribution lies in its explicit attention to patient advocacy within clinical encounters. The acknowledgment that many women experience perimenopause “without any clear guidance from their health care providers” identifies a systemic problem that extends beyond individual physician knowledge gaps to encompass broader issues of medical education, gender bias in healthcare, time constraints within contemporary medical practice, and the historical marginalization of women’s health concerns.
By teaching readers “how to better advocate for yourself with your doctors,” Hirsch addresses this structural inequality at the individual level while implicitly calling attention to the need for systemic reform. This dual approach—empowering patients while acknowledging that the burden of advocacy should not fall entirely on already-struggling women—navigates a delicate balance. The necessity of such advocacy training reveals troubling truths about contemporary healthcare: that women’s reported symptoms are often dismissed or minimized, that many physicians lack adequate training in menopausal medicine, and that achieving appropriate care frequently requires patients to possess medical literacy, assertiveness, and persistence that should not be prerequisites for competent treatment.
The book thus functions simultaneously as practical guide and implicit critique of healthcare systems that fail to adequately serve women during this life stage.
Symptomatology and Temporality: Beyond the Immediate
Hirsch’s attention to both immediate symptom management and long-term health implications represents a sophisticated understanding of perimenopause as simultaneously an acute experience requiring intervention and a critical preventive health moment. The assertion that treatment is “important to your health today and in the years to come” positions perimenopause within a longitudinal health trajectory, connecting hormone transition to later-life outcomes including cardiovascular disease, osteoporosis, and cognitive health.
This temporal expansiveness challenges the common medical tendency to address only the most disruptive acute symptoms—typically hot flashes—while ignoring subtler changes that nonetheless significantly impact quality of life: brain fog affecting professional performance, anxiety disrupting relationships, sleep disturbances compounding physical and mental health challenges. By insisting on comprehensive symptom acknowledgment and treatment, Hirsch resists the minimization that has historically characterized medical responses to women’s health concerns deemed “not life-threatening.”
The promise of achieving “an easier menopause journey” positions perimenopause treatment as preventive intervention, suggesting that addressing hormonal transition early and comprehensively may mitigate later difficulties—a public health perspective often absent from discussions focused solely on symptom suppression.
Credibility and Authority: The Expert-Advocate Hybrid
Dr. Hirsch’s credentials—MD, MS, MSCP, certification in menopausal medicine, board certification in internal medicine—establish traditional medical authority while her specialization in a historically marginalized subdiscipline positions her as an advocate for this neglected area of medicine. This combination of insider status and outsider perspective (insofar as menopausal medicine remains peripheral to mainstream medical education and practice) creates a unique authorial ethos that can speak both to medical professionals and to frustrated patients.
Hirsch successfully navigates the challenging task of writing accessibly for lay audiences while maintaining medical rigor. This balance is crucial: oversimplification diminishes utility for readers seeking substantive information, while excessive technical language alienates those without medical training.
Pedagogical and Clinical Implications
Beyond its value to individual readers, The Perimenopause Survival Guide holds potential significance for medical education and clinical practice. The book could serve as:
-Supplementary Medical Education: Providing physicians-in-training with patient-centered perspectives on perimenopause management
-Clinical Reference: Offering practicing clinicians a resource to recommend to patients, potentially reducing the explanatory burden during time-limited appointments
-Healthcare Reform Evidence: Documenting the gap between patient needs and current healthcare delivery, supporting calls for improved menopausal medicine training and healthcare system reform
-Research Agenda Setting: Identifying areas where patient experience outpaces medical knowledge, suggesting directions for future clinical research
Broader Cultural Significance
The book’s existence and reception reflect larger cultural shifts in women’s health discourse. The increasing visibility of perimenopause and menopause in public conversation—through social media, celebrity advocacy, and workplace policy discussions—creates both demand for resources like Hirsch’s guide and receptivity to its message. This cultural moment represents a potential inflection point where women’s midlife health transitions might finally receive attention commensurate with their significance.
Simultaneously, the book participates in the complex politics of medicalization. By insisting on medical recognition and treatment of perimenopause, it risks reinforcing frameworks that pathologize natural biological processes. Yet given the real suffering caused by severe perimenopausal symptoms and the documented health benefits of appropriate intervention, this medicalization may represent not a capitulation to medical control but rather a strategic deployment of medical authority to secure resources and legitimacy for women’s health concerns.
Conclusion: A Necessary Resource in an Inequitable Landscape
The Perimenopause Survival Guide addresses a genuine and pressing need within contemporary women’s health. Dr. Hirsch’s combination of medical expertise, patient-centered approach, and explicit advocacy orientation creates a resource that is simultaneously practical manual, educational text, and implicit critique of healthcare systems that have long failed perimenopausal women. The book’s emphasis on personalization, advocacy, and longitudinal health perspectives distinguishes it from superficial health literature while its accessibility ensures utility for its target audience.
The necessity of such a guide—the fact that educated, resourced women between 35 and 50 require 336 pages of instruction to understand their bodies and navigate healthcare systems—reveals troubling truths about medical education, gender bias in clinical care, and the persistent marginalization of women’s health concerns. That this book appears valuable and necessary is simultaneously a testament to Dr. Hirsch’s expertise and a damning commentary on the state of women’s healthcare.
For scholars in medical humanities, gender studies, public health, and bioethics, the text offers rich material for analyzing how medical knowledge is produced, disseminated, and deployed in the service of patient empowerment. For healthcare practitioners, it provides insight into patient perspectives and needs. For perimenopausal women themselves, it promises something both more modest and more profound: the tools to understand their bodies, advocate for their needs, and reclaim their health during a transition that need not be suffered in isolation or silence.
Recommended for: Women’s health researchers, medical humanities scholars, healthcare practitioners in primary care and gynecology, medical educators, public health professionals focused on women’s health, and general readers navigating or approaching perimenopause.
Hirsch, Heather, MD, MS, MSCP. The Perimenopause Survival Guide: Make Sense of Your Symptoms and Build Your Personalized Treatment Plan. Balance, 2025. 336 pp. ISBN 9781538774106.
Disclosure: I received a print copy of this book from Balance for review purposes. All thoughts and opinions expressed in this review are my own.
Introduction: Addressing a Critical Gap in Women’s Healthcare
Dr. Heather Hirsch’s The Perimenopause Survival Guide arrives at a crucial moment in the evolution of women’s health discourse. Published in October 2025, this 336-page volume confronts what might be characterized as a systemic failure within contemporary healthcare: the widespread medical and cultural dismissal of perimenopause as a significant life transition deserving comprehensive clinical attention and patient education. By positioning herself as both medical authority—certified in menopausal medicine and board-certified in internal medicine—and advocate for patient empowerment, Hirsch occupies a unique rhetorical position that allows her to simultaneously validate women’s experiences while providing evidence-based medical guidance. This dual stance addresses what scholarship in medical humanities has long identified as the problematic gap between clinical knowledge and patient experience, particularly in conditions disproportionately affecting women.
The Epistemological Problem: Naming and Knowing Perimenopause
The book’s central intervention lies in its assertion that perimenopause constitutes “one of the biggest transitions of a woman’s adult life,” a claim that directly challenges the medical establishment’s historical tendency to minimize or pathologize women’s reproductive health experiences. The catalogue of symptoms—hot flashes, back pain, anxiety, brain fog—represents only a fraction of the potential manifestations, yet their very enumeration performs important cultural work. By naming and categorizing these experiences within a legitimate medical framework, Hirsch participates in what might be termed an epistemological rescue operation, retrieving women’s embodied knowledge from the realm of the anecdotal or psychosomatic and relocating it within evidence-based medical discourse.
The temporal framing of perimenopause as affecting women “between the ages of 35 and 50” is particularly significant, as it acknowledges that hormonal transition can begin far earlier than many women—and their healthcare providers—anticipate. This expanded timeline challenges the persistent cultural narrative that positions menopause as an event occurring in one’s fifties, effectively rendering invisible the experiences of women who begin experiencing symptoms in their late thirties or early forties. The demographic breadth of this affected population underscores the public health implications of adequate perimenopause education and treatment.
Structural Innovation: Personalization as Pedagogical Strategy
The subtitle’s emphasis on building a “personalized treatment plan” signals a significant departure from one-size-fits-all medical advice literature. Rather than prescribing universal protocols, Hirsch’s approach appears to embrace the heterogeneity of perimenopausal experience, acknowledging that symptom presentation, severity, health history, and individual priorities necessitate individualized therapeutic strategies. This personalization framework serves multiple rhetorical and practical functions:
Validation of Individual Experience: By refusing to homogenize perimenopausal women, the text implicitly validates that differences in symptom experience are real and medically significant, not merely variations in pain tolerance or psychological resilience.
Patient Agency and Autonomy: The concept of building one’s own treatment plan positions readers as active participants in their healthcare rather than passive recipients of medical authority, aligning with contemporary bioethical emphasis on patient autonomy and shared decision-making.
Recognition of Intersecting Variables: Personalization necessarily accounts for the complex interaction of biological, environmental, psychological, and social factors that shape both symptom experience and treatment efficacy.
At 336 pages, the text provides substantial space for this nuanced approach, suggesting depth beyond superficial symptom lists and generic recommendations that characterize less rigorous health literature.
The Advocacy Imperative: Navigating Healthcare Systems
Perhaps the book’s most significant contribution lies in its explicit attention to patient advocacy within clinical encounters. The acknowledgment that many women experience perimenopause “without any clear guidance from their health care providers” identifies a systemic problem that extends beyond individual physician knowledge gaps to encompass broader issues of medical education, gender bias in healthcare, time constraints within contemporary medical practice, and the historical marginalization of women’s health concerns.
By teaching readers “how to better advocate for yourself with your doctors,” Hirsch addresses this structural inequality at the individual level while implicitly calling attention to the need for systemic reform. This dual approach—empowering patients while acknowledging that the burden of advocacy should not fall entirely on already-struggling women—navigates a delicate balance. The necessity of such advocacy training reveals troubling truths about contemporary healthcare: that women’s reported symptoms are often dismissed or minimized, that many physicians lack adequate training in menopausal medicine, and that achieving appropriate care frequently requires patients to possess medical literacy, assertiveness, and persistence that should not be prerequisites for competent treatment.
The book thus functions simultaneously as practical guide and implicit critique of healthcare systems that fail to adequately serve women during this life stage.
Symptomatology and Temporality: Beyond the Immediate
Hirsch’s attention to both immediate symptom management and long-term health implications represents a sophisticated understanding of perimenopause as simultaneously an acute experience requiring intervention and a critical preventive health moment. The assertion that treatment is “important to your health today and in the years to come” positions perimenopause within a longitudinal health trajectory, connecting hormone transition to later-life outcomes including cardiovascular disease, osteoporosis, and cognitive health.
This temporal expansiveness challenges the common medical tendency to address only the most disruptive acute symptoms—typically hot flashes—while ignoring subtler changes that nonetheless significantly impact quality of life: brain fog affecting professional performance, anxiety disrupting relationships, sleep disturbances compounding physical and mental health challenges. By insisting on comprehensive symptom acknowledgment and treatment, Hirsch resists the minimization that has historically characterized medical responses to women’s health concerns deemed “not life-threatening.”
The promise of achieving “an easier menopause journey” positions perimenopause treatment as preventive intervention, suggesting that addressing hormonal transition early and comprehensively may mitigate later difficulties—a public health perspective often absent from discussions focused solely on symptom suppression.
Credibility and Authority: The Expert-Advocate Hybrid
Dr. Hirsch’s credentials—MD, MS, MSCP, certification in menopausal medicine, board certification in internal medicine—establish traditional medical authority while her specialization in a historically marginalized subdiscipline positions her as an advocate for this neglected area of medicine. This combination of insider status and outsider perspective (insofar as menopausal medicine remains peripheral to mainstream medical education and practice) creates a unique authorial ethos that can speak both to medical professionals and to frustrated patients.
Hirsch successfully navigates the challenging task of writing accessibly for lay audiences while maintaining medical rigor. This balance is crucial: oversimplification diminishes utility for readers seeking substantive information, while excessive technical language alienates those without medical training.
Pedagogical and Clinical Implications
Beyond its value to individual readers, The Perimenopause Survival Guide holds potential significance for medical education and clinical practice. The book could serve as:
-Supplementary Medical Education: Providing physicians-in-training with patient-centered perspectives on perimenopause management
-Clinical Reference: Offering practicing clinicians a resource to recommend to patients, potentially reducing the explanatory burden during time-limited appointments
-Healthcare Reform Evidence: Documenting the gap between patient needs and current healthcare delivery, supporting calls for improved menopausal medicine training and healthcare system reform
-Research Agenda Setting: Identifying areas where patient experience outpaces medical knowledge, suggesting directions for future clinical research
Broader Cultural Significance
The book’s existence and reception reflect larger cultural shifts in women’s health discourse. The increasing visibility of perimenopause and menopause in public conversation—through social media, celebrity advocacy, and workplace policy discussions—creates both demand for resources like Hirsch’s guide and receptivity to its message. This cultural moment represents a potential inflection point where women’s midlife health transitions might finally receive attention commensurate with their significance.
Simultaneously, the book participates in the complex politics of medicalization. By insisting on medical recognition and treatment of perimenopause, it risks reinforcing frameworks that pathologize natural biological processes. Yet given the real suffering caused by severe perimenopausal symptoms and the documented health benefits of appropriate intervention, this medicalization may represent not a capitulation to medical control but rather a strategic deployment of medical authority to secure resources and legitimacy for women’s health concerns.
Conclusion: A Necessary Resource in an Inequitable Landscape
The Perimenopause Survival Guide addresses a genuine and pressing need within contemporary women’s health. Dr. Hirsch’s combination of medical expertise, patient-centered approach, and explicit advocacy orientation creates a resource that is simultaneously practical manual, educational text, and implicit critique of healthcare systems that have long failed perimenopausal women. The book’s emphasis on personalization, advocacy, and longitudinal health perspectives distinguishes it from superficial health literature while its accessibility ensures utility for its target audience.
The necessity of such a guide—the fact that educated, resourced women between 35 and 50 require 336 pages of instruction to understand their bodies and navigate healthcare systems—reveals troubling truths about medical education, gender bias in clinical care, and the persistent marginalization of women’s health concerns. That this book appears valuable and necessary is simultaneously a testament to Dr. Hirsch’s expertise and a damning commentary on the state of women’s healthcare.
For scholars in medical humanities, gender studies, public health, and bioethics, the text offers rich material for analyzing how medical knowledge is produced, disseminated, and deployed in the service of patient empowerment. For healthcare practitioners, it provides insight into patient perspectives and needs. For perimenopausal women themselves, it promises something both more modest and more profound: the tools to understand their bodies, advocate for their needs, and reclaim their health during a transition that need not be suffered in isolation or silence.
Recommended for: Women’s health researchers, medical humanities scholars, healthcare practitioners in primary care and gynecology, medical educators, public health professionals focused on women’s health, and general readers navigating or approaching perimenopause.
July 31, 2025
I've been reading a lot about perimenopause...as have so many women around my age! This book did a great job of sectioning things together, making connections, and providing the facts. I also liked the resources sections. Knowing how to better talk about symptoms, and even providing a sample script to begin a conversation with a health care provider goes a long way!
November 16, 2025
Low hanging fruit. Quite a bit redundant. Felt a little dated and I was frustrated by the push towards HRT.
October 27, 2025
First I want to thank Heather Hirsch MD, MS, MSCP and Balance for providing me with this book so I can bring you this review.
Thank you Heather Hirsch MD, MS, MSCP from the bottom of my heart for writing this guide!! Too many women like myself are wondering what is going on with our bodies that our health care providers seem to keep blowing off. It is extremely frustrating to know something is wrong with your body but you can’t pinpoint what it is exactly. But thanks to Heather she is now opening up the conversation that we women need to start talking about and that is Perimenapause.
Heather would like to dedicate this book to her daughter Demille Margaret Hirsch and all the future generations of woman. May we all receive the care we need throughout our lives.
In the beginning of this book there was a very well written forward by Avrum Bluming MD, MACP who is a Medical Oncologist.
Heather wrote this book to help you develop a plan to address your symptoms and protect your long term health that combines medical treatments, prescriptions, labs, etc.
By explaining how to treat your symptoms and why doing so is so important to your health today and long term. She wants you to be seen and know she understands what you’re going through and that you are not alone.
What was eye opening to me was that during in Perimenapause our long term care can decline with our GI system, muscular system, pelvic floor, cardio and brain function can go downhill as well.
Heather Hirsch shows you how to use the book to your advantage before outlining it for you:
Part 1: “Understanding the hormonal hijacking"
Part 2: “Pinpoint your Perimenapause pausal set”
Part 3: “Set yourself up for smooth menopausal sailing”
The Perimenopausal Survival Guide is designed to help you understand what’s happening with your body, find and make shared decisions with knowledgeable about treatment and know what you can do on your own.
Heather defines the differences between Perimenapause, Menapause, and Postmenapause for us readers. For me personally I am on the crazy stage of Perimenopause which is why I took a personal interest in reading this book. But after reading this book I am not looking forward to 10 years of this lmao!!!
There is a great chart that Heather includes in the book of all the stages, symptoms, hormonal hallmarks and durations of them all as well.
Heather educates her readers on what she calls her cast of characters that make up what is going on within your body. Within these cast of characters she elaborates on what they do for the body cut as Estrogen, Progesterone, Testosterone, Follicle Stimulating Hormone, Thyroid Hormone, ETC.
Heather educates her readers on heavy periods, symptoms of Anemia, polyps, fibroids, adenomyosis, endometrosis, uterine cancer, and medications that can cause heavy bleeding.
One procedure she mentioned that I had personal experience with was an endometrial ablation. It was not an easy decision to make but being a Mom wasn’t in the cards for me. However, I am a very proud Auntie to four amazing kids.
Oh the lying awake and worrying chapter I felt like that was written just for me!!! I am an overthinker, a worrier, and an insomniac!! I have racing thoughts and there are days when I wish I could just shut off my brain!! Even a low dose of sleeping pill does not help!
She gives us advice about estrogen therapy options such as a transdermal patch (that is the one I am on the Dotti Patch), transdermal gel/spray, oral pills, vaginal ring. However, she also gives you non hormonal options as well.
If you are wondering if you have Perimenapause but not sure of the symptoms have no fear Heather has a list of symptoms for you to check to see if you match with. I have 10 of the 34!
Oh and if you wonder if any of the myths are true about Permenapause she has a list of them that she will give you the correct answer for too.
Heather thinks of everything in this book even down to the diet and gives a list of high protein and high fiber foods with portion size. She also gives exercise advice as well.
Heather Hirsch needs to be commended for all the time and effort she put into educating herself to educate her readers on this topic. Her medical knowledge, her attention to detail, and how she had a heart for what we women were going through during all of this. Amazing read! Definite 5 star read!! This needs to be on every OBGYN shelf!!
Thank you Heather Hirsch MD, MS, MSCP from the bottom of my heart for writing this guide!! Too many women like myself are wondering what is going on with our bodies that our health care providers seem to keep blowing off. It is extremely frustrating to know something is wrong with your body but you can’t pinpoint what it is exactly. But thanks to Heather she is now opening up the conversation that we women need to start talking about and that is Perimenapause.
Heather would like to dedicate this book to her daughter Demille Margaret Hirsch and all the future generations of woman. May we all receive the care we need throughout our lives.
In the beginning of this book there was a very well written forward by Avrum Bluming MD, MACP who is a Medical Oncologist.
Heather wrote this book to help you develop a plan to address your symptoms and protect your long term health that combines medical treatments, prescriptions, labs, etc.
By explaining how to treat your symptoms and why doing so is so important to your health today and long term. She wants you to be seen and know she understands what you’re going through and that you are not alone.
What was eye opening to me was that during in Perimenapause our long term care can decline with our GI system, muscular system, pelvic floor, cardio and brain function can go downhill as well.
Heather Hirsch shows you how to use the book to your advantage before outlining it for you:
Part 1: “Understanding the hormonal hijacking"
Part 2: “Pinpoint your Perimenapause pausal set”
Part 3: “Set yourself up for smooth menopausal sailing”
The Perimenopausal Survival Guide is designed to help you understand what’s happening with your body, find and make shared decisions with knowledgeable about treatment and know what you can do on your own.
Heather defines the differences between Perimenapause, Menapause, and Postmenapause for us readers. For me personally I am on the crazy stage of Perimenopause which is why I took a personal interest in reading this book. But after reading this book I am not looking forward to 10 years of this lmao!!!
There is a great chart that Heather includes in the book of all the stages, symptoms, hormonal hallmarks and durations of them all as well.
Heather educates her readers on what she calls her cast of characters that make up what is going on within your body. Within these cast of characters she elaborates on what they do for the body cut as Estrogen, Progesterone, Testosterone, Follicle Stimulating Hormone, Thyroid Hormone, ETC.
Heather educates her readers on heavy periods, symptoms of Anemia, polyps, fibroids, adenomyosis, endometrosis, uterine cancer, and medications that can cause heavy bleeding.
One procedure she mentioned that I had personal experience with was an endometrial ablation. It was not an easy decision to make but being a Mom wasn’t in the cards for me. However, I am a very proud Auntie to four amazing kids.
Oh the lying awake and worrying chapter I felt like that was written just for me!!! I am an overthinker, a worrier, and an insomniac!! I have racing thoughts and there are days when I wish I could just shut off my brain!! Even a low dose of sleeping pill does not help!
She gives us advice about estrogen therapy options such as a transdermal patch (that is the one I am on the Dotti Patch), transdermal gel/spray, oral pills, vaginal ring. However, she also gives you non hormonal options as well.
If you are wondering if you have Perimenapause but not sure of the symptoms have no fear Heather has a list of symptoms for you to check to see if you match with. I have 10 of the 34!
Oh and if you wonder if any of the myths are true about Permenapause she has a list of them that she will give you the correct answer for too.
Heather thinks of everything in this book even down to the diet and gives a list of high protein and high fiber foods with portion size. She also gives exercise advice as well.
Heather Hirsch needs to be commended for all the time and effort she put into educating herself to educate her readers on this topic. Her medical knowledge, her attention to detail, and how she had a heart for what we women were going through during all of this. Amazing read! Definite 5 star read!! This needs to be on every OBGYN shelf!!
October 26, 2025
Oh how I wish this book was around a decade ago when I was (unknowingly) in the early stages of menopause and my flooding cycles started!
As a 51yo in perimenopause, I read 8 books focusing on the menopause transition for World Menopause Month this October. This one was last and answered my final questions - ones that the others couldn’t answer because my questions were period specific and obviously once you’ve hit menopause those days are gratefully over.
I’d recommend this book for any pre-menopausal adult with a uterus. Perimenopause can start to affect you in your mid-thirties, so reading it before then and hanging onto the book as a reference would be wise.
Dr Hirsch covers menopause symptoms from A to Z, a brief overview of hormones and how the Women’s Health Initiative unfortunately scared everyone with grossly inaccurate interpretations of the data. She provides a scaffolding for those in perimenopause to determine which symptoms to focus on first and what treatment options they have for each symptom cluster. There is solid, realistic lifestyle advice that accounts for the average busy, overwhelmed perimenopausal person.
One thing that annoyed me is that on social media Dr Hirsch posts frequently that compounded hormones should NOT be used, but in the book she mentions prescribing compounded progesterone for folks with a peanut allergy. This nuance should be shared on social media as well in my opinion because her posts there come across as shaming for those who *need* their hormones compounded for allergy reasons (there are more allergies than peanut…)
Note: I have 2 issues with the audiobook version. The tracks are not labeled with the chapter titles and there should be a pdf of the Appendixes (tracks 16-18) in my opinion.
Track 3: Forward by Dr Avrum Bluming
Track 4: introduction
Track 5: Part 1 - understand the hormonal hijacking
Chapter 1 - can it really be my hormones?
Track 6: Perimenopause myths and misconceptions
Track 7: Assess your symptoms, set your priorities
Track 8: Part 2 - Pinpoint your perimenopausal symptoms set
Chapter 4 - bleeding till you drop
Track 9: Lying awake and worrying
Track 10: Dragging yourself through life
Track 11: Feeling unrecognizable to yourself
Track 12: Gaining weight for no apparent reason
Track 13: The silent symptoms
Track 14: Part 3 - Set yourself up for smooth perimenopausal sailing
Chapter 10 - Targeted treatments for solo symptoms
Track 15: Navigating the transition with confidence
Track 16: High protein foods
Track 17: High fiber foods
Track 18: Appendix C
Tract 19: Appendix A FAQ
Track 20: Acknowledgments
As a 51yo in perimenopause, I read 8 books focusing on the menopause transition for World Menopause Month this October. This one was last and answered my final questions - ones that the others couldn’t answer because my questions were period specific and obviously once you’ve hit menopause those days are gratefully over.
I’d recommend this book for any pre-menopausal adult with a uterus. Perimenopause can start to affect you in your mid-thirties, so reading it before then and hanging onto the book as a reference would be wise.
Dr Hirsch covers menopause symptoms from A to Z, a brief overview of hormones and how the Women’s Health Initiative unfortunately scared everyone with grossly inaccurate interpretations of the data. She provides a scaffolding for those in perimenopause to determine which symptoms to focus on first and what treatment options they have for each symptom cluster. There is solid, realistic lifestyle advice that accounts for the average busy, overwhelmed perimenopausal person.
One thing that annoyed me is that on social media Dr Hirsch posts frequently that compounded hormones should NOT be used, but in the book she mentions prescribing compounded progesterone for folks with a peanut allergy. This nuance should be shared on social media as well in my opinion because her posts there come across as shaming for those who *need* their hormones compounded for allergy reasons (there are more allergies than peanut…)
Note: I have 2 issues with the audiobook version. The tracks are not labeled with the chapter titles and there should be a pdf of the Appendixes (tracks 16-18) in my opinion.
Track 3: Forward by Dr Avrum Bluming
Track 4: introduction
Track 5: Part 1 - understand the hormonal hijacking
Chapter 1 - can it really be my hormones?
Track 6: Perimenopause myths and misconceptions
Track 7: Assess your symptoms, set your priorities
Track 8: Part 2 - Pinpoint your perimenopausal symptoms set
Chapter 4 - bleeding till you drop
Track 9: Lying awake and worrying
Track 10: Dragging yourself through life
Track 11: Feeling unrecognizable to yourself
Track 12: Gaining weight for no apparent reason
Track 13: The silent symptoms
Track 14: Part 3 - Set yourself up for smooth perimenopausal sailing
Chapter 10 - Targeted treatments for solo symptoms
Track 15: Navigating the transition with confidence
Track 16: High protein foods
Track 17: High fiber foods
Track 18: Appendix C
Tract 19: Appendix A FAQ
Track 20: Acknowledgments
July 9, 2025
Just finished The Perimenopause Survival Guide by Dr. Heather Hirsch, and wow! This book is exactly what I didn’t know I needed.
I’m only in my 30s, but I’ve been feeling this pull to better understand and prepare my body for the next chapter. Let’s be honest: perimenopause is one of those things that barely gets talked about, but affects so many of us, and often earlier than we expect. The whole transition can feel mysterious, scary, and overwhelming, especially when real guidance is hard to find. That’s why this book felt like a godsend.
Dr. Hirsch does such a phenomenal job of breaking everything down in a clear, relatable, and science backed way. She’s not just an expert (though she is; she is the founder of the Menopause Clinic at Brigham and Women’s Hospital and featured on Oprah’s series), but she writes like a friend who gets it.
From explaining why our bodies start to feel different, to helping us figure out what treatment options are actually safe and effective, to empowering us to advocate for ourselves at the doctor’s office, this guide truly covers it all. I especially appreciated how she talks about managing symptoms now to support our long term health. That perspective shift was huge for me.
If you’re like me and want to approach perimenopause proactively instead of reactively, this book is essential. Whether you’re just starting to notice subtle shifts or want to feel more prepared for when the time comes, this guide offers clarity, calm, and confidence. 10/10 recommend for every woman in her 30s and beyond!
Thank you to NetGalley, Heather Hirsch, and Balance for the eARC of this book.
I’m only in my 30s, but I’ve been feeling this pull to better understand and prepare my body for the next chapter. Let’s be honest: perimenopause is one of those things that barely gets talked about, but affects so many of us, and often earlier than we expect. The whole transition can feel mysterious, scary, and overwhelming, especially when real guidance is hard to find. That’s why this book felt like a godsend.
Dr. Hirsch does such a phenomenal job of breaking everything down in a clear, relatable, and science backed way. She’s not just an expert (though she is; she is the founder of the Menopause Clinic at Brigham and Women’s Hospital and featured on Oprah’s series), but she writes like a friend who gets it.
From explaining why our bodies start to feel different, to helping us figure out what treatment options are actually safe and effective, to empowering us to advocate for ourselves at the doctor’s office, this guide truly covers it all. I especially appreciated how she talks about managing symptoms now to support our long term health. That perspective shift was huge for me.
If you’re like me and want to approach perimenopause proactively instead of reactively, this book is essential. Whether you’re just starting to notice subtle shifts or want to feel more prepared for when the time comes, this guide offers clarity, calm, and confidence. 10/10 recommend for every woman in her 30s and beyond!
Thank you to NetGalley, Heather Hirsch, and Balance for the eARC of this book.
January 12, 2026
Not the first book I've read on this subject, nor will it be the last! Really liked this one, as it's specifically geared toward this transition period. Would strongly encourage any woman 35+ to start learning about what's coming, so that they don't waste years of their life thinking they're losing their damn minds. They say the average start of peri is 45-47, but I definitely started at 40 (and it can start even earlier). If I hadn't had a handful of hot flashes a year ago, I don't think I'd have any idea that I had entered perimenopause! I haven't even had a hot flash since, but I apparently have 20 other symptoms THAT I HAD NO IDEA WERE PERIMENOPAUSE SYMPTOMS. I didn't know what was wrong, only that everything was wrong. So ladies, spare yourself the existential crisis. It's your hormones. They have so much more reach than you realize. Start reading. Knowledge is power. And if you are one of the lucky ones that breezes through it with minimal symptoms, read up anyway so you can help your friends!
September 18, 2025
This book is the first book that I feel should be given to every person born female. It could be a 35th birthday gift that every female individual receives. Happy birthday! Don't be scared, but this is what's in store for you. Heather Hirsch does a fabulous job of explaining every element of perimenopause in an easy to understand way that doesn't leave the reader feeling scared or confused. This is the first book that left me feeling hopeful. Heather Hirsch shows the reader that there is hope and happiness in the future.This book is made up of true stories of her patients, to research, and easy to digest facts. I appreciate the book and predict that I'll reread this book in the future. Finally, I would like to thank NetGalley and Grand Central Publishing for providing this ARC for my honest review.
January 29, 2026
Helpfully enlightening. Now that I'm in my mid-40s, I've started to seek out more information about menopause to prepare myself for it, and this book fit the bill perfectly. While I suspected that I had started experiencing some indicators of perimenopause, it was a shock to realize the extent of this when confronted with a full list of symptoms. Hirsch doles out helpful advice through suggestions of treatment options as well as how to create an individualized care plan, even if some of what is recommended becomes a bit repetitive. The audiobook was an engaging listen, but this would be a much better title to read, and I would like to pick up a copy of my own in the near future for reference as I continue through this pivotal stage of life.
Thanks to Libro.fm for providing me with an ALC of this title.
Thanks to Libro.fm for providing me with an ALC of this title.
August 3, 2025
As the eldest millennial I have started seeing and feeling symptoms that my friends and I have diagnosed as perimenopause. I was scared and relived to get this arc from NetGalley so I can learn more and I sure got a lot of information. Dr. Heather Hirsch has laid out a guide that is extremely helpful and informative. I have found so many more symptoms that I didn’t know were related to this and writing the questions down for my own doctor and writing down data that will help see where I can go from here is so valuable.
When this comes out I will be purchasing to read and highlight and pass out to my friends going through the same thing. Thank you NetGalley for this arc in exchange for my honest review.
When this comes out I will be purchasing to read and highlight and pass out to my friends going through the same thing. Thank you NetGalley for this arc in exchange for my honest review.
November 11, 2025
Thank you to Grand Central Balance for the free book and to Hachette Audio for the free audiobook. These opinions are my own.
Story time: I was less than one chapter in when I texted my best friend who I talk to most often about perimenopause and symptoms and told her she needed to borrow this book. The next day I texted to tell her she couldn't have it, and I was buying her a copy of her own.
I found this incredibly well done. I was quite impressed by Heather Hirsch's experience and credentials. The book was written for an audience that it understood might not have easy access to a doctor trained in perimenopause. And it was organized in chapters based on clusters of symptoms that could be addressed together. The author even encouraged reading the chapters that were most urgent for any given reader. The tone was conversational with just enough medical knowledge about hormones and lots of recommendations.
My only wishes were that it spoke a bit more to women who are not cis het. In the discussions of libido, there was an acknowledgement that women's partners might not be men. And throughout, it did use the term partner. But there wasn't any discussion of people who are trans. And while it did say a section could be skipped if a woman did not have children, there was a consistent call for generational health that suggested a primary motivator for being healthy was for the next generation. I didn't find either of these interfered with my learning from the book, but I did want to highlight them for others. And they are the only reason I don't give a full five stars.
The audiobook was read by the author. She did an amazing job connecting to the listener through her tone. I found the audiobook a good option for listening on the run, but I am grateful to have the hardcover to write in and use in conversations with providers. It even includes templates for what to say.
4.5 stars rounded up
Story time: I was less than one chapter in when I texted my best friend who I talk to most often about perimenopause and symptoms and told her she needed to borrow this book. The next day I texted to tell her she couldn't have it, and I was buying her a copy of her own.
I found this incredibly well done. I was quite impressed by Heather Hirsch's experience and credentials. The book was written for an audience that it understood might not have easy access to a doctor trained in perimenopause. And it was organized in chapters based on clusters of symptoms that could be addressed together. The author even encouraged reading the chapters that were most urgent for any given reader. The tone was conversational with just enough medical knowledge about hormones and lots of recommendations.
My only wishes were that it spoke a bit more to women who are not cis het. In the discussions of libido, there was an acknowledgement that women's partners might not be men. And throughout, it did use the term partner. But there wasn't any discussion of people who are trans. And while it did say a section could be skipped if a woman did not have children, there was a consistent call for generational health that suggested a primary motivator for being healthy was for the next generation. I didn't find either of these interfered with my learning from the book, but I did want to highlight them for others. And they are the only reason I don't give a full five stars.
The audiobook was read by the author. She did an amazing job connecting to the listener through her tone. I found the audiobook a good option for listening on the run, but I am grateful to have the hardcover to write in and use in conversations with providers. It even includes templates for what to say.
4.5 stars rounded up
November 3, 2025
Glory, Glory, Hallelujah!!!!!
A whole book dedicated to perimenopause!!! Until recently, it’s been treated as a throwaway topic on the way to menopause. As it turns out, perimenopause is the stage that has a greater influence on our bodies. Its fluctuations create a wide variety of symptoms. These symptoms play a large part in why doctors have been deeming women “emotional,” “unstable,” “crazy,” and the like throughout all of human history.
My only complaint about this book is that I wish it had been available about 10 years ago when I started developing mystery symptoms. I truly believe the information included in this book should be mandatory education. It answered some questions that doctors have never been able to when I’ve reached out for help, and I’m grateful to have read it.
A whole book dedicated to perimenopause!!! Until recently, it’s been treated as a throwaway topic on the way to menopause. As it turns out, perimenopause is the stage that has a greater influence on our bodies. Its fluctuations create a wide variety of symptoms. These symptoms play a large part in why doctors have been deeming women “emotional,” “unstable,” “crazy,” and the like throughout all of human history.
My only complaint about this book is that I wish it had been available about 10 years ago when I started developing mystery symptoms. I truly believe the information included in this book should be mandatory education. It answered some questions that doctors have never been able to when I’ve reached out for help, and I’m grateful to have read it.
November 10, 2025
I’ve read other books on peri menopause to help me understand what I’m going through. This book was just as helpful as another I read. I highly recommend this to other women who are struggling to make heads or tails of what they’re going through. Anytime a new symptom has made an appearance, I go back to this book looking for answers and explanations. I’m glad there’s this type of information out there that can give peace of mind when a doctor isn’t very forthcoming with the answers I’m looking for. Thank you for sharing this with the women who are struggling to know what’s going on with their bodies!
October 14, 2025
As someone who is going through perimenopause, I found this book to be so helpful.
It's very informative and breaks things down into different sections. It also gives ideas in each section of how to help make you feel better.
Some you need to speak with your doctor, but it really goes into such detail that it really helped me understand what is happening in my body.
Thanks NetGalley for this ARC.
It's very informative and breaks things down into different sections. It also gives ideas in each section of how to help make you feel better.
Some you need to speak with your doctor, but it really goes into such detail that it really helped me understand what is happening in my body.
Thanks NetGalley for this ARC.
November 17, 2025
When the local library gets new books that I think may be of interest to my patients, I will pick them up. This one has a lot of reliable information presented in a clear manner. I found it very repetitive, but the author intended to spread the information around in a such a way that a reader who was looking up their particular symptom would not miss out on info provided in another section of the book. This is a book that I would feel comfortable recommending to women approaching menopause.
October 3, 2025
This book is a great resource for women 35 and up. Dr. Hirsch explains perimenopause symptoms and solutions in a clear, relatable way, including the reasons why hormone therapy has been disparaged in recent years. The book is very repetitive if read straight through, but excellent as a reference for different symptoms and "symptom sets." Thanks Dr. Hirsch and Netgalley!
January 26, 2026
I’ve started a couple other books on this topic, but this was the first one I read quickly and completely (skipping a few clearly marked sections that were not pertinent to me). It’s accessible with clear evidence-based recommendations that are actionable and clearly laid out. This book felt empowering where others do not.
October 18, 2025
The Perimenopause Survival Guide was a 5 ⭐️ read!! I love how the author broke this book down and really separated the information by symptoms. It felt so easy to read and helpful to understand! We will definitely keep coming back to this one in the next decade! Thank you for our copy!!!🙌💗
December 20, 2025
Skimmed through it, and it was great! Covered and verified many things I have learned from other professionals and through other means so far. Also gives great advice on alternatives to medications/HT, if that is unavailable to you at this.
Overall, a compassionate and helpful book!
Overall, a compassionate and helpful book!
August 20, 2025
If you need it, get it!
November 29, 2025
Great info for managing perimenopause - both stuff you can do yourself and stuff to talk to your doctor about. All women should read it at age 40 and refer back as needed as you age!
December 13, 2025
Recommended reading for husbands, not just the wives going through this difficult transition. Eye opener!
January 4, 2026
My daughter is currently reading this one and taking notes.
January 8, 2026
I highly recommend this book for EVERY woman. So helpful with information and how to navigate perimenopause and menopause. So glad I took the time to read this slow and soak up all the info!
January 27, 2026
very comprehensive. great explanations of complex concepts. some of the resources are all ready out of date.
February 2, 2026
I devoured this. This is required reading for women approaching perimenopause or in perimenopause.
Displaying 1 - 29 of 29 reviews