The New Perimenopause: An Evidence-Based Guide to Surviving the Zone of Chaos and Feeling Like Yourself Again

by Mary Claire Haver

Brought to you by Penguin.

The #1 New York Times bestselling author of The New Menopause explains everything a woman needs to know to thrive during the often-misdiagnosed and medically ignored perimenopausal years

I’m just not feeling like myself! This is the battle cry of the perimenopausal woman.

Though menstrual cycle changes and the emotional rollercoaster that accompanies them are the hallmarks of the transition to menopause, many women with regular periods as young as 35 can also start to feel irregular, with symptoms that include anxiety, fatigue, joint pain, brain fog, sexual symptoms and volatile moods. This can be hugely disruptive – all the more so when a doctor dismisses a woman’s complaints as all in her head or prescribes unnecessary and potentially harmful treatment.

In The New Perimenopause, Dr Mary Claire Haver – the trailblazing voice behind the movement to revolutionise health care for women – sets things straight. She explains that the numerous and varied symptoms of perimenopause occur in direct response to normal endocrine changes; this is the hormonal 'zone of chaos.'

A comprehensive, authoritative book of science-backed information and lived experience, The New Perimenopause


Clear, science-backed explanations of what's going on in your body, from changes in your menstrual cycle to energy levels, mood, sleep and sexual issues.How and why dealing with these changes now is preventative medicine for your later years.Checklists, questions for your doctor and how to insist on good care.The very latest research on the benefits and side effects of progesterone therapy to help ease your hormonal transition.Whether you have symptoms or not, The New Perimenopause helps remove the mystery around this time of change, putting women in control of their health going forward.

'Don’t tolerate shrugged shoulders from your doctor during your perimenopausal journey. Get ahead of the issues and your potential symptoms with this important, empowering and scientifically dependable book.' – Dr Vonda Wright, author of Unbreakable

© Mary Claire Haver 2026 (P) Penguin Audio 2026

Genres: Nonfiction, Health, Self Help, Science, Audiobook, Medical, Mental Health

368 pages, Hardcover

Published April 7, 2026

Reviews

[Rachel · Rating 3 out of 5]

I am disappointed in this book when comparing it to “The New Menopause” by the same author. This book was repetitive and very scientific with very little layman terms. I have a doctorate in a medical field and still felt bogged down by all of the chapters. I skimmed a lot! I also felt a lot of the book was the author discussing woman’s health disparity issues, which is accurate and needs to be addressed, but the author spent many, many paragraphs saying the same things about it.
My suggestion would be to read “The New Menopause” instead. It is written with easier to digest wording, has a better overall structure (especially when it comes to symptoms and how to treat), and is less repetitive. This book offers little to no additional information that is specific to perimenopause versus menopause.
Thank you to Netgalley and the publisher for an ARC in exchange for my honest review.

[Bharath · Rating 5 out of 5]

This is an important book which many should read – women to cope with a difficult period which they go through; and possibly also men so that they can understand and offer support.

As the book points out, data statistics tell us that women live longer on average but spend 25% more of their lives in poor health compared to males. Perimenopause is a difficult period when women typically experience - hot flashes and night sweats, weight gain & redistribution, anxiety - depression & panic attacks, sleep disturbances, fatigue, and quite a few other very difficult symptoms - brain fog, digestion issues, etc. Irritability is one of the most detrimental symptoms affecting relationships. Perimenopause finds cursory treatment in medical school and is low on research funding. Hormonal changes lead to the brain struggling to react appropriately. This is not a gradual change making it overwhelming.

This book has detailed descriptions of the typical symptoms and options which women have (such as hormone therapy). There are ways to cope and minimize the impact with a combination of medicine/supplements, diet and lifestyle changes. Most of these are good for overall health, in any case. The diet plan included at the end isn’t very suited to many regional cuisines though.

The author mentions in her foreword that she wrote the book with her daughters in mind. Sometimes, similarly, in rare cases, we readers read books with someone else in mind. I did that with this one.

My rating: 4.5 / 5.

Thanks to Netgalley, the publisher Convergent | Rodale Books and the author for a free electronic review copy.

[Abby · Rating 4 out of 5]

The New Perimenopause by Dr. Mary Claire Haver is an incredibly informative, helpful, and educational read. Even as a healthcare professional, I learned far more than I expected … which really highlights how little depth we’re often given in training when it comes to perimenopause and women’s health overall.

At times, the book felt repetitive, with a strong emphasis on encouragement and reassurance. While I personally didn’t need as much of that, I recognize that many women will find it validating and empowering.

I received an advance copy of this book in exchange for an honest review, and I would absolutely recommend it to all women. The education alone makes it a valuable resource, especially for anyone wanting a deeper understanding of perimenopause

[Sheila · Rating 4 out of 5]

I received a free copy of, The New Perimenopause, by Mary Claire Haver, MD, from the publisher and Netgalley in exchange for an honest review. This book is about Perimenopause, and how it affects women's bodies. This is a helpful book on what women can look forward to in menopause.

[Marlana Pagano · Rating 5 out of 5]

Many thanks to NetGalley and the publisher for the advance copy.

I’ve just finished it, and honestly? It’s a game-changer. I walked away feeling less like I’m heading toward a biological cliff and more like I’m armed with a tactical map for the years ahead.
There is a lot of jargon which sometimes makes it difficult to follow. However, it seems like the jargon is thoughtfully included so that readers know exactly what to ask for at their doctors appointments. The science shared in these pages is so compelling that I didn't just take notes—I took action. I immediately went out and purchased a weighted vest. Dr. Haver makes a bulletproof case for the necessity of resistance training and bone density preservation during this transition. I’ll admit, the irony isn't lost on me that her Pause company sells the very vests and supplements she recommends. However, I’m choosing to believe that her intentions are genuine and rooted in a desire to provide quality tools for women. The underlying science she presents is robust enough to stand on its own, regardless of where you buy your gear.
The book replaces "shrugged shoulders" from the medical community with hard data. I finally feel prepared and empowered for what’s coming next.

I was thrilled to find a selection of recipes in the back! Though I have not made them yet. They seem flavorful, hormone-conscious, and easy to follow. While the recipes included seem to be fantastic, I found myself wanting so much more. I know she has The Galveston Diet book, but I would love to see a dedicated, standalone recipe book specifically tailored to the principles in The New PeriMenopause. A compact kitchen companion would be the perfect "part two" to this guide.

Final Verdict: If you are in your 30's or anywhere near perimenopause, buy this book. It’s an essential toolkit for navigating midlife with your health, strength, and sanity intact.

[Heather~ Nature.books.and.coffee · Rating 4 out of 5]

This was an informative read. I am trying to educate myself more on this stage of a woman's life, as I am dealing with symptoms myself right now. I found it easy to read, encouraging, and I learned some new things. I would definitely recommend this book to any woman that's in, or soon to be in perimenopause. Every little bit of information can be so helpful.


Thank you to the publisher, and netgalley for the gifted copy. All opinions are my own.

[indy · Rating 2 out of 5]

I am in the minority of readers who found this book frustrating, upsetting, and disheartening. Ultimately, it reads like a Ted Talk-style manifesto, not a practical guide for premenopausal women in the here and now.

The book made me cry on more than one occasion, and – if anything – gives me even more medical things to worry about than I already had on the list. Maybe the entrepreneurial, go-getter, have-it-all women find the book energising?

Haver spends many pages making repetitive, rhetorical pronouncements about what women deserve from doctors and (still) aren't getting. We already know all of that – that's why we are reading the damn book! Motivational speaker fluff is no help to me. I also don't need sales pitches for "Pause life" merchandise like weighted vests.

The book's advice boils down to:

— Perimenopause manifests in all kinds of ways and the problems are biological, not imagined
— Look after yourself (eat well and get enough sleep)
— Engage in aerobic exercise and weight/resistance training
— Stand up for yourself at the doctor's office
— Find another doctor if your current one refuses to take perimenopause seriously
— Ask about getting pathology tests done (see Haver's list at the back of the book)
— Explore the possibility of hormone-based therapies and other supplements

There are some structural issues that make the book feel repetitive in places, and difficult to follow in others. A few times I wondered whether I'd missed a section about a particular term or an acronym, only to find that kind of explanation later in the book. Perhaps that's a sign of clumsy editing, or the book trying to be too many things for too many types of reader.

[Erin Kerry · Rating 3 out of 5]

While I’m grateful for the awareness this brings to the perimenopause era, I’m bummed that she discounts helpful tools like urine hormone testing during particular phases. Understanding patterns of estrogen detox completely changed how I approach my cycle, and I wasted a lot of time and money “guessing” before I took an inexpensive lab test that helped me streamline my health. She talks about FDA guidelines with testing and hormone use as if they’re the ultimate deciding factor, yet promotes supplements that aren’t FDA-approved. I wish there was more room for outside-the-box thinking. I also felt like certain sections were repetitive and written using AI phrasing: “it’s not just ____; it’s _____.” Or “you’re not broken; you’re becoming…” I much prefer the open-minded, holistic approach of Dr. Amy Shah and Dr. Mindy Pelz. That being said, this would be a great overview for someone (especially a practitioner) who doesn’t know anything about the changes in this phase. I’d read this, then find a more open-minded functional medicine provider.

[Renee M Young · Rating 5 out of 5]

You’re not crazy. You’re probably just entering perimenopause! 🙃

My body is changing, I can feel it in my cluttered and tired mind, see it in the honest mirror, and hear it in my forgotten and angry words. And then there are countless other womanlier changes 🫣that I’ve simply been told were ‘normal’ and to deal with it ⏳I know there is no stopping that change, HOWEVER, Dr. Mary Claire Haver has reminded me that “the perimenopause body is a foundation to be fortified, not a problem to be fixed” (251). I am SO thankful for this book,and even more thankful that I am reading it now, at nearly 37 years old, while the road is still long and time is in my favor.

This book is a treatise on the complete, holistic—and often overlooked, neglected, and ignored—health of a perimenopausal woman. This book will “empower you to advocate for yourself and make informed choices about your care in a time when the medical establishment often fails to provide the answers you need” (226).

👩🏻‍⚕️In this book, Dr. Haver:
•admits the glaring failures in current medical practices (and, humbly, in her own career)
•provides a practical starting point to “secure muscle, movement, metabolism, and independence” (149)
•gives the reader encouragement “to intervene before irreversible damage occurs” (134) in the bones and muscles
•validates the reader’s symptomatic experiences
•outlines how the female body functions and changes over time
•includes a 5-day meal plan that prioritize protein and fiber

I really appreciated Dr. Haver’s flexibility in practice and her ability to offer broad (and somehow even very, very specific!) advice to women who have unique symptoms, family history, and needs. So much wisdom here and she clearly articulates everything in poised seriousness and dedicated compassion. I appreciated Dr. Haver’s research on hormones, her support of a holistic lifestyle without a blanketed ‘one-size-fits-all’ bandaid 🩹and her explanation of the visible and invisible changes caused by the changes happening within the body.

“I’ve seen how empowering it can be when women finally understand what’s really happening in their bodies. When they realize their weight gain, rising cholesterol, or sudden fatigue is not a personal failure, but a physiological response to estrogen loss, it changes everything. It opens the door to action, to options, to hope” (120).

I hope every woman will read this book and be motivated to not “procrastinate on prevention” (127). 💪🏽🚺🩸



⚠️I put this book on par with Jonathan Haidt’s The Anxious Generation as it pertains to overall impact, enjoyability, research thoroughness, and the severity of consequences for failing to prepare or act.

Forever changed.
Forever thankful.

[Laura · Rating 4 out of 5]

In The New Perimenopause, Dr. Haver breaks down this major life change for women in an approachable way. She provides a description of exactly what is going on in a woman's anatomy during this time, and she expands by explaining what functions of the body are affected by perimenopause (pretty much all of them). The last section describes what avenues women can take to improve their health, including hormone therapy, lifestyle changes, and how to prepare for a doctor's visit.
I am so glad there are healthcare providers like Dr. Haver who genuinely want to enhance women's health outcomes. This is an excellent resource for someone who is just beginning to learn about this topic, although for readers who are more interested in non-HRT holistic therapies, they might find this book lacking. All in all, it's an encouraging and hopeful book for women who may have felt dismissed or hopeless about their physical and mental health.
Thank you to NetGalley and the publisher for the advanced copy.

[Stacey Beane · Rating 5 out of 5]

This book is a wealth of information! I’d say the last 25-30% is the reference guides, dietary suggestions & recipes for weekly meals! This covers everything you need to know from sleep issues, sexual health, mental health, hormone replacement therapies & so much more & I’d absolutely recommend reading this book if you are in your mid 30’s & up especially if early menopause runs in the family!

[Andrea Frazee · Rating 4 out of 5]

Audiobook

[Annelise · Rating 3 out of 5]

Read this book with caution because reading it is like playing two truths and a lie. She does provide information that can be helpful but some of her recommendations do not have strong evidence to support them. For example, she enthusiastically recommends weighted vests. The evidence on using weighted vests to prevent bone density loss is mixed at best, however, she does sell weighted vests on her website, starting at $100 a pop. She also sells supplements. This should be a red flag.

[Monica Lennon · Rating 5 out of 5]

I’m not a science person, so it was hard to get through some of the medical dense parts of this book. But I think it’s a must-listen for any woman in their 30s or older. So much information great functional tips. Favorite quotes from the book:

“Aging isn’t a curse, it’s a blessing.”

“Focus on function and longevity. Strong over skinny.”

“Longevity isn’t just about living longer. It’s about living better for as long as possible.”

“The way we eat, move and rest can make a huge impact on perimenopause symptoms now and in the decades to come. It starts with reframing our goals: not being skinny or counting calories, instead we are prioritizing nutrient-density and blood sugar stability. We are no longer dieting for summer. We are fueling for longevity. We aren’t shrinking, we are fortifying. It’s not fluff, it’s evidence based…How well you move manners for more than the number on the scale for longevity.”

[Kimmy Sue Neal · Rating 5 out of 5]

I don’t read self help books very often but this was exactly what I needed as a 43 year old woman in the thick of this perimenopause storm. I feel seen 🙏🏻 Loved all the entries of other women’s stories at the start of each chapter. Helped me to feel less alone on this journey. This was very informative and I love how Dr Mary Claire broke everything down and explained the WHY behind the science and offered solutions.

Also her letter to herself at the end brought me to tears

[Lauren Smith · Rating 5 out of 5]

Women in their late 30s, I know you think that's too young for you, but thus book is for you! Im glad I started asking questions in my late 30s. The information in this book is very literally life changing for the perimenopausal woman. Seriously, you need to read it. Then you need to share it with your girlfriends. Then, you need to have a frank conversation with your healthcare provider. Gone are the days of white-knuckling it to the end. We deserve better care, and Dr. Haver is our very own Joan of Arc, championing better care and understanding from the healthcare system. Cannot recommend enough.

[Alissa · Rating 5 out of 5]

I own The New Menopause and requested this book for review to see if it differed much from the first book, or if it was a rehash of the original. It’s different enough from the first book and between the two, is the one I would recommend if you are in the thick of perimenopause, or if you are in your late thirties or above and not quite there yet, so you can be proactive about this (terrible) upcoming stage in your life. Had these books been available side-by-side when my body first went awry, this would have been the better one to choose.

If you’ve read the other book, this one does differ significantly. It focuses a lot on the misdiagnoses you may experience, and how to differentiate peri symptoms from these other, similar issues. Half of the first book was “a symptom based resource system” and additional appendices, this book is less of an encyclopedia of symptoms and treatments. It discusses the failure of the medical system to adequately train physicians in this and other women’s issues. It spends a lot of time on the brain issues in peri, both cognitive and mood. And it gives advice on how to prevent/ameliorate symptoms. It discusses GLP-1 as a tool to lose weight (among other benefits), which was absent from the first book.

I’d recommend this book. After you get through the first section about how thoroughly we have all been ignored/belittled/gaslit by the medical system, take a breather, then read about what we can demand and what we can do (and what’s safe and what is a gimmick).

Dr. Haver has a thriving online presence, she has written multiple books, appears on many social media platforms, has an online clinic, and sells supplements. I was worried there would be a lot of self-promotion in this book, but aside from mentioning her clinicians lists and having her brand of supplements listed as ingredients in a smoothie recipe, the book was mostly grift-free.

I requested this book for review from NetGalley, and thank them, Convergent, and the author for the opportunity to read.

[Jessica · Rating 5 out of 5]

As a woman in my mid-to-upper-40's, I knew I was probably in perimenopause but no doctors were talking to me about it at all. I had seen some videos from Dr. Haver on Instgram and so when I saw this book I decided I should probably read it to understand more about my current stage of life. And I am so glad I did! I realized that almost ALL of my current health issues can be tied back to perimenopause - things like suddenly my cholesterol and a1c numbers are up, my already pretty short fuse being markedly shorter, frustration, joint issues, weight gain - ALL OF IT is tied to the changing hormones of perimenopause. In America we have sick care, not health care, so as Dr. Haver points out most doctors aren't trying to be dismissive of your symptoms, they are just doing what they've been taught about perimenopause and menopause - which is next to nothing. Dr. Haver began doing more research as she began to get into menopause and is now sharing what she's learned and how she's changed her own medical practice to better address women's health needs throughout their entire life. Dr. Haver shows how just about every system in the body is affected by changing sex hormones during perimenopause. She also gives tips about what you can do to find some relief for each of those area/issues. She reiterates that this is not a one-size-fits-all situation and lifestyle (sleep, diet, exercise, etc.) definitely plays a role as well. This was a VERY eye-opening book for me and I'm so glad I read it now. If you are a woman who is in your 40's even if you think you're too young for perimenopause - you're not and you need to read this book.

Some quotes I liked:

"But another complicating factor is that perimenopause requires a symptom-based diagnosis rather than a lab-test-based one. There are currently no lab tests that allow for a conclusive and straightforward diagnosis of perimenopause, so a doctor must rely on their knowledge of symptoms related to this reproductive transition to make that diagnosis. Well, this is a big problem since doctors aren't being educated about symptoms. I was never taught during my residency that perimenopause had any symptoms other than disrupted periods. The majority of clinicians don't have a bank of knowledge to rely on for the diagnosis and treatment of perimenopause, so many sadly default to dismissive condolences." (p. 16)

"This is why I've been working hard to promote the message that perimenopause is a metabolic event, not just a reproductive milestone. If we're not looking at the whole picture - including cholesterol, inflammation, blood sugar, and fat distribution - we're missing key opportunities to protect women's health." (p. 111)

[Amy Angers · Rating 5 out of 5]

Right here, ladies! This book is chock full of accessible, understandable information on the role your hormones play in overall organ/system function and how those changes effect you as you age. You will walk away with a deeper understanding of what may be going on, how to manage your symptoms and how to get a conversations going with your healthcare team, if that's what you choose. A worthy read. If you know me personally and would like to borrow it, let me know.

[Heidi Hankins · Rating 5 out of 5]

This book was very helpful in the knowledge gathering phase of perimenopause. A lot of the book was the why and what and a medical explanation given in palatable bites. I plan to purchase this book so I can refer to things as they come up. I found the last few chapters of the book filled with practical advice of how to talk to you pcp, steps to fortify the body and more. I think what spoke most to me (bc I can only take in so much information at a time) were the testimonials at the beginning of each chapter. “I just don’t feel like myself” “I feel crazy” were validating.

[Kelley · Rating 5 out of 5]

EVERY woman in their 30's to 50's should read this. Even if you are past this or not experiencing this. It gives wonderful insight on a painfully overlooked, mostly ignored, sector of women's health. the insight on strength vs. # on the scale, what you are eating and how you are coping and ways to combat all the things makes this book worth it alone.
I hope women's health (except your fertile years) and the research and studies and instruction of doctors vastly improves by the time my daughter gets to be my age, as in the US especially, we are HIGHLY overlooked.

[Katie · Rating 4 out of 5]

Libby audio. 5 stars for the science and recommendations. 3 stars for the medical influencer grifting.

[Jennifer Redlin · Rating 4 out of 5]

After 35, everything is because of perimenopause. Eat better, build muscle, track your numbers

[Laura Adams]

Only DNF because I had to give it back to the library.

[Staci · Rating 4 out of 5]

Thank you, first, to Dr. Haver for writing this book, and second, to Convergent for the ARC in exchange for an honest review. I’m really thankful to be in a timeline where women in medicine are choosing to get loud and push for research in what can be a very tumultuous time when going through perimenopause. From a medical standpoint, I think this is a great introductory text that could give a nice starting point to try to understand the experience of women during this stage as well as some treatment options, for clinicians. For the layperson entering perimenopause, this will be a validating text. The only issue I see (which is a problem in healthcare due to insurance and what they will cover/old school mentality/comfort level of prescribing clinician,) is that not everyone has access or the funds to access this type of care. I’m in a rural area and used to work in primary care: my colleagues were not comfortable prescribing MHT. There was mention about the access issue but not really advice other than go to an online provider, about how to solve this issue…and as I stated previously, we don’t talk about whether you have the financial means to receive the most appropriate perimenopause care. I just wish women who already do not feel like themselves didn’t have to fight so hard for the care they deserve. But Dr. Haver is shining a light on the issue and continues to provide many free resources and updates on her site. Thank you for this ARC and good luck to all in their “zone of chaos.”

[Amber Coones · Rating 4 out of 5]

4.4

[Nicole Ramirez · Rating 5 out of 5]

It’s amazing how little is known about the female body in 2026, in favor of studying the male body and curing their ailments like male pattern baldness.

The New Perimenopause was eye opening in so many regards, and it makes me sad, mad, hopeful, and grateful. This is something all primary care, internal medicine, family medicine, and OB/GYNE students should have to read. At minimum.

Thank you, NetGalley, for the ARC.

[Kristin Wickham · Rating 5 out of 5]

If you are a woman in your mid 30s pick up this book immediately. Perimenopause is near and I want to be ready to tackle it. I love all the information and it is all evidence-based instead of fear based. 100% recommend, and I will be taking it on our next move and that is the highest honor a book can have in this house.

[Eva · Rating 3 out of 5]

I am starting this review by saying that I am a 40yr old woman, and I am currently in perimenopause. I have been told for the last 4-5 years that I am too young, and have been brushed off every time. It was not until a couple of months ago that my doc confirmed it.

This book needs to go into the hands of every single doctor who sees female patients. Ever.

The information in this book is wonderful. It's easy to understand and it set off light bulbs in my head - and so many "wow", "yep that's me", and "hey husband listen to this".

My rating is 3 stars only because it does not read smoothly. It did feel a little choppy.
Otherwise, great source for women who keep wondering what the heck is going on, and honestly, the men in their lives could benefit from it.

Thanks Netgalley for the advanced copy, in exchange for my honest opinion.

[Kathy Boskind · Rating 4 out of 5]

This is a well-researched book with lots of information about symptoms that women might have during perimenopause. It was much more scientific (less anecdotal) than I anticipated, which made it hard to read at times. Not a bad thing, necessarily, but not what I was expecting.