Mary Claire Haver Explains the ‘Zone of Chaos’ in Perimenopause—and Why Research Is Lacking
The renowned ob-gyn revealed a startling research gap on this major life transition
Between 50 and 75 million women are navigating perimenopause and menopause in the U.S. right now. And most have never been told what’s really happening inside their bodies. A conversation between Woman’s World editor-in-chief Liz Vaccariello, host of What Matters With Liz, and Mary Claire Haver, MD—a board-certified ob-gyn, Menopause Society certified practitioner and New York Times best-selling author—laid bare the science and the systemic gaps that leave millions of women without the support they need. “Perimenopause is the zone of chaos,” Dr. Haver said.
The conversation touched on everything from the dramatic hormonal shifts that define perimenopause to the staggering lack of research. And woven throughout was a message of hope: Menopause is inevitable, suffering is not.
The perimenopause research gap is staggering
Search the National Institutes of Health database for the word “pregnancy” and you’ll find about 1.2 million articles. Search “menopause” and there are just under 100,000. Search “perimenopause”—the transitional phase that can last up to a decade—and you’ll find roughly 8,000 entries.
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“Now think about what that represents—how many institutions, how many researchers, how much money to fund all these studies,” Dr. Haver said. “Women are owed centuries of research on this.”
That research gap has real consequences. It means that many physicians, even ob-gyns, have received minimal training on perimenopause. It means that the symptoms women experience during this transition are often misidentified, dismissed or treated in isolation rather than understood as part of a larger hormonal shift. “We have a lot of work to do,” Dr. Haver added.
Why perimenopause is ‘the zone of chaos’
Dr. Haver’s analogy may change how you understand everything you’ve been feeling. Here’s why: “We reach a critical egg threshold where the signals from the brain become resistant—the ovaries become resistant because there aren’t enough eggs to create that feedback loop,” she explained. “The brain gets frustrated. It sends more and more stimulating hormone trying to force ovulation. And when ovulation does finally happen, you get these wild spurts of estrogen followed by crashes, and the progesterone never quite keeps up like it used to.”
Instead of that smooth, predictable pattern, your hormones become erratic. Dr. Haver offered an image that captures it perfectly: “Take spaghetti and throw it at the wall. That’s what the hormone levels look like. On a downward trend until you reach zero.”
Your hormones—the chemical messengers that influence your sleep, your mood, your weight, your memory, your energy, your ability to regulate emotions—are no longer following the orderly pattern they’ve kept for decades. They’re spiking and crashing unpredictably. And according to Dr. Haver, “this process can last up to 10 years.”
What Dr. Haver wants women to know about perimenopause
Here’s what Dr. Haver wants you to take from all of this: You’re not losing yourself. You’re going through a biological process that millions of other women in this country are also navigating. You deserve to understand what’s happening in your body. You deserve to have options.
“The loss of hormones has a domino effect on social interactions, mental health, cognitive health, heart health, brain health, bone health,” Dr. Haver said. “If we could change that trajectory and give women back the person they built—allow her to be her again—I think we can change the world.”
Talk to your doctor. Ask about perimenopause by name. And know that the “spaghetti on the wall” isn’t you falling apart. It’s your hormones on a predictable (if chaotic) trajectory that medicine is finally starting to take seriously.
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