Earlier this year, Diana Phillips stood during an open mic night at a pub in Quincy, Mass., and scanned the faces in the crowd. Mostly men, she noticed. Then, she launched into a five-minute standup comedy set about menopause. 

Phillips’s bits are “fairly punchy stories,” she says, about her own (and friends’) experiences. At 53, the Holliston, Mass., mother and business owner is on the tail end of perimenopause, the phase of women’s lives that precedes menopause, usually beginning in their 40s. This is when the ovaries are gradually producing less estrogen and progesterone, which can cause women to experience varying symptoms not limited to irregular periods, mood changes, hot flashes, and weight gain. 

“It’s a period of so much transition. Our marriages change, our friendships change, our kids grow up,” Phillips says. “There are so many things that are challenging but ripe to make fun of.”

Phillips’s set goes into detail about highly specific experiences that may ring relatable to anyone familiar with the end of a woman’s reproductive years. She says she takes the stage partly to help others feel seen, and perhaps to offer a sense of what to expect as they age.

“The goal of my comedy is to have ways that people can laugh at themselves and me, and people can come together,” she says. 

Phillips is part of a rising tide of women reclaiming their menopause experience by talking openly about it, breaking stigmas, finding community, and accessing better treatments. 

The long road to new understanding

Perimenopause is difficult to test for and treat because a perimenopausal woman’s hormones can fluctuate vastly from day to day. However, scientific research over the last 30 years has contributed to more mainstream medical understanding about menopause and perimenopause, including how hormone replacement therapy can be an effective treatment, says Amy Boutwell, MD. 

A board-certified internal medicine physician, Boutwell had been seeing primary care patients at major Boston hospitals for nearly two decades when she started to feel her body changing in ways she now recognizes as perimenopause. But at the time, the doctor “had never heard the word.”

This was surprising, given that Boutwell, 52, had studied at ivy league universities before training at one of the world’s top internal medicine residency programs. 

“We’ve always known that medical research has underrepresented women, but that structural awareness doesn’t mean there was investment,” she says. The first paper about perimenopause from the National Institute of Health wasn’t published until 1996. “So there’s a major lag in understanding women’s post-reproductive biology,” Boutwell says. 

It was only after experiencing her first hot flash that Boutwell realized what was causing her symptoms. “My body composition changed, my energy changed. All these things that now we know are totally hormonally driven.” 

But when she went to her trusted primary care physician and OB-GYN and described her symptoms, both doctors provided misinformation and a lack of support, she says. So, she took matters into her own hands. 

At 50, she acquired additional certifications focused on menopause and opened a small, private clinic out of her home in Lexington, Mass., dedicated exclusively to the care of women 40 and older. She also founded Healthspan, a 10-month program of strategic medical advisement for the same age group of women, incorporating internal medicine, lifestyle medicine, and updated menopause care. 

“I am in the best health of my life and I can’t wait to share this with other people,” she says. “ It truly is what’s missing in health care.”

Making connections and creating sisterhood

Like Boutwell, Paula Brown, 56, also went through years of misinformation when first dealing with perimenopause. 

After seeking medical treatment for brain fog and cognition issues going back to 2018, she was misdiagnosed for the better part of six years before finally being prescribed hormone therapy. That lag in care “resulted in me being fired from two jobs in less than a year” between 2023 and 2024, Brown says. “Because I didn’t have any other answers, I just kind of white-knuckled it.”

The turning point came when Brown, who lives in the same town as Phillips, was on a walk with the comedian and menopause advocate, trading stories about their midlife health issues. “She is the one who cracked the code for me,” Brown says. 

Phillips told Brown that menopause-related estrogen depletion is linked to cognitive function, based on her own knowledge gleaned from seeking relief for similar brain fog. Phillips also informed her about a telehealth company that prescribes hormone treatments. And soon, Brown crowdsourced from Facebook groups other resources for perimenopause support and started writing a business plan for a vetted network of providers. 

Brown and her business partner, Jennifer McMahon, a licensed counselor and certified menopause coaching specialist, launched Konenki Menopause Solutions in August 2025. Their platform now has a directory of more than 40 providers across North America offering the full spectrum of menopause care, from hormone therapy to boudoir photography. “Part of why we’re doing what we’re doing is so that other women have the chance to get better support than I did,” Brown says.

Now, there is more awareness of perimenopause than ever before — thanks in part to the ongoing efforts of women like Phillips, Boutwell, and Brown who share their experiences and advocate for greater understanding every day. 

“It’s an equity thing, it’s a bias thing. Unless a woman is reproducing, the investment in her health is very scant,” Boutwell says. But, she adds, thanks to younger generations not tolerating the same old stigmas, and social media raising awareness, “now I truly, truly do believe that things are changing.”