The science of perimenopause is evolving — and so is our understanding of when it actually begins. For too long, perimenopause has been defined by irregular cycles, but emerging research tells a different story. In this session, Dr. Marcie Richardson draws on decades of clinical expertise and her own peer-reviewed research to explore the earliest signs of hormonal change, why current definitions of perimenopause may leave patients without support for years, and what clinicians can do to better recognize and support women earlier in the transition. With a particular focus on the Late Reproductive Stage — the often-overlooked phase before cycles become irregular — this talk will expand the way clinicians think about, identify, and care for women entering the menoverse.

Marcie Richardson, MD, FACOG, is a board-certified obstetrician-gynecologist, menopause specialist, and Director of the Menopause Consultation Service at Atrius Health in Boston. She holds a faculty appointment as Assistant Clinical Professor at Harvard Medical School and is widely regarded as one of the foremost clinical experts on the perimenopausal transition. Dr. Richardson is a co-founder and core researcher of Women Living Better, a research and education initiative dedicated to improving the experience of women on the path to menopause, where she has co-authored eight peer-reviewed papers on perimenopause and midlife women's health. She has delivered a plenary talk on perimenopause onset at The Menopause Society annual meeting and is a trusted voice in helping both clinicians and women better understand the earliest stages of hormonal change.