Gather initial thoughts and broad opinions about the book.

1. Dr. Haver frames this book as a guide she wishes her younger self and her daughters had. Before reading, what were your expectations for a book about perimenopause? How did the final text meet, challenge, or change those expectations?

2. If you’ve read Haver’s other books, like The Galveston Diet or The New Menopause, how does this one compare in its tone, scope, and impact?

3. What was the single most surprising or paradigm-shifting concept you learned from the book?

Encourage readers to connect the book’s themes and characters with their personal experiences.

1. The book opens each chapter with a personal story, from Amy’s experience with medical dismissal to Caroline H.’s journey with insomnia. Which of these patient narratives resonated most with you, and why?

2. Haver dedicates a significant portion of the book to the theme of Confronting Medical Gaslighting. Has this book changed how you think about advocating for yourself or others in a healthcare setting?

3. The final section provides a framework for resilience built on four pillars: nutrition, movement, sleep, and stress reduction. Which of these lifestyle recommendations felt most accessible or actionable to you? Did any of the specific suggestions, like aiming for 30 different plant foods a week, feel new or particularly insightful?

4. A central message in the conclusion is the call to shift focus from “thin to strong” and focus on “nutrition over calories” (280). How does this reframing of health goals connect with your own perspective on aging and well-being?

5. How did you react to the idea of perimenopause as a finite “window for prevention” (95)? Did this framing feel more empowering or create a sense of pressure regarding how you might implement her advice in your own life?

6. After reading about the profound effects of hormones on mood and cognition, how has your understanding of mental health in midlife evolved? Did any of the anecdotes or symptoms she described resonate with your experiences?

Examine the book’s relevance to societal issues, historical events, or cultural themes.

1. The book highlights a 17-year average gap between new scientific evidence and its adoption in clinical practice. What does this delay suggest about the priorities and structure of the US healthcare system, particularly regarding women’s health? How does it reframe the role of patient education and self-advocacy in bridging this gap?

2. What parallels can you draw between the public health advocacy in The New Perimenopause and other influential books that challenge established systems, such as Michael Pollan’s work on the food industry in The Omnivore’s Dilemma? Both authors aim to empower individuals with knowledge against systemic inertia. Where do their approaches converge or differ?

3. How does the discussion of the economic costs of untreated perimenopause, such as lost work time and reduced earnings, fit within the broader context of wage gaps and lower socioeconomic brackets for women in the US? How does Haver portray these phenomena as parts of a system rather than isolated statistics?

Dive into the book’s structure, characters, themes, and symbolism.

1. Haver consistently opens chapters with patient vignettes before diving into the scientific explanations. How does this narrative structure shape the presentation of the clinical information that follows?

2. How does the author’s dual persona as both a board-certified clinician and a patient who experienced her own difficult menopause influence her authority and tone? She openly admits her own past complicity in dismissing patients. What does this technique contribute to her broader argument?

3. What is the rhetorical power of coining terms like the “metabolic syndrome of menopause” or adopting Dr. Vonda J. Wright’s “musculoskeletal syndrome of menopause”? How does creating this new lexicon function as a tool for both patients and clinicians?

4. What function do metaphors like the “zone of chaos” or comparing perimenopause to a “mirror image of adolescence” serve in conveying complex hormonal science to Haver’s audience (210)?

5. Haver structures the book to move from identifying the problem and its systemic roots, to explaining the biology, and finally to presenting solutions. How does this structure contribute to her recurring message of holistic approaches to women’s healthcare?

Encourage imaginative and creative connections to the book.

1. Chapter 16 provides scripts for talking to a doctor. Imagine you’re designing a wallet-sized “Perimenopause Passport” based on this chapter. What key questions, lab-test names, and “red flag” phrases would you include to make it an effective tool for self-advocacy during an appointment?

2. The book concludes with a letter that Haver writes to her 35-year-old self. If you were to write a similar letter to your younger self based on the book’s insights, what one or two key pieces of advice would you prioritize?

3. If you were tasked with creating a one-page public health poster to capture the book’s most urgent message for a community health center, what would be its central slogan and image?