Therapist Lauren Tetenbaum on navigating menopause as Millennials

In early 2026, Weight Watchers started a book club series where authors, doctors, thought leaders, and social media influencers lead members through a discussion that’s informative, thoughtful, helpful — and a good time.

In front of a live audience (also livestreamed to members at home) at Weight Watchers HQ, comedian Anna Roisman sat down with Lauren Tetenbaum, LCSW, psychotherapist and author of Millennial Menopause: Preparing for Perimenopause, Menopause, and Life’s Next Period. The two, who first bonded at a girls’ summer camp in Maine, approach a chat about menopause with the candor you’d expect from lifelong friends.

Read on for a full recap of the discussion, including viewer questions from WW members on the Zoom. To tune into the next book club event in real time, follow Weight Watchers on Instagram or Facebook so you can get access to RSVP links as soon as they’re live. (You can also catch up on recaps from previous book club meetings on Hormone Havoc, The Lucky Egg, Weightless and The Ozempic Revolution.)

Lauren: I was approaching my 39th birthday, and I am a therapist now specializing in women's reproductive mental health, and as I was approaching my 40s, I realized I knew nothing about menopause, and I thought that was pretty strange for someone who was well-educated and interested. Then I started asking around, and it turned out even my doctor friends knew almost nothing about menopause, so that was also very strange. The more I got into it, the more I realized how much our generation needed to learn so that we can be prepared and proactive as we approach this phase of health. Being a woman can be tough, right? I want women in their 30s to know how their bodies work. I want women in their 40s to know who to call for help. I interviewed health experts and also more than 100 regular women — hearing their stories was really powerful.

Lauren: Those of us born between 1981 and 1996 are millennials. If you weren't, you're still welcome in the conversation because I love to learn and talk and be in community with people of all ages. But I wanted the book to sound like me, because this is a phase of life that can be really scary for people. I really want to destigmatize menopause, and as a therapist, I pride myself on being a big sister, best friend, and guide. Knowledge is power, but along the way it’s also important that we have some laughs. I wanted it written in a tone that people my age could relate to.

Lauren: Low energy, feeling faint, poor focus, exacerbated ADHD symptoms, brain fog, changes to sense of smell, changes to body odor, itchy mouth, burning mouth, metallic taste, frozen shoulder, urinary urgency or incontinence, difficulty breathing, heart palpitations, chest pain, low libido, joint inflammation, really bad PMS, periods involving heavy bleeding that I've heard described as “murder scenes”...the limit does not exist. And there's also a whole host of mental health symptoms that I was particularly struck by, considering I went to graduate school for mental health, and no one ever talked about this. Unfortunately, we know that a high percentage of women experience that rollercoaster of emotions during perimenopause, which is the time leading up to the final menstrual period, and the year after, which is menopause, officially. They don't feel like themselves. So I thought that as a clinician, and as a woman, it's really important to know this stuff so that we're not caught off-guard.

Lauren: Menopause is technically one day: the one-year anniversary of no periods, absent any other health reason. Once you reach menopause, you're always postmenopausal or in menopause. We tend to say, ‘I'm having a hot flash, I'm menopausal,’ but that's actually perimenopause, which can last 4 to 10 years. That’s when estrogen and progesterone in women's bodies are fluctuating like a roller coaster. They eventually decline, but it's that roller coaster that can cause all those symptoms. Or they're having extreme pain and joint inflammation, or heart palpitations, they go to the emergency room thinking they're having a heart attack.

Lauren: Hormone therapy! Which for many women in perimenopause can be hormonal birth control, depending on your symptoms, on your personal health history, or goals. Some women who have an IUD, that's progesterone, and they also add an estrogen patch, or there's various forms of hormone therapy, pills, gels, etc. listed out in the book.

You don't have to suffer through it. So if you don't feel good, there are resources that can help you. So many women white-knuckle it. They'll say things like, ‘This is just aging,’ because that's what the doctors have been saying. But you don't have to do that. Please don't suffer.

Medication is a tool in our toolbox, so it really depends on your symptoms, which certainly can change and do change throughout perimenopause, though they do tend to settle once you reach menopause. Other medications include non-hormonal options, such as mental health medications like SSRIs or SNRIs. Then there are lifestyle strategies, like exercise. We need to prioritize sleep, which is my favorite activity. We need a good diet and stress reduction. A lot of these things exacerbate the other, so if you're not getting good sleep, of course you'll be moody, but I think just having that awareness of what might be helpful and then working towards that as a goal is really important.

If you know that you're at higher risk of a mood disorder, or you know that your mother experienced severe hot flashes, that's a clue you can use to say, ‘what do I need? Who can I build my support team with, including healthcare providers and platforms, and get the right providers who know what they're talking about, the right community?’ Menopause is happening, so we might as well go into it with an open mind and with the resources that we deserve.

Lauren: I work with women in their 20s, 30s, and 40s, primarily, and a lot of women say things like, ‘I don't feel like myself. My coping mechanisms are out the window, I'm super irritable, I'm yelling at everybody.’ We often see these kinds of symptoms start long before the hot flashes or the changes in the menstrual cycle. We're now paying more attention and recognizing that these symptoms are perimenopause, and that it's starting in one's late 30s, early 40s. Right now, that's the age that many women are having babies. So, it's really important to go to a fertility specialist when you are planning to add to your family, and you're 35 or above. That's just biology of the way our eggs work. In addition to fertility issues, often women in the perimenopause life stage are moms — and whether it’s toddlers or teenagers, this stage of life can be really challenging for a variety of reasons, and then you add on all the hormonal shifts. It's important to know that hormones really can and do impact mood, that there's nothing wrong with you, and that help is available.

Lauren: I hear from a lot of women, ‘I don't recognize myself,’ and that's both internal and external. We're not supposed to look the same way we did in our 20s, but that can be really difficult to accept. Our favorite clothes don't fit; we are exercising and eating the same way that we used to, and yet our bodies are different. And that's why I really like communities like this one, because we can come up with healthy ways to feel better and feel more like ourselves through self-acceptance work.

I started weightlifting. It's so good for your bone density, your cognitive health, your cardiovascular health. And that's something that you can also do with friends, and social connection is hugely important in this phase of life, too. So if your body or your weight is bothering you, do what it takes to feel good.

Lauren: I’ve worked as a lawyer, and I bring the advocacy piece to everything I do, and sometimes that means encouraging women to speak up about health issues, including reproductive health and mental health. I went to college in Philly, and there I took a reproductive rights and the law class, and I thought I'd go to law school to help women with reproductive rights. I also got my master's in social work, and I really wanted to help women however I could. I practiced immigration law for many years. Over time and through motherhood, I decided I wanted to focus on mental health and supporting women in that way.

Lauren: A lot can be traced back to a misconception of hormone therapy as dangerous. In 2002, there was a study that was released called the Women's Health Initiative, and it blew up in the media, saying hormone therapy is dangerous. But that conclusion was really misinterpreting the data, and since then, they've clarified what exactly they were studying and what the results really meant, and now we know that hormone therapy is generally safe and effective. But because of this fear, an entire generation of healthcare providers were not taught about menopause care. They were taught, ‘This is a phase of life, so if a woman in her 40s or 50s comes to you complaining, she's a whiny woman — it's just life, and get over it.’ Now we know that that's B.S., and we can demand better.

Lauren: Mindset matters. One thing that I thought was really cool when I was doing this research is that in certain cultures where menopause, and aging in general, is more revered or considered part of the natural process, menopause symptoms tend to be less severe! In America, we tend to be ageist and sexist. But it doesn't have to be that way, and a lot of women in Hollywood are talking about this more. We're making strides, but there's a lot of work to be done when it comes to normalizing women's health. Mindset is so important. I'm not saying we all have to be positive about aging, losing our fertility, our body changing, but at least be neutral and informed. We know, again, that social connection can really help with our longevity. And it's important to laugh!

Lauren: In general, you want to track your symptoms and write down your questions ahead of an appointment. When you go for your annual and you have specific questions about this phase of life, make sure that you're able to ask them. Sometimes doctors do like you to have a separate appointment so that they can discuss it. If your provider is saying things like, ‘I don't know,’ or ‘I don't do that,’ get a second opinion. They don't know everything, and that's okay, but they should say, ‘let me look into that’ or ‘let me refer you.’ Oh and a second opinion doesn’t just mean using Google and A.I., which you have to be cautious about because the information isn’t always correct. There are directories, like the Menopause Society, and Weight Watchers has providers on staff who are trained in prescribing hormone therapy.

Lauren: I generally say to all men, ‘You don't need to be an expert, but you need to have compassion and curiosity.’ Starting with, ‘What can I do to help?’ I hear from a lot of women who are overstimulated in this phase of life. They feel totally overwhelmed. Women need a break: we're burned out, we're overwhelmed. So giving women that time and space to do whatever they want or need is really important. Showing up with compassion and curiosity is always a good idea.

Lauren: Menopause is inevitable if you reach a certain age. I think that given all of the crap that Millennials have gone through, I really, truly believe that aging is a privilege. Sometimes life has peaks and valleys, highs and lows, and that's natural. I really believe that knowledge is power, and if you're scared, or you're not feeling good, I want you to know that you're not alone, and you can get help.