"Cougar puberty" and perimenopause claims, fact-checked

What does this video actually claim?

Hill's Instagram post coins "cougar puberty" as a term for perimenopause and suggests The New York Post has legitimized this phrase by covering it. The video essentially equates the hormonal changes of perimenopause to a second puberty that transforms women into more sexually assertive "cougars."

The post doesn't make specific medical claims about hormone levels or treatments. Instead, it's promoting a cultural reframe of perimenopause as something empowering rather than purely medical. Hill positions herself as a "midlife awakening guide," so this fits her brand of making menopause transitions sound appealing.

But calling perimenopause "cougar puberty" oversimplifies complex hormonal changes and potentially misleads women about what they'll actually experience.

Is there science behind the "cougar puberty" concept?

The puberty comparison has some biological basis, but it's mostly backwards. During puberty, estrogen and testosterone rise dramatically. In perimenopause, estrogen drops by 90% and testosterone declines by about 50% from peak reproductive years.

The Study of Women's Health Across the Nation (SWAN), which followed 3,302 women through menopause, found that sexual desire actually decreases for most women during perimenopause. Only 26% of women reported no change in libido, while the majority experienced decreased interest.

Some women do report increased sexual confidence or freedom during perimenopause. But this likely stems from life circumstances (kids are older, less pregnancy worry) rather than hormonal surges making them more "cougar-like."

What did The New York Post actually say?

Hill claims The New York Post made "cougar puberty" official, but that's not how journalism works. The Post doesn't have authority to declare medical terminology official.

Looking at recent Post coverage of perimenopause, they've covered celebrities discussing menopause and hormone therapy trends. But they haven't endorsed "cougar puberty" as legitimate medical terminology. Hill seems to be conflating media attention with medical validation.

The Post has covered increased interest in testosterone therapy for women, which might be what Hill is referencing. But that's quite different from blessing her "cougar puberty" rebrand.

What about testosterone's role in female sexuality?

Here's where things get more interesting for the TRT category. Testosterone does affect female libido, and levels decline during perimenopause.

The APHRODITE study (Davis et al., NEJM, 2019) found that testosterone therapy increased sexually satisfying events by 1.2 per month compared to placebo in postmenopausal women. That's modest but statistically significant.

However, FDA-approved testosterone products for women don't exist in the US. Off-label prescribing happens, but it requires careful monitoring. Testosterone isn't a magic "cougar" pill, and side effects include acne, hair growth, and voice changes.

The Australian Endocrine Society recommends testosterone only for postmenopausal women with diagnosed low libido, not as general perimenopause treatment.

What should you actually know about perimenopause?

Perimenopause typically starts in your 40s and involves irregular periods, hot flashes, mood changes, and sleep disruption for most women. The North American Menopause Society reports that 75% of women experience hot flashes, not sexual liberation.

If you're experiencing bothersome symptoms, hormone therapy options exist. Estrogen therapy effectively treats hot flashes and night sweats. Testosterone might help with libido issues, but it's not first-line treatment.

The "cougar puberty" framing isn't necessarily harmful if it makes women feel better about aging. But it shouldn't replace actual medical evaluation of symptoms or informed discussions about hormone therapy risks and benefits.