No, You’re Not Crazy
It starts with something most women don’t expect to say out loud.
“I feel like I’m losing my mind.”
That’s what Stefanie DeFiglia hears when women walk into her office. Not occasionally. Consistently. “And they assume that there’s something wrong with them,” she said. “That there’s something wrong with their brains.”
“No, you’re not crazy,” she said. “It’s perimenopause.”
That phrase has become the title of an upcoming event at the Avalon Theatre—and, more to the point, a way into a conversation many women have been having quietly, if at all.
DeFiglia is a nurse practitioner and founder of Two Tree Integrative Health, with training at Johns Hopkins School of Nursing.
“Perimenopause often shows up in the brain before it shows up in the body,” she said. “Brain fog, or brain zaps, as I’ll hear some women call them. Where all of a sudden there is a word you just can’t find. Or a person’s name you can’t remember.” She spoke about a patient standing in a grocery store, suddenly unable to recall the PIN she had used for decades. “I feel like I’m getting Alzheimer’s,” she said.
Instead, she points to something less visible, but no less disruptive. “When those hormones start to drop, it actually impacts the neurotransmitters in the brain first,” she said.
And, not everything that looks like perimenopause is perimenopause. “Something might wake you up at three o’clock in the morning and feel like perimenopausal hormone changes,” she said. “But it’s actually an insulin issue or a blood sugar issue.” You have to tease it apart and figure out what’s perimenopause and what’s not, she said, and have a structured way to do that.
The symptoms don’t follow a single script. “Sexual changes can be an issue,” she said. “Oftentimes, joint pain comes into it, something that looks like frozen shoulder.” But you very rarely see frozen shoulder in 35-year-old women, she said. “If it happens to a 50 or 55 -year-old women you have to look at a possibility of it being cause by lower estrogen.”
“The perimenopausal window is 10 years before you stop your period,” she said. “You can be 35 and in perimenopause and starting to have these symptoms.”
But, what often lingers most isn’t physical. “One of the things I’ll hear a lot from women is they feel like they’re not being the moms they want to be. That’s one of the first signs…lack of resiliency to stress” she said.
It can look like this: “You get an annoying phone call, then the guy cuts you off in traffic, and then you have something that happens at work,” she said. “And by the time you get home at the end of the day, you’re still stuck in fight or flight.” Your kid asks a question and you just blow up, she said. “They feel like they’re not the parent they want to be…not the wife they want to be…not the employee they want to be…not the friend that they want to be.”
Testing for lower hormones, she said, rarely gives a clean answer. “Blood tests are hard to use,” she said. “Because your hormones bounce around all the time.”
DeFiglia’s approach pulls back from chasing a single number. “We’re looking at nutrition, \ food sensitivities, we’re looking at gut health, we’re looking at hormones, we’re looking at stress, we’re looking at relationships.”
Sometimes that can show up in small, practical ways. “I’m sorry, honey, I’m not turning your socks inside out anymore.” Other times, it’s helping women sort through what’s theirs to carry—and what isn’t, she said.
At the Avalon event, that conversation opens up beyond the exam room. The evening includes a screening from the docu-series “Balance,” followed by a panel discussion with DeFiglia and menopause-certified health coach Barb Stacy.
There’s also an intentional effort to make the space feel approachable. Drinks and mocktails from Lyon Rum, along with food from Piazza Italian Market, are part of the evening—small details that help turn what could be a clinical conversation into something more open, more communal.
This event, she says, is for any woman, between 35 and 55, who is suspicious that she may be in perimenopause. “Nothing will be off limits,” she said. “You want to ask questions about lady parts…we’re going to talk about lady parts.” The goal, she said, is to create space for questions that don’t always get asked anywhere else.
Attendees will leave with something tangible, including a perimenopause scale they can bring to their providers. “I’m looking forward to equipping women with the tools that they need to be able to advocate for themselves,” she said.
For a long time, this was a conversation that didn’t have a place to land.
“No, you’re not crazy,” DeFiglia repeats.
And this time, it won’t be said quietly.
No, You’re Not Crazy: It’s Perimenopause
Avalon Theater
Thursday, March 26, 2026.
Doors open: 5:30 PM
Event starts (talk): 6:00 PM